Depression is a disease that affects they young and the elderly. It manifests itself in similar ways in both of these ages groups but different in some very important ways for those who are elderly. These differences can contribute to the fact that 35 million elderly are suffering from depression with as many as 70% of them suffering unnoticed chose to end their lives even though they saw a medical doctor within 30 days of having done so.
How many other people came into contact with them during those 30 days and their depression escaped their attention too? Understanding how depression differs in the elderly can make recognizing it much easier.
One major drawback to knowing someone is depressed is when that person does not communicate that they are sad. Elderly individuals who have difficulty communicating are even more unlikely to give direct clues to those around them. Elderly depression symptoms can take many forms including physical, psychological and emotional.
The elderly person suffering from depression may physically look different from the usual appearance. The clothes they wear may be dirty, slept in, or worn several times. They may not shower or bathe as often as they should. They may not see the need to wash their hair or do other personal hygiene such as that which is necessary to control body odor. Their disinterest in food may show up in a noticeable body weight loss as clothes become loose. They may experience medical or dental problems from not keeping appointments or because they do not take medications or follow proper dental care procedures.
Psychologically they may be confused, become more irritable than usual, have delusions or hallucinations or show signs of severe sadness. Individuals in the over 65-age group rarely admit to being sad, at least not to others. They may however give clues that they are extremely sad when they complain of persistent aches and pains or other ailments so that they seek frequent attention or help form others. Sometimes their behavior can seem on the demanding side of what would seem normal.
Emotional signs of depression express as feelings of anger, crying for extended periods of time and other expressions of Normal grief is understandable in those of advanced age as so many of their peers are dying or have retired and moving away. Adult children may have also moved away leaving them feeling isolated and alone in a life that seems totally changed and foreign. These lifestyle changes usually create emotional signs of depression.
Recognizing and interpreting these signs and symptoms of depression in the elderly individual may take a trained eye and ear. Listening to what someone who is elderly is saying or not saying can be very important when it comes to understanding depression. Depression will not usually go away on its own and will worsen with time. Clinical depression can last for months. When the elderly suffer from untreated depression the immune system can be affected making them much more susceptible to contacting other diseases.
Although we have discussed physical, psychological and emotional signs of depression there are also biological factors that some scientists suspect may also play a role in elderly depression. They think that there is a biological pattern to those who suffer from clinical depression. Depression often times will be seen in parents, siblings or past family members. Those individuals who have a past history of depression will often have a reoccurrence of depression in later life.
Impact of Depression in the Elderly
Those who work with the elderly on a regular basis will tell you, that they see the evidence of depression in these individuals routinely. The trouble with something that is observed on a routine basis is that it becomes normal to witness the occurrence of the event or condition in the case of depression; and it is often than ignored by medical personnel. Depression should never be viewed as a “normal part of aging”. When caregivers and medical professionals assume that depression is normal, they ignore it. Ignoring depression is never a good thing for the individual experiencing it. Depressed individuals need immediate attention, diagnosis, treatment and support.
The very natural progression of years that an elderly person as experienced predisposes them to a higher incidence of disease and situations like loss, that are known to put them at risk for depression. This fact is the reason doctors often assume that it is normal for anyone over 65 to be depressed (they have more reasons to be depressed).
The facts are that:
- Depression in the senior years does go hand in hand with other medical chronic or terminal illnesses.
Depression will tend to last longer in the elderly individual.
Depression compounds medical risk for cardiac disease.
Depression in the elderly is more likely to end in suicide than it will for someone who is depressed and much younger.
Those at most risk for depression are the elderly population that are female, unmarried and especially those living alone, those who have experienced stressful life events such as natural disasters and loss of close loved ones, and also those who lack a support network.
Other factors that can put an elderly person at risk for depression include certain medications or medication combinations, a recent loss, chronic pain, damage to body image such as an amputation, having the fear of self death, a family history of depression or a history of any major depressive disorder, past suicidal attempts and any substance abuse.
The elderly and those caring for them should understand that not only is depression not normal but that it is common for them to experience it and also more importantly that there are several treatment options available for those who suffer from depression.
The treatment option for those over 65 include: medications, psychotherapy, electroconvulsive therapy, and also a combination of these treatments.
Medications – The medication class is known as antidepressants. Antidepressants have been shown to be very effective for the older individual. There are however risks associated with using these drugs including potential for adverse reactions from antidepressants and other medications that they may already be taking. It is important that both the doctor prescribing the antidepressant and the pharmacist filling the prescription be aware of any other medications that the individual is taking to avoid this risk factor.
Antidepressants are also known to take longer before the benefits can be felt by the individual taking them in those of advanced age. This prolonged effectiveness is due to elderly individuals being more sensitive to medications and the fact that doctors are prone to start them off at lower doses.