Depression and Older Adults

Posted by Donna Mae Scheib on June 01, 2017

Depression and Older Adults

Depression, that feeling of lingering tiredness, helplessness, and hopelessness is often experienced in older adults. But this medical condition that interferes with living is not a “normal” part of the aging process.  

Types of Depression

Depression can be broken up into three categories: minor depression, persistent depressive disorder (dysthymia), and major depression.

The symptoms of minor depression do not last as long as dysthymia and major depression, and they are less severe. Those experiencing dysthymia have symptoms that are less severe than those of major depression, however the symptoms last at least two years. And major depression is defined as having severe symptoms that interfere with enjoyment in life and everyday patterns of working, sleeping, eating, and concentrating over an extended length of time.

Signs of Depression

There are many signs of depression. You or your loved one might be suffering from depression if any of these symptoms persist for more than two weeks:

• A mood of being sad, anxious or empty
• Digestive problems, cramps, headaches and aches/pains without a concrete physical cause or those that aren’t comforted with treatment
• Disturbed sleep patterns: waking up early, oversleeping, inability to go to sleep
• Feelings of helplessness, worthlessness, and guilt
• Feelings of negativity and hopelessness
• Inability to make decisions, remember, and focus
• Irritability, restlessness
• Lack of energy, fatigue
• Lost interest in usual activities and hobbies
• Thoughts of ending their life
• Weight and appetite fluctuations

At-Risk Factors for Older Adults

Individuals who...

• Are socially isolated or lonely
• Have a disability
• Have chronic medical illnesses (heart disease, diabetes, cancer, etc.) or a brain disease
• Have experienced loss of a spouse, divorce, or who have taken care of someone with a chronic disease (caregivers), or those who have experienced other stressful events
• Have a family history of depression
• Misused drugs or alcohol
• Sleep poorly
• Used certain medications

Steps to Take

If you think that you or your loved one has depression, you need to first seek medical treatment. Set up an appointment to talk with the doctor about ongoing symptoms. At the appointment, your doctor will also review your medical history and conduct a physical exam. You may be referred to another type of health care professional (psychologist, psychiatrist, social worker, counselor, etc.) who is specially-trained to deal with depression and older adults.

In the vast majority of the cases, depression is treatable in older adults. Medical professionals claim that with proper diagnosis and treatment, symptoms often start to improve within a few weeks.

What are common treatment options?

Medication, usually antidepressants, are prescribed. There may be some side effects which you need to discuss with the doctor, so these can be more easily managed by lowering the dose or switching to a different medication. Common side effects are weight gain, diarrhea, sleepiness, nausea and vomiting. A medical professional should carefully monitor the medications as older adults typically are more sensitive to the side effects of any new medication and they often take additional medications which may interact negatively with the added prescription. 

And if for some reason, you are having suicidal thoughts or experience unusual behavior or mood changes, it is important to contact the doctor as well.

Another effective way to help those who are depressed is psychotherapy, known as talk therapy. Psychotherapy addresses the underlying causes of depression, rather than the symptoms. Basically, it helps teach different ways of behaving and thinking, aimed to change habits that add to the depression. It can help with negative thinking patterns and in developing stronger coping skills. Research supports the view that cognitive-behavioral therapy (CBT) including problem-solving therapy are useful types of psychotherapy for older adults.

Supportive counseling or support groups play a role in helping with depression as well. Supportive counseling includes religious and peer counseling. It often eases loneliness and the hopelessness of depression while helping the individual find new (or renewed) meaning and purpose in life. Support groups for depression allow you and others who are going through the same challenges to have a safe place to share experiences, advice, and encouragement.

Other approaches in helping with depression include what is known as complementary therapies: yoga, exercise, and certain dietary supplements and herbal remedies (however, these may have side effects or interferences with other medications, so it is important to talk with your doctor about these before using them). More common supplements/remedies include folic acids, omega-3 fatty acid, and St. John’s wort (not to be taken with antidepressants).

There are additional therapies for those suffering from severe depression. Electroconvulsive therapy (ECT) is specially-designed for those who have severe depression and are not responding to medication or psychotherapy. It is a type of brain simulation therapy that aims to activate the brain directly with magnets, electricity or implants. ECT has been used for over 80 years and it remains the fastest and strongest-acting treatment for severe depression. Side effects include memory loss and confusion, usually short-term.

Other Remedies

• Adequate sleep is important. 7-9 hours a night is recommended. Avoid alcohol (it has been known to make depression worse as it impairs brain function and can interact negatively with medications especially antidepressants) and caffeine. Create a bedroom that is quiet, dark, and is of adequate temperature (not too hot or cold). 

• A healthy diet will also support a more positive mood. Go easy on the refined carbohydrates and sugars. Concentrate on protein, complex carbs, and healthy fats which will leave you more satisfied and on an emotional even keel throughout your day. Try to eat every 3-4 hours to boost your mood and to decrease feelings of excessive tiredness and irritability.
• Consider breaking up tasks into smaller tasks and not trying to do too many things at once. Lower your daily expectations of getting so many things done in a day.
• Daily exercise is helpful. Simple household tasks, using the stairs, a short walk – all have benefits. If you are wheelchair-bound or have trouble walking, try some chair exercises and some deep breathing exercises.
• Research also shows that caring for a pet gives purpose to your life, it is a healthy way to have company, and offers an opportunity to get some exercise (if you need to take the animal outside). It may also be a great way to meet people.
• Socialization is important. Talk to a relative or friend about your feelings. If you can’t get out, invite someone to visit or call on the phone, chat on the computer, or email.
• Take care of your body – you will feel better by following a daily routine of taking a bath or shower, getting dressed in clean clothes, etc. 
• This may be a good time for you to go to the park, take a trip to get your hair done, or have lunch with a friend. Get out of the house!
• Try to engage in some of the activities that used to bring you enjoyment. Research indicates that even if you seemingly don’t like to do these things any more, they can lift your mood.
• When you are able, you might consider volunteering your time. Helping others is one way to make yourself feel better.
• You may not feel like laughing, but reading a funny book or watching a comedy show, or sharing humorous stories brings a needed boost.

Remember that isolation and disconnection make your depression worse. The more engaged you are in daily life, the better you will feel physically, mentally, and socially.

What can you do to help loved ones with depression?

• Besides helping find a good doctor for that very important first visit for accurate diagnosis and appropriate treatment, help in scheduling and transporting (if needed) any additional medical appointments and in securing and administering any medications
• Don’t ignore or dismiss suicidal and other negative talk. Report concerns to your loved one’s therapist or doctor.
• Help with healthy meal planning.
• Listen and don’t judge; be empathetic, patient, and supportive.
• Spend time with them. Encourage mutual activities (go for a walk or on an outing that provides mental or physical stimulation).
• Think positive and pass your upbeat mood onto them. Above all, be reassuring with them that, in time, the depression will go away.

Depression, that feeling of lingering tiredness, helplessness, and even hopelessness often experienced in older adults does not need to linger for long periods of time, allowing to increase in deeper and deeper negativity.  Understanding the types of depression, their symptoms, the at-risk factors, steps to take, treatment options and remedies, and how others can help will ease the journey and add to the reassurance that the depression will go away.