Depression in the elderly
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WHAT IS DEPRESSION AND WHAT ARE THE SYMPTOMS?
Depression is a mental disorder that is characterized by deep and prolonged periods of sadness, apathy, anxiety, loneliness and regret. The condition usually starts as a reaction to various adverse random events in the person’s life. For example, the loss of a loved one or a tragic event in the life of a person can trigger the start of the condition.
Depression is considered a modern age disease because there are few recorded instances of long-term depression in people. Unfortunately, it is often downplayed and negatively perceived by the public. A person suffering from the disorder can be mistaken to be self-centred, egocentric and mentally weak.
In order to diagnose depression in a person, medical doctors focus on the most common symptoms of the disorder. In addition to the overwhelming sadness, these include:
- Lack of life energy: The affected person becomes apathetic, constantly tired, irritable and less active. They are not able to perform even the most basic of tasks that did not cause any problems for them in the past.
- Loss of interest: People affected by depression also abandon former hobbies and passions. They no longer find pleasure in their activities and pastimes any more.
- Sleep problem: A person suffering from depression finds it difficult to fall asleep. They also get irregular sleep patterns and wake up early or stay up during the night. This could lead them to feel malaise, fatigue and feeling shattered in the middle of the day. One defining characteristic is that the suffering person feels the worst in the morning and better in the evening.
- Fear and anxiety: The person develops an irrational feeling of danger. They become pessimistic and predict bad events in all situations. Often, the anxiety is long-term and located in the precordial region of the brain.
- Bad Hygiene: The person also starts neglecting their personal hygiene and stops taking care of the environment in which they live.
- Lack of appetite: The person does not feel hungry often and develops eating disorders which lead to weight loss.
- Lack of concentration: The affected person cannot focus on anything. They often get confused, their thoughts run wild and they are unable to concentrate on work or study.
- Guilt and a sense of low self-esteem: People affected by depression start judge themselves and their achievements very harshly. They belittle their own life achievements and see the failures in their lives as a punishment for their inadequacies. In extreme cases, the person can also become suicidal.
Depressed people often develop drug addictions to cope with the constant sadness. They may also have a higher intake of alcohol or other stimulants.
CAUSES OF DEPRESSION IN THE ELDERLY
Depression becomes more common as you get older. Life events that led to a loss evoke strong negative emotions in the affected person. If these events are closely related to everyday life, they can trigger the memories repeatedly causing a chronic case of depression for the person.
When an elderly person is forced to change their existing lifestyle, an urgency of the situation may cause them to re-evaluate current priorities and life goals. In many cases, such changes can force them to adopt a new concept or philosophy of life. This can develop psychological problems for them. It is commonly observed that old people adapt badly to new living conditions.
The most frequent critical events in late adulthood that trigger depression are:
- Loss of close relatives
- Loss of health, fitness or physical attractiveness
- Loss of social and economic status
- Loss of the sense of usefulness, purpose or prestige
- The approaching prospect of death
For most affected people, repeated events that cause periods of grief or anxiety are more likely to develop into depression than a single event, even if it is very strong. There is a correlation between chronic sadness and the occurrence of depression.
Aging is often followed by reflection on your life. In most cases, people judge themselves harshly and this leads to a negative result. People become pessimistic and unhappy about their life’s achievements.
We should also note that depression can be a consequence of various diseases of old age, such as: atherosclerosis, hypertension, heart rhythm disorders or dementia. Lastly, many types of medication can also cause or exacerbate depression.
HOW TO HELP A SENIOR WITH DEPRESSION
Closeness to a kind person is invaluable for people suffering from depression. The person can be a friend, a family member or a caregiver. The most important thing is to show interest and commitment to the affected person. It should be noted that a person suffering from depression will not ask for help for fear of being a burden on others.
It is important never to criticize an elderly person. The carer or family members should also be careful not to express that they feel sorry for the person’s fate. This will only exacerbate their mental condition and feelings of inadequacy.
One good thing that carers can do is take the person out for a walk. You can take them to the park, the cinema or any other entertainment that will provide intellectual and psychological stimulation. The person should also get some physical activity on a daily basis. Endorphins are released into the body during exercise. This has a positive effect on the psycho-physical condition of the person. Exercise should be planned according to the age and ability of the person.
Seniors with depressions should not be stopped from performing their daily duties. If they want to do something, like watering the plants or cleaning their dishes, they should be allowed to do so. This makes them feel that they are still needed and irreplaceable, even for performing simple household activities.
Depressed people must also never be told to get a grip, or do something in a harsh tone. If the person was capable of doing something on their own, they would do it by themselves. Criticizing them for failing to perform a simple task only deepens their sense of guilt. It strengthens the feeling that they are a burden to the loved ones.
Proper nutrition of a person with depression is crucial. It is absolutely necessary to limit sugar, salt and unhealthy fats from their diet. Ensure that the senior has 5 small and properly balanced meals during the day. These meals should be rich in vegetables, fruits and natural grains. This should give the person energy and improve their mood.
If a person suffering from depression is bedridden, additional steps must be taken by the caregiver. It is important to ensure that despite their physical limitations, the person still feels important and essential. Ask for their advice and opinions, even in the most trivial of matters. Tell them how your day went and what happened at work. This helps them feel valued and still actively involved in family’s life.
Carers can also read a book for them or watch an interesting movie together. Caregivers can also suggest memory games. These activities will improve the brain’s function and help them forget about their depressing condition for a while.
DEPRESSION TREATMENT FOR THE ELDERLY
In more severe cases of depression, a visit to a psychiatrist is recommended. The doctor will conduct a thorough interview and establish a treatment plan.
These days, the treatment of depression is largely based on the adaptation of an appropriate antidepressant and referral to psychotherapy as a support treatment.
Previously, depression was also treated with electroconvulsive therapy and sleep deprivation (forced insomnia). However, these methods are being abandoned now, as they are considered too drastic and not too effective.
However, electroconvulsive therapy may be used but only in very severe cases. This is a case where the patient has developed a drug resistance after administration of several different antidepressants over a period of time. Electroconvulsive treatment has improved significantly from the past and it could be an option for some people.
ANTIDEPRESSANTS
These are a category of drugs that increase the level of neurotransmitters in the body. These include serotonin, and norepinephrine which help improve the general well-being of the person. Studies show that the consumption of anti-depressants in the world has been increasing due to their effectiveness.
However, antidepressants should be taken with care. Incorrectly selected antidepressants can be dangerous to health. Their continued use can also lead to a series of adverse side effects such as changes in the circulatory system, psychomotor disorders or wild mood swings.
A very important consequence of treatment with antidepressants is how they interact with other medication. It is important to tell the psychiatrist about all the medication currently being taken by the patient.
Age and other medical disorders do not impede treatment with antidepressants. If the doctor determines that a group of antidepressants do not interfere with existing medical disorders, they may allow the elderly person to take them.
Other forms of depression treatment
In early or lighter depressive stages, the patient is usually referred to psychotherapy. There are several forms and types of psychotherapy. The choice of the most appropriate one depends on the patient’s needs as well as the reasons for the disorder.
TYPES OF PSYCHOTHERAPY:
Cognitive therapy – This aims to find the problem and cause of depression in the patient. The doctor tries to change the pattern of negative thinking. The psychotherapist takes an active part in the process of healing the depression. The therapy usually lasts until shortly after the episode of depression disappears.
Psychodynamic therapy – This aims to change the person’s self-image and self-worth. During therapy, the psychologist analyzes the persons’ childhood and life experiences. The doctor considers how they could have contributed to the current problems of depression. This type of therapy usually lasts much longer. It can carry on even for years.
Interpersonal therapy – This starts with the premise that the source of the problem is the lack of skills in proceedings in interpersonal relations. The therapist then analyzes the existing relationships with other people and recommends behavioural changes for the person.
HOW TO CONVINCE AN ELDERLY PERSON TO GO TO A PSYCHIATRIST?
It could be difficult to get a person to take mental treatment for depression. The following approach can be taken.
Primarily, the family members should:
- Tell the patient that they need to be brought back to normal existence. The person can be reminded how they used to live before they became chronically depressed.
- Ensure them that therapy will improve their well-being and help them return to normal functioning, duties and life passions.
- Slowly familiarize the patient with the idea that it is worth visiting this type of specialist. Give them time to get used to the idea. The approach should not be intrusive in any way. The carer should systematically try to interject benefits of the treatment.
- Openly indicate that today’s treatment with a psychiatrist is the norm and that most people who suffer from depression sooner or later must seek help there. It is also worth informing them how many people are struggling with this problem. Treatments are completely discreet and nothing is shared with third parties.
- Give an example of a well-known person who openly admitted the illness. Thanks to treatment, they are now in good health.
- Provide the senior with a sense of security, ensuring them that if they feel threatened, they will be able to end the visit and leave at any time.
- Offer support during the visits, especially if the elderly person has problems with independent mobility. If it is not possible for them to leave the house the family could try to arrange a doctor’s visit to the senior’s home.
Depression is a very complicated and multilevel disease. A person suffering from this disease shuns people and rarely uses social support systems. Depression can cause alienation, self-closeness and systematic deterioration of health.
The patient needs pharmacological help and referral to specialist therapy. They also need the support and presence of their relatives. Relatives must show them patience and understanding. They should not be judged, criticized or lectured. Carers must be patient with them and listen to their needs. They should also help divert the person’s mind from negative thoughts.
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