Depression in Seniors is Real and Treatable
By Tracy E. RichardsMS, LCMHC
When getting older, in addition to medical concerns, we often forget to look after our mental health. What we don’t realize is there’s an increased risk for depression. It’s not a character flaw or a weakness or the result of guilt or fault and not necessarily a normal part of aging. It is an illness and one that is often overlooked as we focus on other health issues for seniors. It’s also very treatable.
When negative feelings interfere with daily life, it’s time to speak with your healthcare provider about the possible symptoms of depression.
While major life events like loss of a loved one can trigger it, depression can also result from issues like transitioning into retirement and a loss of identity, struggling with changes in relationships, isolation, moving in with your children, losing friends and social connections, giving up driving, new environments, medications and family relations. Depression causes feelings that can be intense, chronic and blow small things out of proportion.
We don’t often realize they can have physical effects. The World Health Organization says depression the leading cause of disability worldwide. The American Heart Association says mental health issues can effect heart health and can be the result of heart disease.
Symptoms of Depression
There are several reasons why depression in seniors might be overlooked. If someone is isolated and not socializing, the physical or behavioral symptoms may not be noticed. Medications can bring on symptoms of depression, as well as not getting the nutrition you need. Feeling ashamed can make a person reluctant to talk about their feelings. Like they should, “just get over it.” The signs of depression include:
- Feelings of hopelessness and/or pessimism
- Feelings of guilt, worthlessness and/or helplessness
- Anxiety and worry
- Irritability, restlessness
- Loss of interest in activities or hobbies once pleasurable
- Fatigue and decreased energy
- Difficulty concentrating, remembering details and making decisions
- Insomnia, early-morning wakefulness, or excessive sleeping
- Overeating or appetite loss
- Thoughts of suicide, suicide attempts
- Persistent aches or pains, headaches, cramps, or digestive problems that do not get better, even with treatment.
- Memory problems
- Lack of motivation and energy
- Slowed movement and speech
- Neglecting personal care (skipping meals, forgetting meds, neglecting personal hygiene).
A primary care provider can help rule out medical conditions that might be causing symptoms of depression like dementia, Parkinson’s disease or heart disease. Screening for signs of depression will help them recommend treatment that could include medication, therapy or counseling or a combination of both.
Depression and Dementia
Symptoms of depression can differ across cultures, gender and age. As we live longer the chances of developing depression and anxiety increases. One of the hardest hit populations can be dementia patients and their caregivers.
You’ve heard plenty of people say they had a “senior moment.” We laugh when we can’t remember where we left our keys or glasses. Add to that the frustration for people with varying degrees of memory loss and dementia who face an inability to mentally process their actions, speech, or remember much of their past. They get frustrated and angry, and that’s when difficult behaviors occur. When they don’t know things that they feel they should know – the names, places, faces, or how to do simple tasks.
You find them getting more aggressive, acting out, and getting angry. That’s often a sign of anxiety because they can’t mentally process things like they used to. Looking at medication for anxiety may help.
It’s kind of like trying to juggle. It gets harder and harder for dementia patients to keep all those balls in the air. So, what you want to do is minimize that distraction, keep things more linear so that they’re able to process better and reduce their agitation. Simplifying tasks and communication, maintaining routines and schedules, explaining things rather than assuming they know or remember are ways to help dementia patients cope before frustration or depression sets in.
Caregiver Depression
One overlooked component of care for the elderly is the stress on the caregiver. Many of the caregivers of dementia patients are family members, spouses, other elders and daughters in particular. The same general symptoms of depression have been shown to impact caregivers who feel overwhelmed by the huge responsibility.
Studies have documented the challenges faced by the so-called “sandwich generation,” children caring for a parent with early-stage dementia trying to create a safe environment while raising a young family.
Recognizing depression and seeking help is the first step in neutralizing a situation that could develop into a deeper mental health illness. For caregivers, respite, self-care, and support groups have become imperative. The Alzheimer’s support group meets at Community Health North Main Street, 231 North Main Street, Rutland, VT on the second Tuesday of each month.
Being on 24/7 is really hard as a caregiver. Often caregivers will get sick after they’ve taken care of somebody for a long time because they neglect their own health and because of the stress, both physical and emotional, taking a toll over time. They get stuck in a state of hyper arousal. They don’t sleep well; they’re eating on the fly because they’ve got a lot to do often in a short time frame for the person they are taking care of. So, self-care for a caregiver is important, whether you have to hire somebody to give you respite on a regular basis or enlist family members that can be used as backup.
The most important thing to know if you or someone you know may be suffering from depression is you are not alone. The biggest thing is not feeling guilty for the times you do get frustrated. Get a counselor to talk to. Depression can be treated.
Don’t wait to get elder care. Too often families wait to make decisions about elder care until it’s a crisis. So being able to talk to someone about how you see yourself aging will make the process less stressful. Evaluate your resources and your options.
Through my experience and understanding of trauma, I see other patterns that occur as a person ages, but these three things are always pertinent for any age group to maintain a healthy physical and mental balance – sleep, diet, and mood. Maintaining family and community connections is also important. Remember, we all get older we can’t control that, but we can manage it better with planning, communication, and support.
Tracy Richards, LCMHC, is a licensed clinical mental health counselor at Community Health Rutland.
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