By Meredith Kimple
One of the first posts I wrote for this blog focused on insomnia in the elderly; an inability to sleep at night is often misunderstood as a normal part of aging. Our senior parents and grandparents who seem to fall asleep any time they sit down, regardless of time or place, are not necessarily tired because they are advanced in age. There are a number of factors that may contribute to their fatigue, ranging from a disrupted circadian rhythm to sleep apnea.
Insomnia is not the first thing that comes to mind when we consider senior health issues, but it can still have a critical impact on an older person’s overall wellness. We might be more likely to associate widespread, well-known conditions with senior health; heart disease, adult-onset diabetes, hearing loss, dementia, and impaired mobility in the elderly may be some that first come to mind.
But how many of us think of depression?
Depression is a medical condition that most of us are familiar with, but despite the great strides we have made in the de-stigmatization of mental illness, the mental health of the elderly may be easy to overlook. That is not meant to imply carelessness on the part of loved ones or caregivers; depression presents differently in seniors than it does in younger individuals, so the symptoms can be more difficult to spot.
Because aging brings with it an abundance of changes in health, ability, and independence, an older person’s depression is often misconstrued as a natural reaction to life’s vicissitudes.
So how can we determine if our senior loved ones are suffering from depression?
The following are some of the more common symptoms:
- Persistent feelings of guilt, worthlessness, and hopelessness
- Strong feelings of anxiety and emptiness
- Loss of interest in favorite activities
- Increased irritability and restlessness
- Difficulty concentrating and making decisions
- Insomnia or oversleeping
- Involuntary weight gain or loss
- Aches, cramps, and physical pains that persist
- Thoughts of suicide or self-harm**
An elderly person dealing with depression may not show all of these symptoms, but if they show any combination from the list for at least two weeks straight, then they should see a doctor. Pay attention to the duration of the symptoms; we all have days where we’re sad, or feel hopeless and empty, but someone who has depression will feel that way for weeks and months at a time.
There are certain factors that increase an older person’s risk of developing depression. For example, women are more likely to have depression than men. Seniors who do not have a significant other are more at risk than those who are married or dating. Those who have a disability, chronic illness, or brain disease are more likely to have depression than an otherwise “healthy” senior. And of course, social isolation and the experience of stressful life events (such as a divorce, or the loss of a spouse) can increase a senior’s risk. A family history of depression should also be considered, as well as prior suicide attempts or episodes of self-harm.
Helping a senior loved one receive the treatment they need may prove challenging, but it is vital that they do for the sake of not only their mental health, but their overall health as well. Depression can have a negative impact on a senior’s ability to rehabilitate after an injury or surgery, and is associated with a greater risk of death from cardiac disease and other chronic illnesses. Mental health is important in its own right, but it has an enormous influence on physical health in that it can determine one’s ability to recover from trauma. Depression can render an elderly person even more vulnerable, so seeking treatment immediately is crucial.
Luckily, depression can be treated using a variety of methods:
- Use of Antidepressants.
Taking antidepressants is often an effective way to treat depression. Because an older body may take longer to process the medication and cannot handle a high dosage, results will not be instantaneous. It is important that once they start taking an antidepressant, they don’t stop without consulting their doctor; it may take weeks or months for the medication to make a difference, so a lot of patience is required. While this method is usually effective, there are some drawbacks. Certain side effects and the long-term cost may lead to an older patient refusing to take the medication; additionally, interactions with other drugs can impair the effectiveness of the antidepressant.
Talking with a professional can be helpful in treating depression. Psychotherapy can aid the patient in changing their negative thought patterns and habits, as well as helping them work through stressful situations in a healthy way. This method can be as effective as taking antidepressants, and is a good alternative if an older person cannot add another medication to their regimen. Of course, if medication is necessary, supplementing with psychotherapy can strengthen a senior’s treatment plan. Psychotherapy can provide insight into one’s relationships and feelings, as well as coping mechanisms to help with future distress.
- Alternative, Complementary Therapies.
While they are not a substitute for medical intervention, activities like yoga, daily walking, and other physical exercises may help to relieve some people’s depression. Physical activity can improve one’s mood, and is a great way to focus the mind and body. Their doctor should be consulted before additional exercise is added to their daily routine.
Though depression is common in the elderly population, it often goes undiagnosed. There is still to this day a stigma that accompanies mental illness, and for the older generations this is especially pronounced. They may perceive depression as a weakness, personal failure, or a burden on others; for seniors who are not familiar with the symptoms of the condition or who have never known someone with depression, it may be difficult to acknowledge what they are suffering from, or to acknowledge that they are suffering at all. They may perceive their thoughts and feelings as “normal” and try to carry on through the pain because they don’t want to worry their friends and family.
We must be their support system.
They may not be willing to discuss how they feel with us, but we can let them know that we are there for them. We can encourage them to see a doctor who can start them on an appropriate treatment, and help them keep track of appointments. We can assure them that they are not alone, and that while what they are feeling is not abnormal, they deserve to feel better. Include them in your activities, and help them get involved in classes, exercise groups, or community service.
Let them know that you love them, and often.
Our society is cultivating a greater awareness of the importance of mental health in maintaining a healthy lifestyle, and people are more willing than ever to be candid about their experiences with mental illness. However, depression is still frequently overlooked in the elderly. As their family and friends, we must be vigilant; do not take mentions of self-harm or suicide lightly. Help them pursue treatment, and offer them your support as they begin their healing process.
Depression is not a normal part of aging, but aging brings a host of new challenges that not everyone can easily adjust to. It is of the utmost importance that we help our older loved ones live lives that are emotionally healthy and fulfilling.