Elderly Depression — A Common Mental Health Problem Among Seniors

Is Elderly Depression a Real Problem?

Elderly or geriatric depression is a medically diagnosable illness that affects about 15 percent of adults aged 65 or older in the United States. This disorder affects a much higher percentage of people in hospitals and nursing homes at nearly double the percent compared to those who are living more independently.

When depression occurs in later life, it sometimes can be a relapse of an earlier depression that a person has already had. However in many cases, when it occurs for the first time in older adults, it can be brought on by the strain of having to deal with another medical illness. In such cases when someone is already ill, depression can be both more difficult to recognize and more difficult to endure.

It is important to note that sadness associated with normal grief is different from depression. A sad or grieving person can continue to carry on with regular activities, whereas a depressed person suffers from symptoms that interfere with his or her ability to function normally for a prolonged period of time and they cannot just “snap out of it.” Depression is a medical illness that must be diagnosed and treated by trained professionals. Untreated depression may last months or even years.

Although depression is a common problem among older adults, it does not mean that it is a normal part of aging. Studies show that most older adults actually feel satisfied with their lives, despite having more illnesses or physical problems.

That said, the elderly do go through important life changes that may cause feelings of sadness and stress, examples include, the death of a loved one, moving from work into retirement, moving out of a longtime home into a new community or relative’s house, or dealing with a serious illness. After a period of adjustment, many older adults can regain their emotional resiliency, but others do not and may develop depression.

How is Depression Different for the Elderly Compared to Younger People?

  • Older adults are at increased risk. We know that about 80 percent of older adults have at least one chronic health condition and 50 percent have two or more. Depression is more common in people who also have other illnesses or whose physical function becomes limited.
  • Older adults are often misdiagnosed and undertreated. Healthcare professionals may mistake symptoms of an elder’s depression as a natural reaction to illness or life changes occurring for them.
  • Depression in older adults is linked to increased risk of heart disease and even death from that illness. Unfortunately, depression reduces an elder's ability to convalesce: studies of nursing home patients with physical illnesses have shown that the presence of depression substantially increases the likelihood of death from those illnesses. 


What are the Symptoms of Depression?

Since untreated depression can worsen the symptoms of other illnesses and may even lead to premature death, it is important to take an older person’s depression very seriously and treat it with a medical professional’s help, even if the depression is seen as mild rather than severe. While depression in the elderly can be more severe than in younger people as seen above, there are similarities in their depression symptoms. The most common symptoms of late-life depression mirrors other age groups by including:

  • Persistent sadness and not finding joy in the things that used to make them happy, persistent as in lasting two to four weeks.
  • Feeling slowed down and unenergized to do daily tasks.
  • Excessive worrying about finances, health problems, or other matters of “life business”.
  • Frequent crying or noticeably more emotional responses than is typical for the situation, either sad, angry, frustrated, or lack of concern.
  • Feeling worthless or helpless in their life or feeling like they don’t have control to solve problems in their life.
  • Weight changes, either an increase or a decrease.
  • Pacing, fidgeting, shakiness, or an inability to sit still and be calm.
  • Insomnia or any difficulty sleeping, such as not sleeping through the night, waking up quite early, or having a hard time falling asleep. In some cases, excessive sleeping may also be a sign.
  • Difficulty concentrating or focusing on tasks, even simple ones, and having a hard time making decisions.
  • Physical symptoms such as pain or gastrointestinal problems.
  • Increased thoughts or discussion of suicidal ideation or talk of hurting oneself, wanting to “just be done” with things, even if the matter is brought up sarcastically or humorously. 


Risk of Suicide Among Older Adults

The last point is particularly important to note among our older loved ones, as suicide is more common in elders than in any other age group. Those aged 65 and older account for more than 25 percent of the suicides in the United States, especially men. White men over age 80 are six times more likely to commit suicide than the general population; they constitute the largest risk group. Suicide attempts or severe thoughts or wishes by older adults must always be taken seriously.


Preventing Depression in Older Adults

What can be done to lower the risk of depression amongst our loved ones as they age? The good news is that there are concrete actions you can take that will mitigate the risk of depression. The first would be to prepare for major life changes with your loved one, like retiring or moving from their longtime home. Before the actual event occurs, it is important to discuss the changes with them and even let them know it will probably be unsettling as they adapt to a new lifestyle.

That conversation itself may be enough, as it increases conversations and sociability. Isolation among older adults is a key driver of depression, so stay in touch and make sure you check in on your family (or have the family check in on their elder). Let them know you are there for them, to listen to their concerns, and to offer support.

It is also important to listen seriously to older adults when they say that they are sad or suicidal, even if they joke about it. Don’t write it off as a common side effect of getting old, retiring, or getting sick. Ask probing questions to see why they are feeling sad, for how long, and to see if they think they have any control or joy in their lives. You may then wish to contact a medical professional for further diagnosis and assistance.

Regular exercise also helps prevent depression, so choosing a low-impact but high-movement activity can be helpful, like swimming or biking. Most important is to pick a type of exercise that the elder likes (or used to like) to do. Diet is also extremely important, so ensure that they  are getting proper nutrition.

Last but not least, remind your loved one that depression is not a normal part of aging, and that if it is treated as a medically diagnosable illness and not just something to be “toughened through,” that the depression will lift and feelings of wellness and meaningfulness will return.

Sources:

  1. https://www.aagponline.org/index.php?src=gendocs&ref=depression&category=Foundation
  2. https://www.nia.nih.gov/health/depression-and-older-adults
  3. https://www.cdc.gov/aging/depression/index.html
  4. https://www.nimh.nih.gov/health/publications/older-adults-and-depression/
  5. https://www.webmd.com/depression/guide/depression-elderly
  6. https://www.healthline.com/health/depression/elderly#causes 


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