Depression Dims the Golden Years
For a society as youth-oriented as ours, it might seem that depression and aging would be synonymous. However, contrary to what many professionals and lay people believe, depression should NOT be considered a normal part of aging. Just because old age is the latter stages of one's life does not mean it shouldn't be meaningful and enjoyable.
Depression in an elderly person can compound other conditions or illnesses, prolonging or even preventing recovery, in addition to simply robbing him or her of the normal joy of living. Lifestyle changes, inability to perform activities of the past, financial difficulties, isolation, chronic pain and buying into the belief that life holds little to look forward to all can be factors contributing to depression in elders. Sadly, as a society, we may unwittingly contribute to the last factor mentioned--by our attitudes about aging and the aged. We perceive every infant as precious; why can we not regard every elderly person as a triumph of survival, a monument to wisdom, a hero or heroine? Tragically, even though our elderly comprise about 12% of our total population, they commit 16% of the suicides. This disproportionate ratio is a glaring statement of the degree to which elder depression is dismissed, discounted and under-treated.
A surprising number of elders resort to alcohol use in later years; even though they often believe it relieves their feelings of depression, it actually intensifies them, as alcohol is itself a depressant. Alcohol use can result in accidental death from interactions with other medications, or more commonly, from falls and accidents from which the depressed aging person never recovers.
Unfortunately, diagnosing depression in the aging population is complicated; it can be a side effect of a great many medications, and there are numerous conditions that mimic the symptomology of depression. More importantly, many people of advanced years are reluctant to admit they feel depressed. Many are from an era when depression might have been associated with a lack in strength of character or personal determination. Depression is sometimes mistaken for dementia and left untreated; however, depression sometimes accompanies dementia and treatment may help with the confusion of dementia. It's also sometimes difficult to discern true depression from the effects of bereavement or a recently-acquired disability or illness. Sleep deprivation can be a symptom of depression but can have other causes which result in confusion and increased emotionality that look similar to depression. It's vitally important for those who interact with an aging person to pay attention and note changes in the person's mood, energy level and general frame of mind. Consider what the person was like before; if there has been a noticeable change, it might be time to consult with a physician.
Treating depression in the elderly can also be more complicated. The bodies of the elderly may be more sensitive to the side effects of medications, plus there are usually more medications to consider for possibilities of interactions. The half-life of antidepressants may be extended in an elderly person due to slower metabolism, making it more difficult to adjust for the optimal dosage. Older patients may be resistant to taking antidepressants either because of their negative beliefs about depression and/or because it can take as long as a month to see any noticeable effects from the medication.
Forgetfulness, either that associated with aging or that which sometimes accompanies depression itself, can prevent one from taking the medication on a regular basis, thus further diminishing its effectiveness.
What can you do if you suspect an elderly person in your life is depressed? For starters, just verbalizing your observations in a casual, non-judgmental way might open the door for a conversation about depression. You might even want to avoid using the word depression initially, referring instead to the observed behaviors as a condition or illness for which treatment is available. Keeping a rating chart of pertinent behaviors might help form a more objective basis for approaching the matter. Whatever your conclusions, consultation with a physician is imperative. A physician can conduct tests to rule out physical problems that might be imitating depression and also determine if medications are indicated. However, if a physician dismisses your concerns about possible depression as being a normal part of aging, don't hesitate to get a second opinion. A short depression screening questionnaire can be administered by a mental health professional to help clarify if further investigation is warranted. A great many elderly people respond positively to therapy, which generally helps them examine and reframe the thoughts that fuel their depression. Group therapy has been shown to be effective, in some cases more so than individual. Being that there are several options for treatment of elderly depression, no one should have to suffer from this disorder in what should truly be the golden years!
Belinda Crosier, Masters of Education and Licensed Professional Counselor at Edmond Family Counseling. She can be reached at 351-3554.
