Depression

caregivinghope.org expert advice on caregiving According to the National Institute of Mental Health, of today’s more than 35 million Americans over the age of 65, only a small fraction, about six percent, suffer from serious depression. The widely held myth that depression is a natural aspect of aging is simply a myth. Research studies tell us that while depression is common in older adulthood, its inevitability should be questioned.

Depression is, though, prevalent in the caregiving experience. It is important to be vigilant and watch for signs and symptoms of disabling depression in care of older loved ones.
 
Depression is
  • A mood disorder that causes symptoms such as low energy, prolonged sadness or irritability and lack of interest in daily activities
  • A psychiatric disorder characterized by symptoms that are severe and last more than two weeks
  • A medical condition. It is not a character flaw or weakness.
What causes depression among older adults? Some of the difficult changes and adjustments of the later years definitely make for sadness. The loss of spouse, friends, independence or one’s career must be felt, mourned and processed before moving on. Grief is good and aids in healing, to a point. When grief over a loss never ends, becomes unrelenting, disabling or extinguishes all signs of joy, depression may be in play. Individuals at highest risk include those with a personal or family history of depression, people with substance abuse problems or poor support systems.
 
How can you tell if an older loved one is depressed? Early warning signs and symptoms can be difficult to detect. Concerned family and friends often see sadness, though it is not the most prevalent symptom. Significant red flags include:
  • Fatigue that lingers after rest
  • Loss of interest in hobbies or other pleasurable pastimes
  • Social withdrawal and isolation (avoiding friends and social situations)
  • Noticeable weight gain or weight loss, or a complete loss of appetite
  • Extreme sleep disturbances (difficulty falling asleep or staying asleep, oversleeping)
  • Loss of self esteem (feelings of worthlessness, of being a burden, self loathing)
  • Increased use of alcohol or other drugs
  • Death fixation, suicidal thoughts or gestures
Older adults who deny feeling sad may exhibit depression in more disguised ways;
  • Unexplained or aggravated aches and pains, both real and imagined
  • Feelings of hopelessness and helplessness
  • Irritability and crankiness
  • Loss of interest in grandchildren
  • Lack of interest in personal care (skipping meals, forgetting medications, neglecting hygiene)
  • Lack of concentration and uncharacteristic forgetfulness
What should you do if an older family member or friend is displaying any of these symptoms? Open, caring communication is the best place to start. Begin a conversation about a time when you felt depressed or blue. It may plant a seed or, even better, open the door to a two-way exchange. Avoid talking down to your loved one and be as honest as you can. You must try to listen actively, without judgment. Make clear that it is not “wrong” to feel bad, and offer hope and a plan for helping. Offer to assist in finding a doctor, making an appointment, and going along for support. Express your concerns as many times as necessary in striving to connect. Be consistently supportive and encouraging without being insincere or overly cheerful.
 
Options for treating depression are many and include personal therapeutic counseling with a trained therapist, creative arts therapy, and/or medication. In the case of older adults, Medicare may, under some circumstances, cover the cost of counseling visits at home. There are also many therapeutic programs within adult day services and community senior centers, providing socialization that alleviates isolation, loneliness and depression. Consultation with a professional social worker, psychologist, physician or geriatric care manager can often direct you to the best healing resources.
 
The good news is that depression is treatable. According to experts, most major depressive episodes resolve within six months, given appropriate treatment.
 
The confidential screening test www.depression-screening.org may help identify if you or your loved one require additional evaluation.
 
The following sections may assist you: