In a world in which youth is glorified and idolized, it can be very hard to cope with aging and all the changes this period of life brings. When people get older, we have to go through major life challenges such as suffering from chronic illnesses, coping with a loss of a family member or/and close friends, ending a professional career, moving to a caregiving facility, or losing mobility and independence.
Many people believe that depression represents a normal consequence of aging and that it goes hand in hand with all of the above-listed challenges. However, this is a misconception. Even though depression is widespread among the elderly population, it is not a normal part of the aging process. Instead, it is a serious psychological illness that requires treatment.
Unrecognized and untreated depression can have negative consequences, the worst being suicide. In fact, depression is the single most significant factor of suicide in the elderly population.
To learn more, visit:
- NIH Senior Health: About depression
- National Council on Aging: Depression in older persons fact sheet
- American Geriatric Mental Health Foundation: Depression in late life: Not a natural part of aging
What is Depression?
Depression is a serious problem that can influence a person’s whole life. It changes how somebody thinks, feels, and copes with daily activities such as eating, sleeping, working, socializing, and spending free time.
It is often described as a feeling of sadness for extended periods of times – such as weeks or months. But how can we distinguish normal sadness from depression? Is there a time limit to feeling sad? After how much time does grief turn into depression?
Unlike normal sadness, depression can persist for months. And, while grief involves a wide variety of emotions such as a mix of bad days and moments of laughter and pleasure; depression, on the other hand, leaves people with constant feelings of emptiness and despair. Feeling sadness and grief as a result of loss or major changes in life is normal and usually does not require mental health treatment. But, depression requires treatment to reduce duration and intensity of symptoms. Furthermore, depression can physically affect the body if it is left untreated by increasing the risk of heart disease or a weakened immune system.
Depression is at the same time much more than just a sad mood. Some people suffering from depression even claim not to feel “blue” at all. They may, instead, show other symptoms such as losing interest in pleasurable activities, low motivation, lack of energy, or physical problems. Physical complaints such as arthritis pain or headaches that seem to be getting worse are often cited as predominant symptoms of depression in the elderly.
It is important to remember that depression is not a sign of weakness or a character flaw. It is a mental illness which is treatable in most cases with the right therapy. However, many older people are often ashamed to ask for help because of depression.
For more information, visit:
- University of Michigan Depression Center: What is depression?
- UMH: Seniors and depression education and awareness
- HelpGuide.org: Depression in older adults and the elderly
- Healthy Aging Partnership: Depression among older adults can be serious and treatable
Causes of Depression
Depression is a multi-faceted disease for which no single cause exists. Factors known to cause it can be divided into:
Physical factors (genetic factors, changes in brain chemistry, or physical illnesses)
Some research shows that genetic factors have a big effect on susceptibility to depression. This genetic predisposition combined with a stressful life event can trigger the onset of illness in both young and old. The data shows that people who have a family history of depression have a 40 percent likelihood of developing clinical depression.
It has been shown that changes in brain chemicals, called neurotransmitters, such as norepinephrine, serotonin, and dopamine are involved in depression.
In addition, depression can be related to a physical illness such as:
- Thyroid disorders
- Parkinson disease
- Heart disease
- Alzheimer’s disease
On top of that, depression can be a side effect of some medications commonly prescribed to elderly such as blood pressure medication, beta-blockers, high-cholesterol drugs, or medication for Parkinson’s disease. While it is true that everyone is at risk from side effects of prescription medication, older adults are more prone to have a reaction because their bodies are less efficient at processing drugs.
Psychological factors (life events and reaction to loss or illness)
Some life events that can trigger the onset of depression are:
- A move from home to a retirement facility
- Chronic illness or pain
- Children moving away
- Spouse or close friends passing away
- Loss of independence
Social factors (isolation, lack of support, and lack of community support)
Some elderly live alone and are isolated in their homes because of their illness or loss of the right to drive, which can leave them lonely, socially isolated, and without an adequate support system to cope with their difficult situation.
To learn more, go to:
- American Psychological Association: Aging and depression
- MedlinePlus: Depression- older adults
- Baycrest: Causes and risk factors
Statistics about Depression in the Elderly
According to America’s Health Rankings, more than 6.5 million Americans aged 65 or older are affected by depression. However, only 10 percent receive treatment. Most of the older adults with depression have already experienced it at least once in their lives, but it is not uncommon for people to experience depression for the first time in late stages of life.
Depression in women and men is expressed differently. Women are twice as likely as men to be affected by severe depression, especially those over 65 that live alone and are in poor physical health. What makes women more prone to depression is a unique combination of biological, life cycle, hormonal, and psychological factors.
Even though women suffer from depression more than men and try to commit suicide more often than men, it is elderly men that have the highest suicide rates in the country. The current rate of suicide for elderly men is 45.23 per 100.000 people compared to the rate of suicide for general population which is 11.01 per 100.000 people.
For more information, go to:
Warning Signs of Elderly Depression
Some symptoms of depression in elderly are also common in other illnesses or the aging process, which is why depression is often unrecognized, misdiagnosed, and untreated.
Depression in older persons is characterized by these symptoms:
- Sadness or feelings of despair
- Inability to laugh
- Memory problems and difficulty concentrating
- Unexplained aches and pains
- Lack of motivation and energy
- Feelings of hopelessness and helplessness
- Loss of self-worth
- Slowed movement or speech
- Reduced energy
- Lack of attention to personal care (skipping meals, forgetting meds, etc.)
- Social withdrawal
- Irritability or demanding behavior
- Weight loss or weight gain
- Changes in sleep (sleeping too much or too little)
- Confusion, delusions, or hallucinations
- Suicidal thoughts or attempts
To learn more about this, go to:
- Mayo Clinic: Depression
- Stanford University: Depression in older adults
- Washington County: Recognize signs of depression and suicide in senior citizens
Holidays and Depression
Holidays are usually the time dedicated to joy, laughter, and celebrations. However, for many people, especially elderly, winter holidays can bring a feeling of sadness and even depression. Most often it is not the holidays that cause depression among elderly, but rather the fact that holidays bring back memories of earlier and happier times.
To help your older family members who might be experiencing the holiday “blues,” you should try to spend more time with them, include them in activities around the holidays, and show them that they are still valuable and loved part of your family. This will mean much more to them than any Christmas present.
- HealthInAging.org: Tips for beating the holiday blues
- Lutheran Senior Life: Holiday blues
- Harris Health System: Seniors and holiday blues
Treatment Options for Depression
Several treatment options for depression are available. They include medication, psychotherapy, and complimentary therapies.
Treatment is created depending on the needs of the patient, type of depression, and its severity. Different treatment combinations might be suggested by the doctor until the right one is found.
Medication is effective for a majority of people with depression. However it might take a few weeks for prescribed medications to start working fully. Sometimes, patients need to try a few medications before they find the one that works for them. Like all other medications, antidepressants also have side effects (which can in most cases be minimized and managed), including:
- Nausea and vomiting
- Weight gain
- Sexual dysfunction
Even after you start feeling your usual self again, you should continue taking antidepressants for a few more months to prevent depression symptoms from reoccurring. When it’s time to stop taking medications, the doctor will slowly decrease the dosage to give the body time to adjust to the change.
Medications are often combined with supportive psychotherapy and cognitive behavioral therapy. These therapies help patients with depression by teaching them new habits and new ways of thinking about problems, difficult situations, and relationships that might be causing their depression or making it worse.
Complimentary therapies used in depression treatment include yoga, exercise, and dietary supplements. They can be very useful, but they should not be a replacement for visiting a health care professional.
- National Institute of Mental Help: Older adults and depression
- John Hopkins Medicine: Depression – what you need to know as you age
- SAMHSA: Depression and older adults
There are many programs aimed at raising awareness of senior depression and helping older adults manage it and lead fulfilling lives.
- The DC Office on Aging offer a list of services available to support senior citizens.
- The Savvy Senior also has a listing with many services not included by the DC Office on Aging.
- Eldercare.gov offers a list of resources provided by the federal government.