Depression Among Seniors
Depression among seniors is a major health concern in the U.S., yet professionals generally agree that depression is not a normal consequence of aging. The condition, however, is under-recognized and under-treated. For people 65 and older, the most noticeable signs of depression frequently differ from those of younger people. The primary symptoms are related to executive dysfunction, for example psychomotor retardation, reduced interest and lack of spontaneity. Geriatric psychiatrists regard depression in the elderly as an interactive process which arises out of an interplay among medical problems, medications, psychiatric disorders and life stressors.
Medical Problems
Some medical conditions, such as subacute delirium, Alzheimer's disease and cerebral vascular degeneration create depression. Further, between 20 percent and 50 percent of stroke patients suffer from depression within one year. Other common medical problems that cause depression in seniors are anemia, B-12 deficiency, diabetes, hepatitis, Parkinson's disease, sleep apnea and thyroid abnormalities.
Medications
Although medications do not typically create depression, many medications have been shown to create depressive symptoms in seniors. Some common medications which do this are benzodiazepines, beta-blockers, clonidine, narcotics and steroids. Further, interactions between some medications can create these symptoms and should be reviewed by your doctor. As these are only possible side effects, never assume that a medication is creating depressive symptoms and always speak with your medical professional before making any changes to your medications.
Psychiatric Disorders
Frequently psychiatric disorders are diagnosed earlier in life, but it is possible for people to reach their senior years without receiving an accurate diagnosis of an existing psychiatric disorder. As an individual ages and adjustments to life circumstances become more frequent while other stressors increase, an existing mild to moderate psychiatric disorder may be exacerbated--bringing it to the attention of care providers. Although depressive episodes can be a part of many psychiatric disorders, the most common are major depression, bipolar disorder and dysthymia.
It is also possible that personality traits that increase the risk for developing depression were compensated for effectively in younger years, but with age, these may become more difficult to manage, leading to significant emotional distress in the senior years.
Life Stressors
Several life stressors more prevalent in our older population increase the risk of developing depression. Most people experience grief throughout life, but the frequency and intensity may be greater in seniors as more of their peers and relatives die. Constant adjustments to changes arising in later life are also a major stressor. As we experience decreasing capabilities, and ever-changing physical conditions, the demands on our capacity to adapt and acculturate can become strained. Social isolation is another major life stressor which increases the risk of depression in seniors. As functional independence and mobility decrease, isolation may become a daily experience along with loneliness and a lack of mental and emotional stimulation.
References
- Depression And Older People: Towards Securing Well-being in Later Life; Tracy Denby and Mary Godfrey; 2004.
- Depression in Elderly People; Robert Howard;1996.
- Loss, Widowhood, and Psychological Distress Among the Elderly; Judith M. Siegel and David H. Kuykendall;1999.
