Identifying Depression in the Elderly

Depression is a severe mental illness. It can have an impact on how you feel, act, and think. Although sadness is a widespread condition among the elderly, clinical depression is not a natural part of the aging process. In fact, despite having more illnesses or physical problems than younger individuals, research shows that most older folks are content with their life. However, if you've had depression as a child or a teenager, you're more likely to develop depression as an adult. 

Depression is more than just "the blues" or the emotions we experience when losing a loved one. It is a treatable medical condition, similar to diabetes or hypertension. It is more common in older adults, and it commonly occurs in conjunction with other medical problems and disabilities, and it lasts longer.

Depression In Elderly: Not A Symptom of Growing Older 

Depression is a medical disorder that may be treated, not a natural aspect of growing older. Clinical depression is frequent in the elderly. That isn't to say that isn't unusual. Research suggests around 6 million Americans aged 65 and up suffer from late-life depression. However, only 10% of those who are diagnosed receive therapy. The most plausible explanation is that older individuals' depression symptoms differ from those of younger people. The consequences of various ailments and the medications used to treat them are commonly confused with depression in elderly persons.

Depression has a different effect on the elderly than it does on younger people. It is linked to an increased risk of heart disease and death from illness in older persons. Depression, on the other hand, limits an older person's ability to rehabilitate. According to studies, depression significantly increases the chance of death from physical ailments among nursing home patients. Depression has also been related to a higher risk of death following a heart attack.

How Is Depression Different in the Elderly 

Adults above the age of 65 are at a higher risk. Approximately 80% of older persons have at least one chronic health issue, with 50% having two or more. People with other illnesses (such as heart disease or cancer) or reduced function are more likely to develop depression.

Adults over the age of 65 are frequently misdiagnosed and undertreated. Healthcare practitioners may misinterpret an older adult's depressive symptoms as a natural reaction to sickness or life changes as we age, hence failing to address the depression. Older folks frequently have this idea and do not seek help because they do not realize they could feel better with the proper treatment.

Because some of their symptoms might mimic everyday age-related concerns, older persons are at risk of being misdiagnosed and receiving inadequate care. Other illnesses, drugs, or life changes can also be misinterpreted for symptoms. 

Patients who are elderly may also be hesitant to express their thoughts or may not realize that physical symptoms can be a sign of depression. Isolation might make it difficult for the elderly living alone to seek assistance.

Symptoms That Can Help Identify Depression

A major depressive disorder is defined as a period of at least two weeks during which the person is depressed for most of the day, practically every day, or loses interest or pleasure in nearly all activities. The following are the most prevalent signs of depression among the elderly, according to the American Association for Geriatric Psychiatry (AAGP):

• sadness that never goes away
• feeling sluggish
• worrying excessively about money and health issues
• frequently shedding tears
• feeling useless or powerless 
• changes in weight
• fidgeting or pacing
• trouble sleeping
•  difficulty concentrating
• complaints about the body (unexplained physical pain or gastrointestinal problems)
• refusal to participate in social activities

Medical Conditions That Exacerbate These Symptoms

Medical issues, such as chronic medical disorders, can cause or exacerbate depression symptoms in the elderly. Any medical condition, particularly ones that are painful, debilitating, or life-threatening, can cause depressive symptoms, such as:

• cancer
• Parkinson's disease 
• stroke
• Coronary artery disease
• Multiple sclerosis
• Lupus
• Diabetes
• Dementia
• Alzheimer's

Problems Associated with Depression in the Elderly 

There are further problems associated with depression in the elderly. 

• Depression and physical symptoms

Some physical disorders might cause symptoms that are comparable to those associated with depression. Thyroid disorders, heart illness, or arthritis, for example, can induce loss of appetite or poor sleep.

• Long-term illness

If you get sad, you may become more concerned about your health, even if it hasn't deteriorated. Although treating depression will not eliminate physical health problems, it will make them far more pleasant.

• Confusion and memory difficulties

Depression, anxiety, and worry may wreak havoc on your memory and leave you feeling befuddled. You may believe you have dementia (permanent memory loss) when it is simply only depression. 

• A new sense of isolation

You don't have to be depressed if you live alone. Feeling more lonely for no apparent cause, on the other hand, could be a sign of depression. This is very common among the elderly that live in nursing homes. 

Treatment for Depression

Treatment of depression in older persons may necessitate a combination of approaches.

• Psychotherapy

For elderly patients, ongoing talk therapy can be a source of support. Solution-focused therapy such as cognitive-behavioral therapy (CBT) or other behavior therapies can also assist elderly individuals in avoiding thinking patterns and behaviors that lead to depression symptoms in the short run. Making changes for elderly patients, such as addressing physical health and religious/spiritual views, has been shown to improve treatment outcomes. 

• Support groups

 Groups that bring together older persons dealing with similar concerns (depression, medical ailments, grief, etc.) can help build social support and provide a safe place to talk.

• Medication

Antidepressants are a type of medication that can be taken to help with depressive symptoms. Antidepressants can have serious adverse effects, and elderly individuals are particularly vulnerable to them. Medication needs to be carefully controlled.

• Lifestyle changes

 Exercise on a daily basis, a nutritious diet, and more social support are all beneficial to senior individuals suffering from depression. The following are some ways that friends and family members can assist:

• make plans for group outings
• assist with transportation to medical appointments
• schedule weekly visits with family and close friends
• prepare healthful meals ahead of time and freeze them for later use
• assist with the development of a system to make taking medication on a regular basis easier

Keep Up Effective Treatment 

The elderly may also be hesitant to take their medication because of side effects or cost. In addition, having certain other illnesses simultaneously as depression, can interfere with the effectiveness of antidepressant medications. Alcoholism and abuse of other substances may exacerbate and interfere with effective treatment. Unfortunate life events, including the death of family or friends, poverty, and isolation, may also affect the person's motivation to continue treatment. It's essential to keep up treatment for the best efficacy. 

How Can Journaling Help 

People who suffer from anxiety and depression have utilized journaling as a supplement to their therapy. It can cause a mental breakthrough by bringing to light past traumas, fears, and worries that contributed to the onset of these mental health difficulties in the first place. Journaling also gives people a secure area to write down their thoughts and anxieties and be completely honest with themselves. It necessitates the least amount of work and consistency. It can assist you in mapping out all of the various concepts that occupy your mind and navigating through them. It's also a terrific tool to keep track of your recuperation and progress. 

One of the benefits of journaling is that it teaches mindfulness. Maintaining awareness of thoughts, feelings, and sensations in the present moment is what mindfulness is all about. Being mindful means not fretting about the past or stressing about the future—it is being present in the present moment, physically, cognitively, and emotionally. Mindful people are present in the moment, where they may benefit their lives and the world.

Keeping a journal, whether it's handwritten or online, is another habit that promotes awareness. Journaling assists the writer in identifying existing ideas and feelings. It allows them to process what's going on in their heads. After expressing and accepting them on paper, the writer can select what to do with those emotions and thoughts.

Lastly, the stigma associated with mental illness and psychiatric therapy is especially strong among the elderly. This stigma can prevent older people from even admitting to themselves that they are depressed. Depression symptoms are commonly misdiagnosed by older persons and their families as "natural" reactions to life stresses, losses, or the aging process.

Furthermore, bodily complaints, rather than typical symptoms, may be used to indicate depression. This causes treatment to be delayed. Again, older persons who are sad may not seek help because they incorrectly assume there is no hope. 

Hence, it is up to the families to check the mental well-being of the older people in their lives. Depression can creep up on anyone of us, and sometimes we may not be strong enough to handle it alone.