As we grow older our lifestyle changes with every passing day and so does our physical and mental health. Physical health is easier to notice when it deteriorates but decline in mental health is a little difficult to notice and most of the people don’t pay much attention towards it. There are number of problems which can affect an old person’s mental health and most common among all is depression. Depression in the elderly has become an issue which affects a large number of people all around the world. Masses need to understand that mental health is every bit as important as the physical health.
It is a combination of emotional and mental disorder and it affects a large fraction of older population. One might feel sad and gloomy more often than not but persistent feeling of sadness is not normal. If caregivers are a little mindful of the signs of depression then it can treated if not prevented. However, knowledge about the symptoms and causes of depression can always be a big help for older people. Clinical depression can only be diagnosed by a mental health practitioner but people should also look for its signs in their grandparents and older people living around them. It is associated with poor quality of life in older adults and that’s why one must pay attention to mental health generally.
Prevalence of Depression in the Elderly
According to Center for Disease Control (CDC), approximately 1 to 5% of older adults suffer from depression and 13.5% of them are the ones who require home care while 11.5% are those in hospital. The problem is the fact that there are a few signs of depression which can also be thought of as age-related problems so they can lead to misdiagnosis and ultimately deteriorating mental health. Moreover, most of the older adults are not comfortable while talking to other people about their feelings which make it difficult to reach out for help and causes a problem.
Symptoms of Depression in the Elderly
To meet the full fledge criteria for depression, one must face symptoms of depression including low mood and sadness for at least two weeks nearly every day. These symptoms are not specific for older adults as these symptoms are found in both younger and older adults. If you are trying to screen out someone for depression, you should look out for the following symptoms in them.
- Constant feeling of sadness and dismay
- Crying spells
- Excessive worry and stress
- Feelings of worthlessness and helplessness
- Sudden weight loss or weight gain
- Problem in concentration
- Sleep problems like difficulty sleeping or regular awakening during sleep cycles or not able to achieve REM (Rapid Eye Movement) sleep.
- Fidgeting and pacing
- Gastrointestinal problems
- Other unexplained psychosomatic symptoms like pain and aches
- Isolation and withdrawal from social activities and patient feels lonely most of the time
- You will feel restless almost all the time
- Suicidal ideation is also present in most of the patient
- Feeling of hopelessness
- The patients become tired and fatigued all the time
If someone faces any of these problems for more than two weeks, he should consult a mental health practitioner and get the symptoms checked for depression.
Causes of Depression in the Elderly
Depression cannot be explained by a single cause, and there is more than one cause to depression. Most of the time the biopsychosocial model is used to explain the underlying causes of depression. All factors including biological, psychological and social are combined to play a major role in the development of depression. However, to further explain the causes of depression following causes are theorized.
- The family history of depression is one of the major causes of this disorder. You are at more risk of depression if one of your close relatives or first-degree relative is suffering from depression. It runs in families most of the time, and people suffer from depression if their parents or siblings are suffering from the same disorder. This can also lead to the hypothesis that depression also has underlying genetic causes. Genetics play an important role in the development of depression, but there are more to this disorder than only genetic and family history.
- Depression can also be caused by the disturbance in the levels of neurotransmitters including serotonin and norepinephrine. Increase or decrease in the levels can cause depression in both younger and older adults.
- A life event which is traumatic in nature can also trigger depression in elderly like the death of significant other or any kind of abuse like physical or sexual abuse. This traumatic event can be a triggering factor for depression, but there are more than one underlying causes or predisposing factors for this disorder.
Aging and Depression
Cause of depression can be biological or psychological, but there are complications related to aging which can be linked with higher risk of depression. These are as following.
- When people grow older, they tend to stay in their homes or even in their bedrooms, and that’s why they go out less and feels alone and isolated. Isolation can ultimately lead to depression.
- Mobility is restricted in older adults, and they feel left out in most of the activities which lead to depression.
- Retirement is a transitional phase, and people tend to feel depressed about having nothing to do in their life after depression.
- Divorce or widowhood can also be linked with depression because of the feeling of loneliness and isolation.
- Financial and health problems can also be linked with depression because these problems cause frustration and in turn depression in the long run.
- Most of the older adults suffer from chronic medical conditions, and long, persisting medical conditions are reasons of frustration in the elderly which can be a strong indicator of depression.
- In order to fight depression both physical and mental health should be taken care of.
Risk Factors of Depression
Depression affects all the people equally, but there are certain demographic characteristics which put you at more risk of depression. One should be really careful if he or she falls under the following categories. These risk factors include the following.
- If you are a female, you are at higher risk of developing depression.
- If you are single or widowed you can also at higher risk of depression.
- Loss of a loved one or any other traumatic life event
- If you don’t have people to take care of you
- Medications’ side effects
- Fear of death in the last stage of your life can also lead you towards depression.
- If you have a history of suicide attempts you are more likely to develop depression
- History of depression
- Reduce blood flow towards the brain can also be a risk factor of depression
- Physical condition likes stroke, hypertension, dementia, and diabetes are also linked to a higher risk of depression in the elderly
Diagnosis of Depression
Self-diagnosis like self-medication is dangerous for your health. One must consult a psychologist, a psychiatrist or a mental health practitioner for diagnosis. The mental health practitioner will give you a proper diagnosis after looking at the history of your disease and asking you some questions. However, if you are facing any two symptoms mentioned above for at least two weeks, you should consult a qualified mental health practitioner as soon as possible and take any treatment necessary.
Treatment of Depression in the Elderly
There is not a single treatment for depression because of different causes behind depression. It takes a lot of effort and time to find out perfect treatment for a patient. Since researchers use a biopsychosocial model to explain the causes of depression, similarly, a combination of medication, psychotherapy, and social change can be the perfect treatment regimen. The details of these treatments are given below.
Following medications can be used to treat depression in older adults as well as the younger ones.
- Tricyclic Antidepressants
- SSRIs (Selective Serotonin Reuptake Inhibitors)
- Monoamine Oxidase Inhibitors (MAOIs)
- SNRIs (Selective Serotonin-Norepinephrine Reuptake Inhibitors)
Depression is considered mainly as a psychological disorder and that’s why psychotherapy can have a tremendous effect on patients suffering from depression. Psychotherapy is used both ways including individual therapeutic sessions as well as group therapy sessions. Cognitive Behavior Therapy (CBT) is considered the most effective one in treatment of depression.
A patient has to make some lifestyle changes in his life too, in order to get rid of depression. One can start from being more physically active and then take it to more socialization and increasing social interaction with friends and family.
Depression in the elderly is a serious problem and people should be more mindful of it. However, it is not totally uncontrollable, and a caregiver can prevent and treat depression by being more careful and getting more information on the subject. One should take care of both mental and physical health of the elderly to combat depression.