Depression in the Elderly

Sometimes, it is mistakenly assumed that aging and depression go hand-in-hand.  Well, they do not have to.  Depression does not need to be part of the life-cycle of growing older; but, sadly, it many elderly do suffer from depression.  The question becomes, why does aging and depression sometimes go together?  As it turns out, there are many answers to this question:

  • Personal loss – Losing a loved one, spouse, family member, or pet can be difficult for anyone, but more so, perhaps, as we age.  The loneliness and grief causing by personal loss can contribute to feelings of depression and despair;
  • Loss of job – For many of us, our lives are defined, in a way, by what we do for a living.  When we retire or stop working, the results can be a loss of our sense of self / identity;
  • Restricted social life – For many elderly, there is a restriction in social life as difficulties getting around as well as the experience of losing friends and family gradually reduces social experiences – contributing to feelings of depression;
  • Medical problems – Sickness and disease contribute to feelings of depression in the elderly.  As physical and mental functioning decreases, there is often a realization of “feeling one’s age” that can be very aggravating.  Often in early stages of Alzheimer’s Dementia, for instance, elderly individuals might be acutely aware of memory loss and cognitive deficits which can foster feelings of helplessness, hopelessness, and sadness;
  • Loss of Independence and Control – For many elderly, the aging process carries with it loss of independence and control.  There are often tremendous adjustments that must be made as we age – including losing physical and mental abilities, losing the ability to drive and get around unassisted, losing the ability to adequately care for oneself, etc.  For some elderly, these losses are punctuated with transferring to assisted living or skilled nursing facilities which can further intensify the feelings of loss of independence and control.

 

Depression in the elderly is often overlooked by healthcare providers and is known to be a serious problem in the elderly.  Depressed elderly, for example, are significantly more likely than those who are younger and battling depression to actually kill themselves.  So, it is clearly that depression in the elderly should be taken seriously.  The key becomes in recognizing the warning signs of depression in the elderly.

 

  • Depressed / anxious mood
  • Frequent bouts of sadness / crying
  • Sleep / appetite disruption
  • Changes in level of energy / weight / personality
  • Loss of interest in previously enjoyable activities
  • Letting oneself or one’s household cleaning go
  • Impaired concentration
  • Hopelessness / negativity
  • Suicidal thoughts / plans
  • Use of alcohol / other drugs

 

Depression in the elderly in treatable.  The best treatment for depression starts with accurate diagnosis to rule out other diseases that might mimic depression.  Once properly diagnosed, the best strategy to is treat the depression “holistically” – focusing on the unique factors that might have contributed to the depression in the first place.  For example, to the extent that social isolation and grief is contributing to depression, the elderly individual might be encouraged to get involved in activities outside of the house and referred to a grief support group.  If professional help is needed, a combination approach that utilizes both medication and psychotherapy is often the most effective approach.  Here, it is essential that healthcare providers communicate with each other to avoid dangerous drug interactions.  In the end, though, it is critical that the signs and symptoms of depression in the elderly be taken seriously because of the devastating effects of depression on the lives of the elderly if left untreated.