Symptoms, Causes and Risk Factors of Depression in Elderly

Depression in Elderly

The number of elderly people suffering from depression is on the rise. Sadly, a large number of the elderly with depression don’t seek professional help. Even those who do seek professional help don’t always get the treatment they need. This article looks at the different symptoms, causes and risk factors of depression in elderly, its prevalence, available treatments, and how you can help your aging family members and friends.

Depression in the elderly is a problem that affects many people around the world. Studies by the Centers for Disease Control and Prevention (CDC) estimate that 7 million American adults over the age of 65 experience depression each year. This is a very large number of people especially considering that the population under question is aged between 65 years and 85 years.

However, only a small percentage of people in this population usually seek treatment for depression. Majority of those who fall under this category prefer to ‘ride it out’ so to speak. Most of the people suffering from depression normally confuse the symptoms of clinical depression with other old age related diseases.

Symptoms of Depression in Elderly

It is very hard to identify depression in the elderly in its early stages. In fact, most people, even some doctors, usually fail to notice the early signs of depression, as symptoms are wide and varied and often mirror the symptoms of other diseases. Depression in the elderly is often mistaken for other age related ailments that affect the elderly.

Some of the common signs of depression among the elderly include the loss of sleep, loss of interest in social functions and normal activities, feelings of guilt and persistent sadness.

The most common symptom of depression is the feeling of sadness and misery. Usually, the person suffering from depression fails to see the joy in the small things of life. For instance, such a person may fail to see the joy in such things as his or her children, avoid contact with the child or other people in his/her surroundings. This feeling of sadness may go on to express itself in other formats.

Feeling of exhaustion is another symptom that's also looked for when treating depression in the elderly. As exhaustion can result from other ailments such as arthritis and other health issues as well, doctors keep into mind those factors when diagnosing and treating depression in the elderly.

The feeling of anxiousness is a common symptom among people with depression. Many a time, anxiety comes with a host of other feelings such as the feeling of worthlessness and irritability.

Among the elderly, depression is normally brought about by different causes; however, the most common cause is the exclusion of such persons from the normal running of the day to day businesses. As such, the elderly person begins to wonder what the future holds. They begin to try and define their lives in the future based on their current situations. This may make the elderly person anxious, especially if the current situation is not as good as they would have wanted it to be.

In addition, depression in the elderly is often coupled with other the feeling of being a burden to the people around them. This especially comes about if the elderly person relies on the family or other such person for upkeep. If that elderly person develops the knowledge that their children or family is straining to maintain them, they usually begin to feel unworthy and pity. Eventually, this develops into a feeling that life is unfair.

The absence of the means to support one’s lifestyle usually reduces the level of confidence that such a person normally had.

The most common symptom of depression in the elderly is the thought of death and end of the world. This is not only one of the symptoms of depression, but also one of the causes of depression. The thoughts of death are common among the elderly as they come to the tail end of their lives.

It is important to note that the symptoms of depression usually vary from one person to another. Again, at times, depression may result from the occurrence of other diseases, especially terminal diseases such as cancer. So it's important to keep in mind that symptoms of depression may vary significantly, and may occur in combination with other diseases or conditions.

Causes of Depression in Elderly

What are some of the causes of in the elderly? This is a question that most people would like answered since it is always almost unfathomable that the elderly are depressed.

Health problems

Old age comes with a host of diseases that tend to pegging on the reduced capacity of the body to deal with intrusions. Some of these diseases may arise from surgical procedures, chronic diseases, cognitive decline and damage to some of the body parts. These diseases often result in a number of trips to medical institutions and the consumption of many types of drugs. The result of all that ingestion of drugs and medical trauma can trigger clinical depression.

Often, the elderly begin pitying themselves as their bodies fail to live up to former healthy standards. In addition, the mere fact that the body is weaker and cannot sustain some of the other strenuous physical activities like exercises, also reduce the fitness of the body. In fact, the largest percentage of depression in the elderly is normally brought about by health problems.

Loneliness and isolation

As people grow older most of the times they tend to end up living alone and in seclusion. The family members often move out and start families of their own, which keep them busy, thereby have less time to spend with them. In addition, most of their age mates tend to pass away or develop other complications that keep them away from them. Loneliness is especially common in older people who have lost their partners in the latter stages of their lives.

Depression in the elderly due to loneliness is not uncommon and accounts for quite a huge number of clinically depressed individuals. The effect of a dwindling circle of friends coupled with ever increasingly busy family members as well as reduced participation in normal life activities gives the elderly a lot of time to spend. With a lot of time to spend and fewer activities to cover the time, the elderly usually have a higher chance of getting depression.

Some of these issues can be easily avoided by engaging in a number of leisurely activities that help you keep your mind off things and focused on the interesting parts of life.

Reduced sense of purpose

Often the elderly are usually retired from their active cycles of life. For instance, if they were in charge of a family business, then younger members of the family are usually groomed to take over while the older ones are retired. The gradual transition from an active lifestyle to a less stressful life is usually harsh on some people. Some of the elderly usually fail to accept the reality that their input into the daily lives of people around them is dwindling and therefore end up being depressed as a result.

Depression in the elderly, which is a direct result of the feeling of purposelessness, can usually be treated through therapy or involvement. By involving the elderly in some of the key decision making processes, they get to feel that they are part of the family and still as useful as they were. In addition, the elderly should be prepared for the life after retirement through a comprehensive system.

Fears and recent bereavement

At old age, most of the people usually develop a much tighter bond with those people whom they consider very close. As such, it is usually a very deep blow to them, if any of the people who are in this circle of friends pass on, the elderly tend to get gravely affected, especially since this represents the reality of mortality that is nigh.

In addition, paranoia that an old person may develop in the latter stages of life can also result in depression.

The cases of depression in the elderly are caused by a very wide variety of reasons, it is important to find that which is related to that particular people's case.

Risk Factors of Depression in Elderly

While people may be aware of the fact that depression in the elderly is a common problem, most of the people do not know why people get depressed. As such, this article seeks to analyze the factors that often set up people for depression. These are the factors that make people susceptible to falling into depression. Treating depression is way easier compared to enlightening people on the risk factors of depression in elderly so that they can be aware and guard against such situations.

It is estimated that approximately 2 out of every 3 adults suffer depression. This in itself is a depressing statistic especially considering that people adulthood is normally considered to begin at 25 years in most societies. Among the elderly, the statistic is much worse and it grows worse as the years go by. It is common knowledge that as you grow older, you are bound to feel lonelier since most people in your social circle tend to die off. In essence, the older you grow, the more you are susceptible to depression.

The absence of a supportive social framework that you can rely on only adds to compound the problems. Those who do not fall into depression usually have a network of family and friends that they build to replace the ever reducing circle of friends. Without this supportive framework of friends and family, the elderly tend to feel neglected and alone. Depression in the elderly that is a direct result of neglect, so to speak, can often be treated through re-integrating that person into the normal schedule of life, which makes them feel loved.

Being single, unmarried, divorced or widowed in your old age is also considered to be a factor that puts you at risk for development of depression. This is because these situations often leave the individual alone and without the proper structure to support you as you grow older. Without the proper structure, the probability of falling into depression, often due to loneliness increases triple fold.

Being female is considered to be a risk factor as well. It is believed that men are less susceptible to depression as compared to women. This is because men in old age tend to find other things to keep them busy, while women tend to involve themselves more with the family. The logic behind this thinking being that, family members tend to get busier with time, at times neglecting the woman in question.

Some of the other known risk factors include: the use of particular types of medication, damage to the body, history of depression in the family and recent loss of a loved one.

There are some medications whose effect in treatment may lead to depression. As such in treating depression it is expected that the medical practitioner shall prescribe antidepressants to counter the effect of these medication.

Substance abuse has also been linked to depression. This has been seen in parts of North America and Europe especially among celebrities. With the use of some of the drugs, depression is virtually guaranteed. Often, people resort to drugs and substance as a way of escaping from their troubles. As such, addiction is bound to develop out of such a habit, which eventually leads to a magnified level of depression. Anyone abusing substances should be quickly placed under therapy and placed on antidepressants.

The fear of death is one of the most overlying risks of depression. The fear of death especially in old age stalks almost everyone. The curious ability to almost map out the way in which such a death may come makes depression a very likely scenario in such persons. Usually, in a bid to harmonize yourself with the fact that death is imminent at old age, you will begin to prepare yourself for your eventual demise. What follows is a marked inability to prepare enough for this eventuality. Depression among the elderly due to the fear of death cannot be ignored. Often, this affects those people who have lived with great family responsibility.

There are numerous risk factors that can lead to the occurrence of depression in the elderly; it is important to ensure that the elderly people in your environment are as comfortable as possible. This eases the anxieties that come with old age thereby helping them settle into their roles as older people in peace and readiness for the task ahead.

Areas of Depression in the Elderly

Can depression be treated? This is the most common question that people ask whenever the topic of depression arises. Most of the people do not consider depression to be a ‘serious’ medical condition. In fact, a larger percentage of the people think of depression as a simple condition that can be easily sorted with a few laughs. As such, the concept of seeking medical intervention for the purposes of treating medical depression in the elderly seems to be foreign in most communities.

To understand the concept of depression in the elderly, it is important to know exactly how depression occurs and in what ways it is considered a medical condition. Some of the common areas of depression include:

Physical depression

Physical depression normally expresses itself in a variety of ways. Some of these include: constipation, headaches, ingestion, general pain and dizziness. Physical discomfort especially among the elderly is one of the key reasons that they go into depression.

While the cause of depression may be a chronic or terminal disease, the expression of the feeling of depression normally shows itself in a variety of itself. As such, the person is often unable to respond to treatment in the required manner. Such a person may experience the loss of appetite and disruption of normal sleep patterns.

Often, physical depression can be treated by singling out the cause of such depression and treating it instead of treating the symptoms.

Cognitive depression

Treating depression in the elderly can be an arduous task especially if the cognitive ability of the person is gravely reduced. Often, a person suffering from cognitive depression develops a very negative view of the world, which goes a long way in dimming out the optimistic side of his or her life. In old age, cognitive depression may arise due to underachievement or the feeling of unworthiness.

It may also result from the realization that death is nigh; with little time to make up for lost time, most of the elderly tend to regret past decisions, leading to cognitive depression.

Severe cases of cognitive depression may lead to instances of suicide as the person gives up on life or the possibility that his or her situation may never change.

Cognitive depression in the elderly may result from terminal diseases such as cancer or the death of a close person. This is especially so if the person in question is a breadwinner or one of the pillars close to this elderly person.

Emotional depression

How depression is treated is normally determined by the cause of the depression. Often, emotional depression is treated through therapy since it arises from deep seated fears and feelings. Emotional depression usually comes about as a result of sadness, humiliation, emptiness and misery, expressing itself in lack of interest in the normal things such as humor and pleasure. Often, such a person feels anxious and may be angry almost all the time.

While mild, emotional depression is usually manageable; however, while it gets chronic, it is usually much more difficult to treat. Chronic emotional depression usually requires that the person undergoes a very long therapeutic session and some antidepressants.

Behavioral depression

This is a particularly tricky type of depression, especially since it affects the way an individual responds to various situations. Behavioral depression makes the individual very unpredictable, which means that close monitoring is required if the person is to be treated properly.

Usually, behavioral depression results in low energy and a particular sense of unproductiveness. Such a person maybe found sleeping all day or spending the day engaging in very unproductive actions. Such a person may also enjoy spending time in isolation, compounding the original problem.

Motivational depression

The lack of motivation in a person’s life is one of the common reasons for giving up. A person suffering from motivational depression can exhibit quite a number of symptoms such as numbness, isolation from close family members of friends and they may develop a suicidal streak.

Naturally treating depression involves trying to excite the person into developing an interest into the things that they once loved. It is a process through which the person is treated and taught how to accommodate the feelings of sadness and how to deal with depression.

Treating Depression in the Elderly

There are many ways in which depression in the elderly can be treated. The treatment options normally revolve around pills and therapy, at times in combination with each other to achieve the perfect solution.

Medication

The most common way of treating depression in the elderly is the use of antidepressants. There are many types of anti-depression medication offered to clients, each varying with the causes of depression. At times, a concoction of these medications is used in the treatment process.

However, some of the medication used in the treatment of depression normally result in other medical problems such as bone loss. For instance, SSRIs like Prozac have been discovered to have the capacity cause rapid bone loss as well as lead to a high risk for fractures and falls.

Some of the most common types of antidepressants that are normally used in the treatment of depression in the elderly include: Lithium, Monoamine oxidase inhibitors, Selective serotonin re-uptake inhibitors (SSRIs), Tricyclic antidepressants (TCAs) and Noradrenaline re-uptake inhibitors (NARIs).

Treating depression is a skill that most doctors develop over time. In spite of a range of options, different options seem to work differently for some people. As such, doctors often play a little bit of poker, so to say, in the determination of the correct combination of medical procedures to use.

Natural Remedies

The other common method of treatment is the use of alternative medicine such as Omega-3 fatty acids, St. John’s wort and folic acid. Omega-3 fatty acid has the ability to work together with other antidepressants or in solitude as a solitary type of treatment. Folic acid has the ability to relieve the symptoms that usually come with depression. Naturally treating depression is one of the ways that is commonly used in collaboration with other types of treatments, especially therapy and some antidepressants.

Psychotherapy

Therapy on the other hand is a base line treatment for anyone suffering from depression. This is because depression is often the result of some feeling of under achievement. As such, therapy aims at bringing the people to the realization that self-worth is more inborn than what people think about.

Supportive counseling, therapy and support groups are just some of the ways in which therapy works towards the common goal. Among the elderly, therapy is important especially since it helps the elderly come to grip with the fact that life is changing around them. Once this fact is accepted, such a person can begin to understand how to make the relevant changes in his or her life.

ECT

Electroconvulsive therapy (ECT) has been in use for almost a century as treatment for depression in the elderly. However, while most of the doctors and therapists in this field usually recommend it, the public has been a little skeptical in picking up the enthusiasm with which it is sold.

The treatment plan normally involves the introduction of minor fits and seizures by attaching an electrical pulse to the patients head. The effectiveness of this type of treatment after approximately 6 to 12 treatments usually leads to fewer cases of depression. Often, the treatment is undertaken under general anesthesia; however there is a small risk that the patient may suffer brain damage. This is what makes the treatment unpopular amongst most of the elderly patients.

It is important to point out that doctors in this field praise the treatment for its ability to work, not only for depression, but also for the treatment of epilepsy and other conditions.

For this particular reason, the doctors are required to seek the consent of the patient or other family members before the treatment can proceed. This type of treatment is normally used in the treatment of very severe cases of depression and trauma among the elderly.

One of the key factors in the treatment of depression in the elderly is early diagnosis. Often, when clinical depression is diagnosed early enough, the treatment procedure is normally simpler. However, as the condition goes on, often unnoticed and under no treatment at all, then the treatment plan gets more complicated.

Depression, unlike most of the other diseases, is a feeling that results from deep within; as such whatever treatment plan is subscribed for depression in the elderly, it must seek to make the individual feel better about themselves.

Go through this article to know more on How to Help Depression in Elderly → Geriatric Depression: Treatment and Caring.