Depression in the elderly, also known as geriatric depression, is a mood disorder that affects seniors. It causes persistent periods of low mood and sadness that should not be considered a normal part of aging. If you’re an older adult that has been feeling “blue” for two weeks or more, you may have geriatric depression. Luckily, there are many treatment options available to you. Read on to learn more about recognizing and treating depression in elderly adults.
What is Depression?
Depression is more than just feeling down—it is a mood disorder characterized by persistent sadness and loss of interest in things once enjoyed. To be diagnosed as depression, these symptoms must last for two weeks or more.
Depression affects how a person thinks, feels, and acts, and it can cause several complications. In the elderly, depression may be subtler than it is in other age groups. This type of depression is known as subsyndromal depression and it doesn’t always meet the criteria of major depressive disorder.
However, untreated depression in older adults can impact their quality of life and physical health. It may also eventually progress to major depression.
Causes of Depression in Elderly Adults
Depression has no single cause. It often arises from a combination of factors, with psychological, social, and biological factors playing a role in its onset. It may result from:
Biological Changes in the Brain
Depression may arise from physical changes in the brain, although experts don’t understand the significance of these changes or why they occur. Brain scans of those who first become depressed in their later years, highlight certain areas of the brain that lack adequate blood flow. This may result from long-term high blood pressure.
Certain genes may play a role in depression onset. Depression and some other mental health conditions often run in families.
An imbalance of hormones may trigger depression. For example, women may experience depression after menopause. Similarly, thyroid disorders can cause symptoms in some people.
Low levels of these brain chemicals cause depression. Neurotransmitters help maintain a stable mood and may be responsible for feeling of happiness.
Factors that increase the risk of depression in older adults include:
- A trauma, such as physical or sexual abuse
- Abusing drugs or alcohol
- Being female
- Being lesbian, gay, bisexual, or transgender
- Being too dependent on others
- Changes in life circumstances, such as divorce, bereavement, or retirement
- Chronic health problems, such as high blood pressure, diabetes, or dementia
- Damage to body image, from amputation or cancer treatment
- Fear of death
- Feeling isolated
- Financial problems
- Having a family member with depression
- Lack of a supportive network of family and friends
- Limited mobility
- Low self-esteem
- Side effects of some medications
- Severe or chronic pain
- The presence of other mental health conditions, such as anxiety or PTSD
Symptoms and Signs of Depression in Elderly Adults
The symptoms of depression are the same for older adults as they are for any other age group. They include:
- Anger or irritability
- Changes in appetite
- Changes in sleeping habits, such as insomnia or oversleeping
- Feelings of sadness, anxiety, hopelessness, or guilt
- Loss of concentration and attention
- Loss of interest in things once enjoyed
- Low energy and fatigue
- Low self-esteem
- Physical aches and pains without an obvious cause
- Slowed down thinking, speech, or movement
- Thoughts of death or suicide, or suicide attempts
- Weight loss or gain
- Withdrawal from friends and family
Symptoms must be present for most of the day, almost every day, for at least two weeks. Often, symptoms can cause obvious problems at work or in relationships. But sometimes, they may be subtle and go unnoticed by others.
See your doctor or a mental health professional if you are experiencing any of the symptoms of depression. The most important thing is to reach out and talk to others about how you are feeling, such as a family member or care worker.
A doctor will typically diagnose geriatric depression based on your symptoms and signs, and what you tell them. They may ask:
- About your symptoms, mood, and behavior
- How long you have had these symptoms
- If other family members have had depression
- If you have other physical or mental health issues, or if you are on any medications
You may also need:
- A physical examination, to check for an underlying physical cause for symptoms
- Blood tests to check for hormone function and other health markers
- A psychiatric evaluation
Treating Depression in Elderly Adults
Depression is treatable with medication, talk therapy, and lifestyle changes. Many people may require lifelong treatment for depression, but once they keep up their treatment regimen they should be able to manage their symptoms. Just like physical health, we need to look after our mental health on a continuous basis. Some of the best treatments for depression in older adults include:
Your doctor may recommend an antidepressant medication to reduce your symptoms. Some of these cause side effects, so be sure to discuss the pros and cons with your doctor first.
Some people may need to take a combination of antidepressants, while others may need to use other medications such as antipsychotic drugs, anti-anxiety medications, mood stabilizers, or stimulants. It may take a while to find the best medicine for your needs, but be patient as the results will be worth it.
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Once you are taking antidepressant medication, it’s vital that you don’t miss a dose. Keep your medications in order using a pill organizer.
Psychotherapy can be very effective for people with depression, especially if they have unresolved issues such as trauma, bereavement, or addiction. But even if other factors are responsible for your depression, talk therapy can be helpful. A therapist may help you to replace negative thoughts with more positive ones, learn coping strategies and problem-solving techniques, address issues in relationships with others, and set realistic goals for yourself.
Getting Electroconvulsive Therapy (ECT)
Electroconvulsive therapy (ECT) may be used if medications and psychotherapy are ineffective. ECT involves passing electrical currents through the brain. It works by affecting the function of neurotransmitters. ECT may also be used for those who demonstrate a high risk of suicide.
Learning Depression Triggers
Keep a mood diary to track your mental and emotional health status on a daily basis. A mood diary can help you identify warning signs and triggers related to your depression.
If you know that something is likely to trigger your depression, or you notice your mood getting worse, take action. It is helpful to work with a doctor or therapist to make a plan for such as event.
Always contact a health professional if you or someone else observes changes in your mood or behavior.
Avoiding Alcohol and Drugs
Both alcohol and drugs can make depression symptoms much worse, even if they appear to help in the short-term. They can also interfere with antidepressant medications and make depression harder to treat. If you experience problems with substance abuse, speak to your doctor or join a program to help you quit.
Diet can play a big role in mental health. The body needs certain nutrients to ensure the healthy functioning of neurotransmitters and hormones. A balanced diet also staves off many of the health conditions—including diabetes and high blood pressure—that play a role in depression onset.
Aim to eat a diet comprising mainly of fruits, vegetables, whole grains, nuts, seeds, beans, lentils, olive oil, and lean protein sources such as fish, eggs, and tofu. Avoid processed and pre-packaged food, as well as foods high in fat and sugar. Check out these tips to enhance your digestive function, which may boost your mental and physical health.
Regular physical activity has been proven time and time again to boost mental health. Even though exercise may be the last thing on your mind when you are feeling depressed, it may be the one thing to improve your mood. Try to get at least 30 minutes of exercise every day. Start out slowly with a ten-minute walk before working your way up to a full 30 minutes. Some good exercises include:
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Although cardiovascular activity is best for mental health, it’s also important to fit in some stretching activities (with a resistance band if you wish) and muscle-building exercises.
Establishing a Sleep Routine
People with depression often struggle with insomnia or oversleeping. Poor sleep habits can also be a risk factor for depression, especially in older adults. To avoid sleep difficulties and minimize depression risk and symptoms, establish a sleep routine. Go to bed at the same time each night and get up at the same time each morning.
Avoid caffeine during the day, especially in the hours before bedtime, and try to wind down before you go to sleep. Sip a soothing herbal tea, take a warm bath, and read a book. Be sure to stay cozy and safe at night with bed rails and comfortable neck pillows.
Some medications, such as benzodiazepines, may contribute to sleep problems and issues with attention and alertness. Speak to your doctor if you are having sleep difficulties as they may recommend that you take or avoid specific medicines.
Regaining Some Independence
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The loss of independence associated with aging may increase stress and other negative emotions in elderly adults. Luckily, getting older doesn’t mean you have to totally depend on other people. Maintain as much independence as possible using mobility aids like walkers or household aids such as reacher grabber tools.
Prolonged periods of stress can contribute to depression, as can one-off stressful events such as bereavement, retirement, or divorce. Manage your response to stress by engaging in calming activities every day. Some of the best include:
- Creative therapies
- Deep breathing exercises
- Listening to relaxing music
- Progressive muscle relaxation
- Spending time with animals
- Tai chi
To truly reduce stress, you also need to eliminate stressors where possible, exercise regularly, and eat a healthy diet.
Seeking Social Connections and Support
Depression can cause people to withdraw from friends, family, and social situations. Isolating yourself can trigger a depressive episode or worsen an existing bout of depression. Make the effort to take part in social activities, even when it seems challenging. Over time, you may notice your mood and mental health improve.
Also, consider joining a support group for people with depression and other mood-related disorders. It can be a fantastic experience to connect with others who are going through something similar.
Depression is a serious mental health issue that is often underestimated. Luckily, depression is treatable and people can recover from it once they seek the appropriate help.
Left untreated, some of the complications of depression include:
- Eating disorders
- Excess weight or obesity
- Health conditions, such as heart disease
- Other mental health issues, such as anxiety, panic attacks, and phobias
- Physical aches and pains
- Relationship difficulties
- Substance abuse
- Suicide or suicide attempts
Depression can affect anyone, and it is not always preventable. However, you can take steps to greatly reduce your risk of developing depression or triggering a depressive episode. Try to:
- Exercise regularly
- Eat a healthful diet
- Manage stress
- Monitor your blood pressure and blood sugar levels
- Engage in hobbies and enjoyable activities
- Work on relationships with friends and family
- Talk to others if you are feeling down
- See your doctor for regular check-ups
Those who have a history of depression should consider attending a support group as a preventative measure. They should also speak with their doctor about maintenance treatment to prevent a relapse.
Recovery from Depression in Elderly Adults
Although problems associated with aging can trigger depression symptoms, depression and aging
do not go hand-in-hand. If you are experiencing signs of depression, reach out to a loved one or a health professional without delay. With treatment, you can regain some of your spark and live a healthy and happy life.