What Depression in the Elderly Looks Like & How to Get Help

After all, many of us naturally associate depression with characteristics like misery and weakness. But here's the thing: Those stereotypes represent only a narrow slice of this medical condition's broad spectrum of possible effects. You might be surprised to know that many depressed people over the age of 65 don't exhibit those traits. So it's essential to understand what this illness is all about if you want greater vitality for yourself or a loved one.

The more you know about the effects of depression in elderly people, the more empowered you'll be when it comes to creating enjoyable retirement years for you or those you care about. You'll rise above common misunderstandings and discover the benefits of having a broader, more informed perspective on the issue. For many older adults with this condition, the prognosis is good. Safe and effective treatments are widely available. You just need to know all the facts.

What Is Depression? How Does It Affect the Elderly?

Depression is a treatable medical condition that negatively impacts a person's mental health. It can also cause (or be caused by) physical health issues. But here are some key points to remember: Depression in older adults is not just a temporary mood that will pass or a normal part of the aging process. Nor is it just a typical result of life's challenges. Rather, it is a real, unexpected health condition that generally requires professional treatment.Also, you should know this: Anybody can get depression. It doesn't discriminate. And older adults can get it for no apparent reason. People with depression tend to feel powerless to get rid of it.

In older people with depression, loneliness often plays a big role. However, that isn't the case for everyone. Clinically depressed people (of every age) are usually impacted by five or more of the following effects for at least two weeks:

• General unhappiness
• Sleep problems
• Feelings of worthlessness or guilt
• Inability to concentrate or make decisions
• Loss of interest or enjoyment in activities
• Weight loss or anorexia
• An impaired or agitated mental state that may cause unusual movements or behaviors
• Thoughts of suicide

Keep in mind that a lot of seniors with depression don't experience sadness as a primary symptom. The effects of their depression may be seen mostly in physical problems instead. For example, issues like chronic headaches, pain without an obvious cause, unintended weight loss, or persistently low energy or motivation may indicate that they're depressed. In addition, older adults tend to be affected by depression a little differently than their younger counterparts. Older people may have the condition for a longer time. And they often have it in conjunction with other health issues.

Estimates vary, but depressive disorders are thought to affect about 10 to 20 percent of older people worldwide. In the U.S., the numbers vary based on factors like treatment settings and the specific kinds of depression. According to the American Academy of Family Physicians (AAFP), between 17 and 37 percent of elderly patients in primary health care environments have been recognized as having depression. Here are some of the most common types of depressive disorders in older adults:

• Minor depression: People with this condition have just two to five of the symptoms above, which are often mild or moderate. The symptoms also tend to last fewer than two years. Minor depression is thought to be more common in the elderly than major depression. According to the AAFP, minor depression affects nearly a third of nursing home residents. Some people with minor depression eventually develop major depression.
• Major depression: This condition is characterised by several symptoms (such as those listed above) that are severe enough to interfere with most everyday situations. It can be very debilitating. And it can last anywhere from two weeks to two years or longer.
• Persistent depressive disorder (PDD): Also known as dysthymia, this condition generally involves symptoms that last longer than major depression but aren't as severe. PDD is a chronic disorder that often goes undiagnosed since the people who have it may think their depressed mood is just part of their personality.

Regardless of the type of depression you or a loved one may have, it's important to seek treatment. Geriatric depression can increase the risk of death from other medical conditions such as cardiac disease. It can also make it more difficult to recover and rehabilitate after illness, injury, or surgery.

Signs, Symptoms, and Effects of Depression in Elderly People

Unless you know what to look for, it isn't always easy to recognize depression in older adults. That's particularly true for the physical effects of depression, which can masquerade as other health conditions. So it's important to keep a full range of possible symptoms in mind, understanding that red flags may be hidden behind inaccurate assumptions about how depression is "supposed" to look.

Everybody affected by this condition displays a different combination of symptoms. Some of the most common signs of depression in seniors include:

• Persistent sadness or despair
• Lack of self-esteem
• Frequent self-loathing
• General apathy
• Insomnia
• Over-sleeping
• Frequent forgetfulness
• Inability to concentrate
• Slower-than-normal speech or movement
• Loss of interest in previously enjoyed activities
• Social withdrawal
• Persistently low energy
• Unexplainable aches and pains
• Poor appetite
• Neglect of personal hygiene
• Grumpiness and short temper
• More frequent use of alcohol or other substances
• Suicidal thoughts

When evaluating seniors who may be depressed, geriatric mental health professionals often ask several questions designed to illuminate the red flags. Older adults with depression often provide answers that show they suffer from many of the following things:

• Frequently feeling bored
• Experiencing a lack of excitement in life
• Rarely, if ever, feeling happy or in good spirits
• Having difficulty beginning new projects
• Abandoning favorite hobbies and interests
• Frequently feeling fidgety or high-strung
• Having difficulty making decisions
• Frequently getting angry over small stuff
• Feeling generally unsatisfied with life
• Believing that most people are better off than they are
• Avoiding social get-togethers
• Resisting getting out and trying new things
• Feeling that something bad is about to happen
• Feeling hopeless about the future
• Feeling empty or helpless
• Frequently feeling the urge to cry
• Frequently worrying about the past or future
• Having difficulty concentrating
• Feeling that right now is a bad time to be alive
• Disliking getting up each morning
• Feeling worthless to other people
• Experiencing troubling thoughts that won't go away
• Believing that they have more trouble with memory than most people
• Feeling less mentally sharp than they used to be

It's also important to consider some of the common differences between men and women who have depression. For example, men are sometimes more likely to feel tired, frustrated, and irritable. Depression can also make men more likely to abuse substances like alcohol, display reckless behavior, lose motivation for their hobbies, or avoid conversation.

Why Depression Is Often Overlooked in the Elderly

Many older people don't receive the help they need and end up suffering unnecessarily from the full effects of depression. There can be all kinds of reasons for this. For example, depending on the individuals involved, elderly depression can be overlooked or go untreated because:

• People may mistakenly believe that a consistently depressed mood is a normal part of aging or a normal reaction to stressful circumstances.
• The symptoms may be more physical than emotional.
• Older adults may see mental illness as a social stigma and try to keep it hidden.
• Doctors, caretakers, or family members may miss or mistakenly rationalize away certain signs or symptoms.
• The effects of multiple medications or various illnesses may mask symptoms or make it difficult to perform accurate evaluations.
• Depressed seniors are sometimes misdiagnosed with dementia or suspected of being hypochondriacs.
• Substance abuse (including alcohol abuse) can make it difficult to sort out various symptoms and their causes.
• Poverty can make it more difficult for low-income seniors to get the help they need, so they choose not to report their symptoms to anyone.
• Older adults with depression may offer various excuses for not wanting to participate in daily activities rather than directly explaining the symptoms they're experiencing.
• Some seniors are too isolated for anyone to notice their symptoms.
• Seniors who are depressed may mistakenly think that help isn't available.

How to Help an Elderly Loved One Who Has Depression

First, keep in mind that your loved one may put up some resistance, mostly out of fear or resentment. (We are often afraid of the actions we'll have to take to get better. And nobody likes to be seen as having a mental illness. Personal pride sometimes gets in the way of our better judgment.) Your loved one's depression may also make him or her feel hopeless, ashamed, or like a burden to you. All of those feelings can make it very difficult for your loved one to find the motivation to accept help and follow through with appropriate actions.

As you move forward, consider the following tips:

• Be sensitive, patient, and respectful: Listen to your loved one with the sole intention of understanding what he or she is going through. Offer some gentle encouragement and emotional support without judging, criticizing, or trying to fix his or her depression. Instead, acknowledge and validate the person's feelings while gently offering reasons for hope. Respect the fact that your elderly loved one will likely have different preferences than you when it comes to the timing and other aspects of what to do going forward.

• Help arrange visits with doctors or mental health specialists: Your loved one will need to be properly evaluated by one or more professionals in order to receive a correct diagnosis and the best treatment. Try to make this part of the process as easy as possible for your loved one by helping them find the right professionals, scheduling appointments, and attending those appointments in order to provide support and take accurate notes about what was said. If you can't attend appointments yourself, ensure your loved one has reliable transportation or see if somebody else can go in your place.

• Keep track of treatments and ongoing appointments: Older people with depression often have memory lapses and cannot think as clearly as they normally would. Ensure your loved one has an easy way of organizing and remembering to take daily medications, such as using a weekly pillbox or pill dispenser. It's also a good idea to set reminders for your loved one's appointments so that none of them are missed. Recovery from depression requires consistent dedication to treatment. Interruptions in treatment can lead to worsening and prolonged symptoms.

• Assist with lifestyle changes: Make it easier for your loved one to engage in beneficial habits by arranging activities or preparing healthy meals. Invite them to lunch or dinner, suggest that you go on walks, take yoga or art classes, attend live events, or go on other outings together. If you encounter resistance, remain patient but gently persist. And stay mindful of your loved one's limitations when it comes to his or her physical abilities.

• Watch for hazardous behaviors or signs of suicidal thoughts: Your loved one may exhibit slower responses and reaction times when performing certain tasks. So be aware of potential dangers if your loved one drives, cooks, prepares his or her own medications, or does other things that require complete focus and attention to detail. And never overlook any comments by your loved one related to suicide or harming oneself, even if they seem like jokes.

Depression in the elderly doesn't have to be a long-term problem. With help and persistence, almost anyone can get better, regardless of their age. Don't give up. Always remember that there are plenty of reasons to remain hopeful. Move forward gently, but with real purpose. With time, the light will probably return.