Depression In Elderly

Depression is a common problem among older adults, but it is NOT a normal part of aging. In fact, studies show that most older adults feel satisfied with their lives, despite having more illnesses or physical problems. However, important life changes that happen as we get older may cause feelings of uneasiness, stress, and sadness.

For instance, the death of a loved one, moving from work into retirement, or dealing with a serious illness can leave people feeling sad or anxious. After a period of adjustment, many older adults can regain their emotional balance, but others do not and may develop depression.

Elderly patients might also be reluctant to talk about their feelings or fail to understand that physical symptoms can be a sign of depression. For elderly people living independently, isolation can make it difficult to reach out for help.

Symptoms of depression in older adults

The essential feature of a major depressive episode is a period of at least two weeks when the person experiences either depressed mood (most of the day, nearly every day) or loss of interest or pleasure in nearly all activities.3 According to the American Association for Geriatric Psychiatry, the most common symptoms of depression in the elderly include:

Persistent sadness

Feeling slowed down

Excessive worries about finances and health problems

Frequent tearfulness

Feeling worthless or helpless

Weight changes

Pacing or fidgeting

Difficulty sleeping

Difficulty concentrating

Somatic complaints (unexplained physical pain or gastrointestinal problems)

Withdrawal from social activities

Medical conditions and depression

Medical problems, including chronic medical conditions, can trigger, or worsen the symptoms of, depression in elderly patients. Any medical condition, especially those that are painful, debilitating, or life-threatening can result in symptoms of depression, including:

Cancer

Parkinson’s disease

Stroke

Heart disease

Lupus

Diabetes

Dementia and Alzheimer’s

Multiple sclerosis

Treatment of depression in older adults

Effective treatment of depression in older adults can require more than one approach.

Psychotherapy: Ongoing, talk therapy can be a source of support for elderly patients. Short term, solution focused therapy (Cognitive Behavioral Therapy) can also be effective in helping elderly patients eliminate thinking patterns and behaviors that contribute to depressive symptoms. Research shows that making adjustments for older patients to include addressing physical health and religious/spiritual beliefs improves treatment outcomes.

Support groups: Groups designed to connect older adults experiencing similar issues (depression, medical conditions, bereavement, etc.) are beneficial in establishing social support and providing a safe space to talk.

Medication: Antidepressants can be prescribed to relieve the symptoms of depression. Antidepressants can have significant side effects, and elderly patients are sensitive to medications. Medication should be closely monitored.

Lifestyle changes: Daily exercise, healthy eating habits, and increasing social support are all important in helping elderly patients with depression. Friends and family members can help by doing the following:

family members can help by doing the following:

Schedule group outings

Establish a weekly visit

Assist with transportation to medical appointments

Cook and freeze healthy meals for easy preparation

Help create a system to ease with taking medication regularly

Suicide risk

There is always a risk of suicide with major depressive disorder. According to the latest data (2015), the second highest suicide rate in the United States (19.4) occurred in people 85 years or older. The highest rate (19.6) was among adults between 45 and 64 years of age. Though a past history of suicide threats or attempts remains the biggest risk factor, most completed suicides are not preceded by unsuccessful attempts. If an elderly patient shows any signs of suicidal thoughts or behaviours, it is important to seek immediate assistance.