It is a myth that depression is part of the aging process. It is not normal for people of any age to suffer from depression; this includes our elderly population. Major depression (also known as clinical depression) is a medical illness. It is a chemical imbalance in the brain and can appear in people regardless of age, race or economic status. The illness can appear after a triggering event or for no apparent reason at all.
Watch for standard symptoms of depression, as well as these symptoms common among the elderly suffering from depression:
- Complaints of aches and pains (back, stomach, arms, legs, head, chest), fatigue, slowed movements and speech, loss of appetite, inability to sleep, weight increase or decrease, blurred vision, dizziness, heart racing, anxiety.
- Inability to concentrate, remember or think straight (sometimes mistaken for dementia). An overall sadness or apathy, withdrawn; unable to find pleasure in anything.
- Irritability, mood swings or constant complaining; nothing seems to make the person happy.
- Talk of worthlessness, not being needed anymore, excessive and unwarranted guilt.
- Frequent doctor visits without relief in symptoms; all tests come out negative.
- Alcoholism can mask an underlying depression.
A complete physical examination to rule out other problems is critical before a diagnosis of depression is made. Other physical diseases (Parkinson's, multiple sclerosis, diabetes, thyroid disorders, certain viral infections, strokes, tumors) and certain medications (steroids, hormones, blood pressure and arthritis medications) used to treat those illnesses can mimic the symptoms depression; they can cause a chemical imbalance in the brain. Therefore, a thorough exam is extremely important, as well as a complete medical history and list of medications currently being taken (both over-the-counter and prescription drugs). Family history of depressive illness should also be noted, due to the genetic component of brain illnesses. Untreated or mistreated depression can result in suicide.
In Addition to the standard warning signs of depression watch for the following behaviors:
- Talk about suicide, e.g. "I have nothing left to live for." "I won’t be a burden on my family much longer." "I should just kill myself." Statements of hopelessness, helplessness or worthlessness.
- Preoccupation with death.
- Suddenly happier, calmer.
- Loss of interest in things one cares about.
- Unusual visiting or calling people one cares about – saying goodbyes.
- Making arrangements; setting one’s affairs in order.
- Giving things away.
- Stockpiling pills or obtaining a weapon.
- Refusal to follow doctor-prescribed medications and/or special diet.
The National Institute of Mental Health and the Centers for Disease Control report that as many as 3 out of every 100 people, over 65, suffer from clinical depression and that the suicide rate is twice as high in this population compared to other age groups.
Depression is treatable and suicide can be prevented!
Nearly 90 percent of people with clinical depression can be treated successfully with medications and psychotherapy done together. Some depressions among the elderly may respond better to electroconvulsive therapy. ECT is an effective treatment that is used in extremely severe cases of major depression when very rapid improvement is necessary, or when medications cannot be used or have not worked. Improved procedures make this treatment much safer than in previous years.
Where to get help
- Family physicians, clinics and health maintenance organizations can provide treatment or make referrals to mental health specialists.
- Mental health specialists like psychiatrists, psychologists, family therapists and social workers. Psychiatrists can prescribe antidepressant drugs because they are physicians. Other mental health specialists, however, often work with physicians to ensure that their patients receive the medications they need.
- Community mental health centers often provide treatment based on the patient’s ability to pay, and usually have a variety of mental health specialists.
- Hospitals and university medical schools may have research centers that study and treat depression.
What to do
Stigma associated with depressive illnesses can prevent people from getting help. Your willingness to talk about depression and suicide with your family members can be the first step in getting help and preventing suicide.
If you see the warning signs of suicide...
- Begin a dialogue by asking questions. Suicidal thoughts are common with depressive illnesses and your willingness to talk about it in a nonjudgmental way can be the push a person needs to get help. Questions to ask include:
- "Do you ever feel so badly that you think of suicide?"
- "Do you have a plan?"
- "Do you know when you would do it (today, next week)?"
- "Do you have access to what you would use?"
- Don't try to minimize problems or shame a person into changing their mind. Your opinion of a person's situation is irrelevant. Trying to convince a person it's not that bad, or that they have everything to live for may only increase their feelings of guilt and hopelessness. Reassure them that help is available, that depression is treatable, and that suicidal feelings are temporary.
- Get treatment. If a person is suicidal due to a real or imagined life-threatening illness, treatment of depression/anxiety is critical. Once pain, both physical and emotional, is alleviated, the risk of suicide decreases dramatically. If you feel the person isn't in immediate danger, acknowledge the pain as legitimate and offer to work together to get help.
- Follow through. Help find a doctor or a mental health professional, participate in making the first phone call, be available for doctor appointments, explaining medications and offering general emotional support.
- Remove any weapons.
Portions taken from the National Institute of Mental Health booklet, If You’re Over 65 and Feeling Depressed... Treatment Brings New Hope
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