Sadness and Depression in Elders
Sadness is a frequent experience for elders. Aging brings many changes to our bodies and minds that create real losses. As we progress into our senior years, the accumulated losses create challenges to our self-concept, independence and sense of power. Successful negotiation of these challenges allows us to remain vital and active with only short bouts of sadness. Most people are able to face the challenges of aging without sadness developing into depression, but the American Association for Geriatric Psychiatry estimates that 1 in every 5 people over the age of 65 is depressed. For these seniors, depression is expressed differently than in younger people and has a direct impact on their physical health and quality of life.
Expressing Depression
Many seniors do not tell others they are depressed. Instead, they may complain of feeling tired or report that current or past medical problems are causing fatigue. When depressed, many seniors express physical complaints related to arthritis or worsening headaches. Additionally, many seniors are unsure if their problems are related to depression or the natural aging process. The most common manifestations of depression in seniors are sleeping problems and worry. Some seniors will display the usual signs of depression, such as fatigue, memory problems, social withdrawal, loss of appetite and interest, lowered self-worth and increased use of alcohol or drugs. These typical signs of depression, for seniors, can have an immediate and serious impact on their quality of life and physical health.
Health Problems and Depression
Depression interrupts a person's life, causing a decrease in energy, interest and motivation. For a senior, this disruption may be especially difficult to stabilize as health problems may create further complications. This interaction between health problems and the effects of depression can become an accelerated and self-perpetuating cycle of physical and emotional decline. Often, a physical injury, such as a fall, may bring attention to the senior's health, but typically only the physical injury is treated. Untreated depression which came before or was caused by the injury may keep the person from returning to his previous level of functioning. Another risk for seniors is the decreased immune functioning associated with depression. Combine this with the reduction in immune functioning which comes with age and risk for serious illness is increased.
Treatment
Because treating depression in seniors typically requires more intensive and frequent interventions, some believe that treatment is not effective in this population. Research has demonstrated, however, that antidepressant medication, self-help, volunteer support efforts and counseling are all effective interventions. Effective treatment of depression helps slow the natural physical decline in aging and prolongs independence. Overall treatment improves functioning in several life domains, such as self-care, self-image and social interactions. For seniors, it is critical to focus on efforts that support being active in the community, maintaining contact with others, becoming active in hobbies which bring enjoyment, volunteering, caring for a pet, leaning and being creative, diet and exercise. These activities have also been shown to be effective in reducing risk of developing depression in seniors.
References
- Loss, Widowhood, and Psychological Distress Among the Elderly; Judith M. Siegel and David H. Kuykendall; 1999.
- Depression in Elderly People; Robert Howard; 1996.
- Depression And Older People: Towards Securing Well-being in Later Life; Tracy Denby and Mary Godfrey; 2004..
