Despite common assumptions, depression in elderly adults isn’t normal.

 We don’t often think of our elderly loved ones as depressed. After all, they’ve been ill or lost loved ones themselves. It’s natural they’d slow down, show less interest in old pursuits, right? Well, no, it’s not natural, nor is it normal aging. Geriatric depression is a common issue for many seniors.

How depression in the elderly is different.

Depression affects seniors differently than in someone younger. For the elderly, it often occurs with other illnesses or disabilities; it also lasts longer. Researchers studying nursing home patients with physical illnesses found that depression substantially increases the probability of death from disease, especially following a heart attack. It also impacts an elder’s ability to rehabilitate successfully.

The suicide rate for ages 80 – 84 is more than double the general population, and older white men are the most susceptible. Suicide in the elderly accounts for 18% of all suicide deaths but is only 12% of the U.S. population. As the fastest-growing segment of the population, that’s a sobering statistic. Delays in treatment for depression mean that many older adults are struggling needlessly.

Grief vs. depression

As people age, they may experience painful losses of independence, mobility, career, health, or death of a loved one. It’s sometimes hard to distinguish between grief and depression—many of the symptoms of grief are similar to depression.

Grief is normal, even healthy, and it’s not uncommon for the sadness to last a while. While there are good and bad days; someone who is grieving can still take pleasure in other aspects of life, whether it is the grandkids dropping by or something as simple as a beautiful sunset.

However, for a person with depression, emptiness and despair are constant and unrelieved by a pleasurable interest in life. Over time, older people who are grieving adjust emotionally.

Risk factors for depression in the elderly.

• Gender—In general, women are more likely to suffer from depression than men.
• Marital status—Single people, whether unmarried, divorced, or widowed.
• Family & friends—Isolation or a lack of a social network.
• Genes—A family history of depression may increase the chances of developing depression.
• Personal history—Older adults who had depression when younger are at a greater risk for depression later in life.
• Stress—Death of a loved one or anxiety about health or finances can result in depression.
• Damage to body image—Age-related illness, cancer, and its treatment, or a heart attack can cause depression.

Signs of depression.

In the elderly, depression may look different than in younger people. Some depressed older adults may find the main symptom isn’t sadness. Medical conditions—heart disease, cancer, or stroke—can cause symptoms of depression. Medication side effects can also contribute to depression.

The two main criteria of depression are depressed mood and loss of pleasure. There are many secondary symptoms of depression, and they vary from individual to individual. If an older person has several of these for more than two weeks, it may be depression.

• Feeling hopeless, guilty, worthless, or helpless.
• Irritability or restlessness.
• Low energy or fatigue.
• Trouble concentrating, remembering, or making decisions.
• Insomnia or sleeping too much.
• Overeating or not eating enough, accompanied by unplanned weight gain or loss.
• Suicidal ideation or suicide attempts.
• Generalized pain or malaise without a clear cause.
• Frequent crying.

Types of depression.

Major depression interferes with work, sleep, or eating. While it may be a one-off occurrence, most often, there are multiple episodes of major depression.

Persistent depressive disorder means a depressed mood lasting at least two years. There may be episodes of major depression with periods with less severe symptoms, but for persistent depressive disorder, symptoms must last two years.

Treating depression in the elderly.

Depression is treatable; start with an appointment to see a health professional. The choice of treatment varies from person to person. It may be that a combination of treatments or multiple treatments is required.

While antidepressants can be useful in older adults, they may not always be as helpful as for younger patients. The risk of side effects or potential medication interactions has to be considered carefully.

Psychotherapy can help your elderly loved one.

Talk therapy with a licensed professional can help. Treatment may be short-term, 10 – 20 weeks, or longer, depending on the situation.

Cognitive behavior therapy (CBT) is used to treat depression. CBT works to help change negative thinking and behaviors that can make depression worse.

Interpersonal therapy can help to understand and work through the underlying problems.

Other talk therapies, such as problem-solving therapy, can also be helpful.

Medication.

Antidepressants can help improve how the brain uses certain neurochemicals that control mood or stress. It can take from 2 to 6 weeks to be completely effective. It’s important to continue taking the medication; a doctor needs to monitor how it’s discontinued.

It’s important to remember that the elderly can suffer from depression and it may not always look the same as in younger people. Be aware of extended periods of sadness or lack of interest in usual activities and seek help in overcoming depression. Depression is treatable, and your loved one doesn’t have to go it alone.