As people age, many changes both within and around them take place. They retire from jobs, develop health issues, and may even begin to see their loved ones starting to die.
Depression in the elderly is a very real thing that reaches beyond mood. It can affect energy, sleep, appetite, physical health, and even lead to thoughts of suicide.
The symptoms of depression are easy to write off or go unnoticed, but being aware of them can be critical. One of the worst things for a depressed person of any age is to feel alone or like they don’t have anyone to talk to.
Learning about how to recognize and respond to depression or suicidal thoughts in the elderly can both improve their quality of life and potentially save them from an irreversible choice.
Depression Is Not Just About Sadness
Depression does not always mean feeling sad. Many elderly individuals who have been diagnosed with depression specifically state that sadness isn’t something they’ve felt. Even if you or a loved one doesn’t seem sad, there may still be other signs of depression present. Keep an eye out for any of the following:
- A reluctance to engage with friends, participate in activities, or leave the house
- Loss of appetite
- Sleep disturbances, either oversleeping or difficulty falling or staying asleep
- General fatigue
- Worry about being a burden, feelings of worthlessness, or other signs of self-loathing
- Increased use of alcohol or drugs
- Neglecting personal care such as skipping/forgetting meals or medication, or neglecting personal hygiene
- Lack of motivation
- Unexplained aches
It can be easy to write-off the depressive symptoms as simply another result of growing older. Furthermore, elderly individuals can be isolated, which can both be a cause of depression and a reason why the symptoms go unnoticed.
Causes of Depression in the Elderly
Many causes of depression in the elderly are shared among most other age groups. However, elderly individuals are more likely to experience specific causes and can sometimes have more limited access to a support network.
- Health problems: Aging comes with its own host of health difficulties. Illness and disability, chronic pain, the decline of cognitive functions, and damage to our bodies from the results of surgery or disease. These can have very real impacts on one’s sense of self-esteem and quality of life.
- Medical conditions: While depression can be caused by how certain health problems impact one’s life, there are also medical conditions that can directly cause depressive symptoms. These include Parkinson’s, stroke, cancer, diabetes, thyroid disorders, dementia, Alzheimer’s, multiple sclerosis, and vitamin B12 deficiency.
- Medication: Certain medications can cause depression as a side effect. The risk increases the more medications someone is on. Common culprits can be Parkinson’s medication, beta-blockers, sleeping pills, blood pressure medication, steroids, and drugs to treat ulcers, high-cholesterol, or arthritis.
- Loneliness and isolation: Age can restrict mobility due to illness or the loss of driving privileges. Death of a close loved one can also shrink social interactions, and being relocated to a care home or hospital can fuel isolation.
- Loss of purpose: Retirement can deprive someone of a purpose they’ve held for years, sometimes decades. Physical or cognitive impairments might make it impossible to enjoy formerly common activities. This can lead to a sense of aimlessness, purposelessness, and despair.
- Fear: Anxiety can occur over death, finances, or the advancement of health problems.
- Bereavement: The loss of loved ones, whether friends or family members, can take a large toll on a person, especially if they feel like they’re “the last one left.”
A few additional notes on bereavement: there is a difference between grief and depression—and recognizing the difference between the two is very important. Grief often comes in waves, ebbing and flowing with a mix of good and bad days. Depression is more constant and pervasive. Being sad for a long time after a death is normal, but losing a sense of hope or joy is not.
How to Help an Elderly Loved One Fight Depression
The nature of depression often interferes with a person’s ability to fight it on their own. In addition to therapy or support groups, there are a few other options available to helping an elderly loved one cope with their depression:
- Going out together: Keeping the body and mind active and interacting with friends and family are good ways to help improve the symptoms of depression. Talking walks, art sessions, group cooking, going to the movies, visiting museums—anything that gets people moving, socializing, and sharing activities can combat the sense of loneliness and isolation.
- Exercise: Working out and staying active can improve one’s mood thanks to endorphins. Exercise doesn’t have to involve big routines or weightlifting either. Simple things, like light housework, short walks, or climbing the stairs are all beneficial exercises. There are numerous exercise techniques that have been designed for those who are elderly, disabled, ill, or frail—so there are few conditions that truly prevent someone from trying.
- Volunteering: Retirement can deprive an elderly individual of a sense of purpose. Volunteering and helping out at schools or in the community can be a good way to regain that purpose and improve self-esteem.
- Hobbies: Even if aging has deprived someone of an activity they once enjoyed, that doesn’t mean there isn’t another one available. Experiment with different hobbies and activities to find something that can be engaged in and enjoyed.
- A good diet: Eating poorly can make the symptoms of depression worse. Having meals with plenty of fruits, vegetables, whole grains, and a bit of protein can do wonders for improving one’s mood and personal energy.
- Follow treatments: Frustrations with the side-effects of treatments or medications, or the effects of forgetting to take medicine can also lead to depression. Help your loved one maintain their proper medication schedule and get through their treatments.
- Watch for suicidal indicators: Depression can easily lead someone to having suicidal thoughts or impulses. Read below to discover the warning signs and be prepared to act if you notice them.
Dealing with Suicidal Thoughts in the Elderly
Many suicidal people are depressed, but not all depressed people are suicidal. There is no one cause of suicidal thoughts or attempts, but they generally come from some sense of being trapped. Without a sense of control, or a way to feel like a good outcome is possible, it can sometimes seem like suicide is the only true option available.
Many of the signs for being at risk of suicide are similar to the symptoms of depression, but there are a few additional indicators that could mark someone as having suicidal thoughts.
- Guilt: Feeling guilty, whether for unresolved regrets or “survivor’s guilt” is not uncommon in the elderly, but an intense and pervasive sense of guilt can sometimes be a risk factor for suicidal thoughts.
- Self-depreciation: A sense of hopelessness or helplessness can be a warning sign for suicide. This can sometimes manifest as off-hand self-depreciating comments or jokes about death.
- Self-neglect: Deliberately skipping medicine or ignoring prescribed diets can show that someone has stopped caring about their long-term well-being.
- Thoughts of death: This concerns excessive dwelling on death, whether thinking of various methods of dying or having an unhealthy obsession on those who have recently died. Though not common, this can sometimes appear as speaking about the dead with a sense of envy.
- Ordering affairs: People who plan on committing suicide sometimes try to set their affairs in order. They will write a will and may begin giving away prized possessions. Unusual or unexpected visits or calls to friends and family may be a way of “saying goodbye.” Be very aware if someone appears to be engaging in this sort of behavior, especially if they have shown other depression or suicidal warning signs.
- Unexpected calm and/or happiness: When someone has settled on killing themselves, it can feel very relieving. If a formerly depressed or morose loved one suddenly shows surprise euphoria, it could be an important warning sign.
What to Do If You Suspect a Loved One Is Having Suicidal Thoughts
If you suspect a loved one is having suicidal thoughts, there are a few important elements to keep in mind. Speaking with your loved one and asking questions is an important first step, but remember to be non-judgmental in your tone and word choice. Refrain from minimizing the problems the person says they are experiencing.
Trying to offer reassurance is fine, but keep in mind that your opinion on the severity of a problem is often irrelevant in the face of your loved one’s feelings. Additionally, consider removing any weapons or sharp implements that may be available for the time-being.
Following through with a suicidal loved one is especially important. This can include things like ensuring they seek and attend treatment or being available for emotional support. Suicidal thoughts, particularly in the elderly, are a mixture of physical and emotional causes. Being supportive and helping a loved one find and fulfill solutions for both is an integral step of the healing process.
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Sources for Today’s Article:
“Depression and ageing,” Better Health Channel web site; http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Depression_in_the_elderly?open, last accessed September 1, 2015.
“Elderly Depression,” SAVE web site; http://www.save.org/index.cfm?fuseaction=home.viewpage&page_id=a82dfca2-afe8-3478-1a4e1f9445d46407, last accessed September 1, 2015.
Caruso, K., “Suicide Warning Signs,” Suicide.org; http://www.suicide.org/suicide-warning-signs.html, last accessed September 1, 2015.