Seniors and Depression
Is depression a normal consequence of aging?
In a word, NO. Depression is not a natural part of aging any more than it is a natural part of any other life stage. At any stage of life, it is an illness that requires attention.
What are the Causes?
Inherited Risk Factors -Family and Genetics
There is a high risk of genetic connection when a relative or family member
has a depressive disorder.
Biomedical Risk Factors
Depression may also stem from other biomedical risk factors such as, thyroid
problems, vitamin B-12 deficiency, chronic pain, stroke or Alzheimer's
disease. Brain conditions such as epilepsy or migraine headaches and brain
injuries from trauma can cause depression as well. Degenerative brain
disorders such as Parkinson's disease, multiple sclerosis or Huntington's
disease are commonly associated with depression. Even sleep disorders
like sleep apnea (abnormal sleeping pauses during sleep) or narcolepsy
(a tendency to fall asleep abruptly during the daytime) can impair mood.
Medications that may cause or contribute to depression
A long list of medications shows depression as a potential side effect.
Medications used for neurological or psychiatric conditions can also cause
depression. These include the antiseizure drugs Dilantin (phentoin) and
Tegretol (carbamazapine); Parkinson's disease medications, and sedative
drugs such a barbituarates or benzodiazapines.
Recreation Drugs and Alcohol as Depressants
Among those who misuse alcohol and other substances, 15 to 50 percent
also have major depression.
Social Isolation
Depression is often related to social isolation or interaction. Older
adults are often more isolated because of a physical illness, lack of
mobility or because they can no longer drive. The highest rates of depression
occur among hospitalized seniors and those living in nursing homes. Grief
is a common psychological cause for depression in older adults. As people
age, they begin to lose friends, relatives and siblings, their social
circle gets smaller and they miss loved ones and friends terribly. The
most devastating loss to the elderly is the loss of a spouse.
Signs and Symptoms of Depression
Sometimes depression in the older adult is difficult to pinpoint because
it often shares symptoms with other medical conditions. In fact, older
adults are more likely to complain about physical problems (aches and
pains) rather than emotions.
Suicide Suicide is five times more likely in individuals over 60 than in younger groups
- Suicide is more likely to occur in those living alone
- Death of a spouse, other family member, or friend is more common in later life than in other age groups and bereavement is highly associated with suicide
- Loss of mobility, functionality, and independence are related to higher suicide rates.
Suicidal Talk should always be taken seriously and professional help sought immediately.
Getting Help for Depression
Depression in older people is sometimes harder to recognize than in younger
people because it often co-occurs with medical, psychiatric and substance
abuse disorders. When an elderly person is diagnosed with depression,
it is important for them to realize that it is treatable. Research indicates
that the best long term outcomes for the treatment of depression in older
adults in medication, therapy and social supports. Whether depression
is caused by physical, psychological or social factors, the plan for treatment
should address all of them.
Benefits of Treatment
- Partial or complete remission of a broad range of symptoms of depression
- Reduction of pain and suffering associated with physical illness
- Enhancement of general mental, physical and social functioning
- Minimization of cognitive disability
Recommended Reading
Living Longer, Living Depression Free-A Family Guide to Recognizing,
Treating and Preventing Depression in Later Life, Miller, Mark D.
& Reynolds, Charles F., the John Hopkins University Press, 2002.
"Depression and Older Patients, Therapeutic Considerations for the Primary-Care Physician", Continuing Education in Neurology and Psychiatry, vol. 1, number 1, Rabheru, Kiran.
Websites
Depression is not a Normal Part of Aging
www.psychologyinfo.com/depression/seniors.htm
Seniors and Depression
www.checkupfromtheneckup.ca/seniors.html
Depression in Seniors: Signs and Symptoms
http://seniorhealth.about.com/cs/mentalhealth/a/depression.htm