Depression and the Elderly


Depression is not the taboo illness it once was, which is good it is more acceptable.  Mental illness still has some kind of stigma attached to it, and always will I think, but with more of us suffering from stress, which often leads to depression and other related illnesses, people will talk about it more and not brush it under the carpet.

However this does not always apply to our elderly folk, to whom depression, divorce, debt plus many other subjects were all no no’s for discussion.  You just did not talk about anyone in your family who suffered from depression or who had gone through a divorce, it was too shameful.  It is good that some these attitudes have been lifted, just as long as they do not go too far the other way.

A great number of old people do not know they are suffering from depression and do not want to admit it, and it takes a lot of persuading to get them to seek treatment or take pills to alleviate the condition.  As you would take medication for high blood pressure, so you should for the lack of the chemical serotonin in the brain, which often causes clinical depression. There is also reactive depression which is triggered by events e.g. death, divorce, money problems, family problems and this can usually be treated by short term medication until the person manages to deal with what is causing the depression.  In some cases counselling or group therapy can be beneficial.

Many old people suffer depression as the medication they are on for other conditions have a bad reaction and cause low spirits.  They may live alone, have no support network of family and friends, are isolated and have no social interaction, thus leading to loneliness, even suicidal thoughts, if they get so desperate they think they are unloved, no-one cares anymore and their life has become not worth living.  Doctors often struggle to diagnose depression in the elderly as it can be symptomatic of so many other illnesses/conditions associated with growing old.  They may be in pain, not very mobile, or just feeling out of sorts/bad tempered/ frustrated with life, or not even talk about how they are feeling.  Many old people can be tearful at times, thinking of past happy times, or just emotional should family be sharp with them, or even when they get a visit or help, so it is very hard to construe, unless they actively seek help.

Of course even if they do, they will often reject any medication offered, saying they are not taking tablets and will just get on with it, which does not always work.  They cannot be forced to have treatment though, sometimes a sympathetic talk, an outing, a change to their routine, can give them the boost they need to perhaps shake them out of it.  Never tell a depressed person “to snap out of it”.  It is the worst thing you can do, or tell them how lucky they are compared to others, or anything along the same vein.  As when you are depressed, you know you are not the worst off in the world, but want to wallow in your own unhappiness, you do not want to feel like that but until the feeling passes, you just cannot help it.  Churchill and many famous comedians have suffered from depression, and call it “their black dog” like a cloud descending over them and just having to go with the flow until it goes away.  Catherine Zeta-Jones recently admitted she was suffering from bi-polar disorder, which is periods of great highs and lows, earlier referred to as manic depression, which actually sounds worse, as though the person is a maniac!  In Victorian times you were locked up in asylums, sometimes for life if you showed any signs of mental disorder, as they did not know much about it then.

The kindest thing you can do if you spot an elderly relative or neighbour who is very down and low in spirits is to try and befriend them a bit more than usual, ask them if there is anything troubling them, try and get them to talk about any problems or worries they may have.  Many times when you actually tell people what is worrying you, once it is out it sounds very trivial, but is important to you.  They say a trouble shared is a trouble halved, unburdening yourself sometimes is half the battle.

Vitamin D to be found in sunlight is necessary for bones and has many other uses in the body, one of them being your happy state of mind.  A lot of older people are not exposed to this vitamin as they spend a lot of time indoors, covered up, and probably do not get a sunshine holiday.  

Anti-depressants also take longer to work in the elderly, and often interact badly with other medicines. If medication is not suitable, psychotherapy can often be beneficial, but there can sometimes be a waiting list for treatment on the NHS.  

Depression can be a nasty illness that can manifest and present itself in many shapes and forms, but is better caught in its early stages, before it really has a grip and is very treatable.  Once you have had depression you are possibly likely to get another attack, you will get to know your own body though and the signs and symptoms that you are beginning to feel down, so to do something about it as early as possible. Depression also tends to last for longer periods in the elderly.  There are also more suicides linked to depression in the 80+ group than in younger people.  Women, as they live longer will actually suffer from depression more than men, however, apparently elderly white men are more at risk of depression and suicide if they live alone.

Insomnia is another side effect of depression, as it waking early and not being able to get back to sleep, then maybe not wanting to get out of bed to face the day.  We all know the loneliness in the middle of the night when we cannot sleep.  Older people often nap during the day, and also need less sleep so it makes it even harder to sleep at night.  

Depression can often be linked to longer recovering from heart disease, surgery or other life threatening conditions, as it decreases an elderly person’s rehabilitation.

The watchword is to be aware for yourself if you’re in the elderly category, and for friends and family should you notice a change in their mood.  Help is there and can make a real difference to the quality of life in the twilight years.

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