Geriatric Depression
Geriatric depression is a mental and emotional disorder affecting older adults. Feelings of sadness and occasional “blue” moods are normal. However, lasting depression is not a typical part of aging.
Older adults are more likely to suffer from subsyndromal depression. This type of depression doesn’t always meet the full criteria for major depression. However, it can lead to major depression if left untreated. Depression in older adults can reduce quality of life, and it increases risk of suicide.
More than 1 in 10 older people, and more than 3 in 10 people living in residential aged-care, experience depression.
It’s important to remember that not all older people become depressed, and just because you are older, you don’t need to accept that you will become depressed, or that your depression can’t be treated.
Symptoms –
Geriatric depression have different symptoms of depression than others which are as follows –
• Feel tired
• Have trouble sleeping
• Be grumpy or irritable
• Feel confused
• Struggle to pay attention
• Not enjoy activities they used to
• Move more slowly
• Have a change in weight or appetite
• Feel hopeless, worthless, or guilty
• Endure aches and pains
• Have suicidal thoughts
Causes –
The main causes of geriatric depression includes –
• Poor physical health
Physical illness can cause depression both directly and indirectly. Medical conditions such as vitamin deficiencies, cancer, thyroid disease, and even infections can change the way your body works and so cause depression.
Other medical conditions that make it harder for you to manage by yourself — such as arthritis and reduced mobility — can mean that you need to ask for more help from other people.
Loss of independence and dignity can sometimes cause depression too. Sometimes the medicines you take can play a part in depression, especially blood pressure medicines, steroids, and pain medicines.
• Social isolation
People can sometimes become isolated from their friends, family or communities as they age. This may be due to friends and peers passing away, or because they find it harder to get around to visit people.
The COVID-19 pandemic has caused disruption for many people, who may have been away from friends and family for a long time, leading to an increased risk of depression.
• Loss in old age
Older people tend to experience intense periods of loss as they get older. This can be loss of family members or friends, and can also involve loss of their health, their pets or their home. While some people cope well with these difficult circumstances, the experience of repeated loss can sometimes cause depression.
There is no single cause of depression in any age group. Some research indicates that there could be a genetic link to the disease. However, biological, social, and psychological factors all play a role in depression in older adults.
Risk Factors –
Things that raise the risk of geriatric depression include –
• Being female
• Being single, unmarried, divorced, or widowed
• Lack of a supportive social network
• Stressful life events
Additionally, these risk factors for depression are often seen in older adults –
• Certain medicines or combination of medicines
• Damage to body image (from amputation, cancer surgery, or heart attack)
• Dependence, whether through being hospitalized or needing home health care
• Disability
• Family history of major depressive disorder
• Fear of death
• Living alone, social isolation
• Other illnesses
• Past suicide attempt(s)
• Presence of chronic or severe pain
• Previous history of depression
• Recent loss of a loved one
• Substance abuse
Diagnosis –
Proper diagnosis of geriatric depression can be difficult.
A mental health expert will assess your symptoms, mood, behavior, day-to-day activities, and family health history. They will ask –
• how long you’ve been feeling depressed
• what brought on the depression
• if you’ve experienced depression in the past
A person must display symptoms of depression for at least two weeks to be diagnosed with the condition.
Treatment –
Treatments for depression include medicine, psychotherapy or counseling, or electroconvulsive therapy.
• Medications
Studies have found that while antidepressants can be helpful in older adults, they may not always be as effective as in younger patients. Also, the risk of side effects or potential reactions with other medicines must be carefully considered.
Medications you might get include:
• Selective serotonin reuptake inhibitors (SSRIs) like citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft)
• Serotonin and norepinephrine reuptake inhibitors (SNRIs) like desvenlafaxine (Pristiq), duloxetine (Cymbalta), and venlafaxine (Effexor)
• Psychotherapy
Psychotherapy is especially beneficial for those who have gone through major life stresses (such as loss of friends and family, home relocations, and health problems) or who prefer not to take medicine and have only mild to moderate symptoms.
• Electroconvulsive Therapy
ECT can play an important role in the treatment of depression in older adults. When older people can’t take traditional antidepressant medicines because of side effects or interactions with other medications, when depression is very severe and interferes with basic daily functioning (such as eating, bathing and grooming), or when risk for suicide is especially high, ECT is often a safe and effective treatment option.
• Self help
Self-help, alternative and complementary therapies can also be useful for older people with mild or moderate depression, such as:
• spending time with friends, family or the community.
• being physically active, either alone or with a group.
• participating in music therapy designed for people with depression
How Can You Help Someone with Depression?
Help your loved one get to a doctor if you suspect they have depression. The doctor can diagnose the condition and prescribe treatment. You can also help in the following ways.
• Talk
Talk with your loved one regularly, and listen carefully. Give advice if they ask. Take what they say seriously. Never ignore a suicide threat or comments about suicide
• Support
Offer support. Be encouraging, patient and understanding.
• Friendship
Be a friend. Regularly invite them to come and spend time with you.
• Optimism
Keep reminding your loved one that, with time and treatment, their depression will lessen.
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