Depression in the Elderly: Signs, Symptoms, and Treatment
Depression is a fairly common mental illness faced by the elderly. Geriatric depression occurs mostly in senior citizens that have other physiological health problems and/or disabilities. A lot of mental health issues go unnoticed in the context of associated physiological problems. Many people confuse geriatric depression as a byproduct of dementia or misdiagnose it for other problems. Sometimes, the changes that geriatric depression brings with it can mimic life changes that normally occur with ageing, making it difficult to identify depression as a distinct disorder in the elderly.
Older adults suffer from depression at an alarmingly high rate. In India, one in four senior citizens is depressed. One of the reasons their problem goes unnoticed is because they are not comfortable talking about their feelings or even if they do, they do not get the assurance or the appropriate console they seek. Senior citizens often feel isolated and ignored. Their needs are not met properly and their inability to help themselves develop insecurity, frustration, anxiety and a range of other underlying issues that need addressing.
One way to identify a depressive episode in senior citizens is to monitor their mood over two or more weeks. If their mood is persistently low and they lack enthusiasm in activities they traditionally enjoy including interactions with friends, family or other members of their social circle, experience significant changes in appetite and weight, notable loss of energy to the point that even the slightest activity or movement requires an overwhelming effort, sleep difficulty, or other cognitive symptoms such as excessive feelings of worthlessness, indecisiveness or guilt without any significant cause or other medically diagnosed problems these symptoms could be a part of, it could be a sign of depression.
Older adults often experience lows and dips in their energies and mood. A feeling of sadness or less energized occasionally for a day or two is not the same as depression. What distinguishes the state of depression is that people without it can take charge of their emotions and mood. People with depression have difficulty rebounding back to a normal mood. Be it their thinking style, genetic design or other environmental factors, making that boomerang movement to a normal state seems like an unachievable goal.
Depression in the elderly can be caused due to many reasons. Some elderly have biological predispositions, i.e., some members of their inner circle in the family suffer from a mood disorder. It could also be because of low serotonin, a neurochemical responsible for our elevated moods. Life events such as physical disabilities, financial problems, chronic illnesses, caregiving for an ill spouse, or the death of someone close add up to the list of causes. Developing a negative thinking style to the point of believing that no matter how much they try, good things will never happen to them further intensifies the risk factor of depression.
While there could be many reasons for depression in the elderly, it is important to identify its symptoms early on and help your loved one improve. If left unattended, depression could become a serious problem that could bring other health risks with it. The physical pain that is not explained by other health conditions is often linked to depression in senior citizens.
Geriatric depression comes with a few textbook symptoms. These include uncontrollable crying, feelings of inadequacy or helplessness, extreme distress about financial and physical health problems, fidgeting, difficulty in sleeping and extreme changes in diet and weight. Your loved one could show all these symptoms and more, or maybe they could show only some of these symptoms. It is always best to consult a professional if you are unsure.
Many a time, geriatric depression could also be a side effect of medication for problems such as cancer, anxiety, and heart problems. If your elderly has a family history of depression and other mental health issues, it could be a genetic problem as well.
Once you have identified the cause of your elderly’s depression, it is important to formulate a holistic plan for their improvement. It is merely not enough to give them medication and expect they would be back to normal. Caring for the elderly when they are depressed can be difficult and it requires you to be patient and compassionate.
Psychotherapy has proven to help senior citizens battling depression. It might not give them a solution, but it gives them an outlet and is often more about talking to and understanding the senior, their history, and how they feel. Cognitive and behavioural therapy also helps the elderly break negative thinking patterns and establish newer, healthier ones over time. A mindful conversation helps your elderly gain insight into their problem and also be cooperative if any treatment or activity is suggested.
Older adults could also be prescribed antidepressants and serotonin-inducing drugs if the reasons for depression cannot be addressed without medication. Caregivers could also introduce social and lifestyle changes that help build a more fulfilling routine. For example, an increase in physical exercise, regulating and maintaining a good sleep circadian rhythm, the development of a new skill or hobby, and even socialising with friends and family can have a positive impact on your senior’s mental health.
One of the best ways to treat geriatric depression is to prevent it. Creating a conducive environment for your loved one to thrive in can be the difference between a happy or a depressed old age.