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Depression in Seniors

May 26, 2019 | Health | By Lisa Smith

Depression amidst seniors is common but it is not normal. It occurs due to different reasons but can be dealt with. Read on to find out more.

Why Does Depression Occur In Seniors?

Seniors often suffer from depression not only because they are alone or have just witnessed something traumatic like the passing away of a loved one or an accident but due to other conditions as well. These are:

Conditions like hypertension, high blood pressure, stroke, diabetes, cancer, dementia also increase the chances of depression
Certain medicines taken to cure other illnesses can lead to depression as a side effect of it
Has a family history of depression
Substance abuse

How Is Depression In Elderly Different From That Of Younger People?

Unlike younger people, depression in seniors is different in the following ways:

It usually occurs along with other illnesses
It usually stays for a longer period of time
It is associated with increased chances of other cardiac illnesses and may even prove to be fatal

Why Does Diagnosis Get Delayed?

Seniors are often alone – due to the passing away of a spouse, the kids moving out, or retirement. Hence, there is often no one to notice symptoms that say that he could be suffering from depression
Seniors, due to their age, slowdown in their response rate and so doctors and family often miss the signs, thinking that it is more just an age related issue
There is still a stigma attached to mental illness. Hence often it is difficult to make seniors admit that they could be suffering from depression. When they hide this, the diagnosis gets further delayed
Elderly people are sometimes unwilling to take their medicines due to the possible side effects. In addition if they are patients of substance abuse and alcoholism then the medicines might not be able to give the desired effect
Sometimes they are so depressed due to loss of loved ones that they simply give up on their daily lives and refuse treatment

Symptoms of Depression in Seniors

Some of the symptoms of depression in seniors are:

Thinking and fearing death
Attempts at suicide
Completely cutting themselves off from socialising
Constantly feeling sad
Extreme cases of fatigue and yet have issues in sleeping
Constant irritability
Loss of interest in sex
Talk more slowly
Difficulty remembering incidents
Sudden weight gain or loss
Crying frequently
Confusion – but this often looks like Alzheimer’s.

A doctor can, with the help of series of questions, diagnose depression in seniors. They should, in fact, routinely screen for depression when a senior is visiting for a general check-up or for a check-up for a chronic illness.

Treatment Of Depression

Treatment for depression in seniors that are available are:

Antidepressants

When antidepressants are being suggested to a senior patient the doctor must be careful. This is because there is always the chance of it adversely reacting with other medicines that he might be already taking for other ailments. Also, usually elders are more sensitive to medicines and so a lower dose is prescribed. For example, the antidepressant amitriptyline has a sedating effect and can cause confusion or a sudden fall in blood pressure. If you are taking care of a senior who has just begun taking antidepressants then remember that it might take longer to show its effect than it would in a younger person. Antidepressants can take anywhere between 2 to 4 weeks to start showing its effect. Usually better sleep and improved concentration begins to happen before mood upliftment starts.

Psychotherapy

Psychotherapy is useful for those seniors who have recently witnessed trauma in their life like the death of a near one, a major accident, home relocations etc. It is also beneficial for those who are unable to take medicines due to other health complications and show only mild symptoms to depression. For some the sessions are short and last for 10 to 20 weeks while, for others, it can be for a longer period. One type of psychotherapy is called cognitive behavioural therapy. In this talking is used as the therapy mode and focuses on changing the negative thought process of the patient. Another type is known as interpersonal therapy. In this the patient works with the doctor in trying to analyse his reason for depression and then trying to find out a solution to it.

Electroconvulsive Therapy

Electroconvulsive therapy is useful when the senior patient is unable to take the antidepressant medicines due to other complications and chronic illnesses. It is also used for those who show extreme symptoms of depression as well as suicidal tendencies. Sometimes brain stimulation like repetitive transcranial magnetic stimulation is also used by doctors.

Which treatment the doctor chooses ultimately depends on the severity of the depression, other treatments that the patent is currently receiving, and his age.

Treatment of Insomnia

Insomnia is often one of the effects of depression. To treat this, doctors recommend avoiding exposure to benzodiazepines drugs like Ativan, Xanax etc. This is because these drugs can lead to further complications like reduced alertness, respiratory issues etc. Instead it is treated with the hormone melatonin or antidepressants like Remeron that help with sedation as well.

Depression not a normal part of growing old. It is a real illness and can even lead to death amidst seniors. Since depression, in seniors, can co-occur with other illnesses it can make the situation graver if not treated on time. Hence, if you know of an elder who is in depression, immediate treatment should be begun.