Depression in Seniors
Depression is not a normal part of the aging process, though many suffer through it without ever getting treatment. Lowered health and mobility, forced retirement, the demands of caregiving or the loss of a spouse; many of the events of older age can increase the risks of depression but fortunately, depression, when correctly diagnosed, is very treatable.
Why Is Senior Depression Under Diagnosed?
Although adults and older adults experience similar symptoms of depression, when examining seniors, doctors may discount some symptoms, such as insomnia or fatigue, as normal signs of getting older. Additionally, some seniors may feel reluctant to raise mental health concerns.
In many cases, depression emerges as seniors deal with illness or disease. Doctors often misinterpret symptoms of depression as symptoms of an existing disorder.
Some common symptoms of depression include:
- Feeling worthless
- Guilty feelings
- Fear of death
- Aches and pains
- Changes in eating patterns
- Lack of concentration
- Memory loss
- Loss of enjoyment from activities that used to bring pleasure
Symptoms must continue for 2 weeks and with enough severity to influence social, familial or professional life.
Doctors will often use the Geriatric Depression Scale, a 30 question yes or no test designed for older adults, to screen for depressive symptoms.
What Causes Depression in Seniors?
Depression causes changes in the structure and working of the brain, but the exact cause of these changes remains unknown. There is almost surely a genetic aspect to depression, but social and environmental variables also very likely influence the development of the disorder.
- Losing a spouse
- Social isolation
- A strong fear of death
- Abusing drugs or alcohol
- Chronic physical illness
- The use of certain medications
- An earlier in life episode of depression
- Mental disorders more common to seniors, such as dementia
- Vascular problems
Doctors will first want to rule out any physical cause for symptoms of depression, and so will often perform a physical exam and certain medical tests, such as blood, liver and thyroid tests. Barring a physical cause, doctors will proceed with conventional depression treatments.
Seniors respond well to the same treatments offered to younger adults, most normally a combination of anti depressant medications and psychotherapy. Recovery rates using this combination of therapies range as high as 80%, although seniors take about a month longer to respond to the treatment.
Older adults diagnosed with depression (especially sedentary seniors) are often counseled to increase their level of physical activity. Exercise elevates mood and increases physical health, which can reduce symptoms of depression.
Some seniors may experience depression, at least partly, due to social isolation. A diagnosis of depression can lead to social services interventions to limit this isolation.
Anti Depressants for Seniors - Special Considerations?
Certain anti depressant medications have side effects that can be dangerous for some seniors, such as hypotension, urinary retention and constipation. Selective Serotonin Reuptake Inhibitors (SSRIs) are very commonly prescribed to older people, due to their efficacy and lower side effect profile; most people tolerate SSRIs very well.
No one should live with untreated depression. Current treatments work very well and work for people of all ages. Depression decreases physical health. It causes unhealthy eating, sleeping and activity patterns and increases the chronic release of harmful stress hormones. It can, in some cases, shorten a lifespan. It does, in all cases, reduce the quality and enjoyment of life.
If you or someone you care about is feeling depressed, talk to your doctor about treatments and medications that can make a big difference.
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