Contrary to what it may seem, depression does not come pre-packaged with aging. Not all older people are depressed; not all older people experience a major depressive episode. As with any other population or demographic, depression needs to be treated as a serious condition and not “just part of growing old.”
Here are some signs that can be typical of depression across the age spectrum:
- Abandoning or losing interest in hobbies or other pleasurable pastimes
- Social withdrawal and isolation (reluctance to be with friends, engage in activities, or leave home)
- Weight loss or loss of appetite
- Sleep disturbances (difficulty falling asleep or staying asleep, oversleeping, or daytime sleepiness)
- Loss of self-worth (worries about being a burden, feelings of worthlessness, self-loathing)
- Increased use of alcohol or other drugs
- Fixation on death; suicidal thoughts or attempts
If these symptoms appear and persist across time, the elderly person who exhibits them probably should be seen by a medical doctor. There are other things that need to be ruled out before clinical depression is diagnosed. Things that can cause depression include a long list of medications that has not been recently reviewed for how these meds interact with each other. Also, depressive symptoms can be the result of low blood sugar, diabetes, thyroid issues, cancer–it’s a pretty long list. Many medical conditions can be the underlying reason for depression, especially in the elderly when the condition has become chronic.
Not all elderly people who are depressed will manifest symptoms of sadness. Sometimes their complaints will include, instead: Low motivation, a lack of energy, or physical problems. In fact, physical complaints, such as arthritis pain or worsening headaches, are often the predominant symptom of depression in the elderly.
Here are some depression clues that often appear in older adults:
Often, older adults fall into depression because of normal life transitions. As they see the end of their lives approaching, they can begin to believe there is no longer any point in going on, and they just give up. Here are some situations in which the elderly can feel depressed:
- Health problems – Illness and disability; chronic or severe pain; cognitive decline; damage to body image due to surgery or disease.
- Loneliness and isolation – Living alone; a dwindling social circle due to deaths or relocation; decreased mobility due to illness or loss of driving privileges.
- Reduced sense of purpose – Feelings of purposelessness or loss of identity due to retirement or physical limitations on activities.
- Fears – Fear of death or dying; anxiety over financial problems or health issues.
- Recent bereavements – The death of friends, family members, and pets; the loss of a spouse or partner.
Sometimes, it is difficult to say whether the person is suffering grief over the losses that accompany old age, or if it is clinical depression. Loss is a part of life for all of us, but the elderly can feel especially helpless when it comes to losing a spouse, a child, or a beloved pet. Fear is often a constant companion to the elderly person who is facing prolonged, painful illness and death. Sometimes that fear devolves into depression.
Other symptoms that suggest depression, not just grief:
How to Help
I cannot stress enough how important it is to get a thorough physical workup for the elderly person you may suspect is depressed. Once that has been accomplished and appropriate recommendations are made concerning medication, then it is important to get the person into some sort of therapeutic environment, preferably with someone who specializes in geriatric care. Getting the depressed elder to talk is vital to his recovery. There are Area Agencies on Aging in every county in America that can help point you toward getting good help. Your medical doctor may be a good resource. If the elder you are helping has a strong faith, then his church may be a good source of help.
Also important is to make sure the person has as much activity and contact with others as is reasonable considering age, health, mobility, and transportation options. Most communities have senior citizen centers with good programs to help people find new friendships and activities.
If the person is homebound, that makes it a bit harder to keep her involved with other people. Many churches have programs of visitation for elderly shut-ins. Again, the Area Agency on Aging in your area is a good resource for getting help. Family involvement is of vital importance whenever possible.
You can find a lot of good resources online. Here’s a good place to start:
Never just accept that an older person is going to be depressed. It is NOT necessary, and there is help.