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Depression in Older Adults and the Elderly

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7/30/2019 Depression in Older Adults and the Elderly http://slidepdf.com/reader/full/depression-in-older-adults-and-the-elderly 1/15 Depression in Older Adults and the Elderly Recognize the Signs and Find Treatment that Works Share: The changes that often come in later liferetirement, the death of loved ones, increased isolation, medical problemscan lead to depression. Depression prevents you from enjoying life like you used to. But its effects go far beyond mood. It also impacts your energy, sleep, appetite, and physical health. However, depression is not an inevitable part of aging, and there are many steps you can take to overcome the symptoms, no matter the challenges you face. IN THIS ARTICLE:   A common problem  Causes of depression  Bereavement and loss  (Show more...) Depression: a problem for many older adults and the elderly Have you lost interest in the activities you used to enjoy? Do you struggle with feelings of helplessness and hopelessness? Are you finding it harder and harder to get through the day? If so, you’re not alone. Depression is a common problem in older adults. The symptoms of depression affect every aspect of your life, including your energy, appetite, sleep, and interest in work, hobbies, and relationships. Unfortunately, all too many depressed seniors fail to recognize the symptoms of depression, or don’t take the steps to get the help they need. There are many reasons depression in older adults and the elderly is so often overlooked:  You may assume you have good reason to be down or that depression is just part of aging.  You may be isolatedwhich in itself can lead to depressionwith few around to notice your distress.  You may not realize that your physical complaints are signs of depression.  You may be reluctant to talk about your feelings or ask for help. Feeling good as you age
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Depression in Older Adults and the Elderly 

Recognize the Signs and Find Treatment that Works

Share: 

The changes that often come in later life—retirement, the death of loved ones, increased isolation,

medical problems—can lead to depression. Depression prevents you from enjoying life like you used

to. But its effects go far beyond mood. It also impacts your energy, sleep, appetite, and physical

health. However, depression is not an inevitable part of aging, and there are many steps you can taketo overcome the symptoms, no matter the challenges you face.

IN THIS ARTICLE:

   A common problem 

  Causes of depression 

  Bereavement and loss 

  (Show more...) 

Depression: a problem for many older adults and the elderly 

Have you lost interest in the activities you used to enjoy? Do you struggle with feelings of 

helplessness and hopelessness? Are you finding it harder and harder to get through the day? If so,

you’re not alone. 

Depression is a common problem in older adults. The symptoms of depression affect every aspect of 

your life, including your energy, appetite, sleep, and interest in work, hobbies, and relationships.

Unfortunately, all too many depressed seniors fail to recognize the symptoms of depression, or don’t

take the steps to get the help they need. There are many reasons depression in older adults and the

elderly is so often overlooked:

  You may assume you have good reason to be down or that depression is just part of aging.

  You may be isolated—which in itself can lead to depression—with few around to notice your

distress.

  You may not realize that your physical complaints are signs of depression.

  You may be reluctant to talk about your feelings or ask for help.

Feeling good as you age

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Depression isn’t a sign of weakness or a character flaw. It can happen to anyone, at any age, no

matter your background or your previous accomplishments in life. Similarly, physical illness, loss, and

the challenges of aging don’t have to keep you down. Whether you’re 18 or 80, you don’t have to live

with depression. Senior depression can be treated, and with the right support, treatment, and self-

help strategies you can feel better and live a happy and vibrant life.

Causes of depression in older adults and the elderly 

As you grow older, you face significant life changes that can put you at risk for depression. Causes

and risk factors that contribute to depression in older adults and the elderly include:

  Health problems – Illness and disability; chronic or severe pain; cognitive decline; damage to

body image due to surgery or disease.

  Loneliness and isolation – Living alone; a dwindling social circle due to deaths or relocation;

decreased mobility due to illness or loss of driving privileges.

  Reduced sense of purpose – Feelings of purposelessness or loss of identity due to retirement

or physical limitations on activities.

  Fears – Fear of death or dying; anxiety over financial problems or health issues.

  Recent bereavements – The death of friends, family members, and pets; the loss of a spouse

or partner.

Bereavement, loss, and depression in the elderly 

As you age, you experience many losses. Loss is painful—whether it’s a loss of independence,

mobility, health, your long-time career, or someone you love. Grieving over these losses is normal and

healthy, even if the feelings of sadness last for a long time. Losing all hope and joy, however,

isnot 

common.

Is it grief or depression?

Distinguishing between grief and clinical depression isn’t always easy, since they share many

symptoms. However, there are ways to tell the difference. Remember, grief is a roller coaster. It

involves a wide variety of emotions and a mix of good and bad days. Even when you’re in the middle

of the grieving process, you will have moments of pleasure or happiness. With depression, on the

other hand, the feelings of emptiness and despair are constant.

While there’s no set timetable for grieving, if it doesn’t let up over time or extinguishes all signs of 

 joy—laughing at a good joke, brightening in response to a hug, appreciating a beautiful sunset—it may

be depression.

Other symptoms that suggest depression, not just grief:

  Intense, pervasive sense of guilt.

  Thoughts of suicide or a preoccupation

with dying.

  Feelings of hopelessness or

  Slow speech and body movements.

  Inability to function at work, home, and/or

school.

  Seeing or hearing things that aren’t there. 

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worthlessness.

Depression and illness in older adults and the elderly 

Depression in older adults and the elderly is often linked to physical illness, which can increase the risk

for depression. Chronic pain and physical disability can understandably get you down. Symptoms of 

depression can also occur as part of medical problems such as dementia or as a side effect of prescription drugs.

Medical conditions can cause depression in the elderly

It’s important to be aware that medical problems can cause depression in older adults and the elderly,

either directly or as a psychological reaction to the illness. Any chronic medical condition, particularly

if it is painful, disabling, or life-threatening, can lead to depression or make depression symptoms

worse.

These include:

  Parkinson’s disease 

  stroke

  heart disease

  cancer

  diabetes

  thyroid disorders

  Vitamin B12 deficiency

  dementia and Alzheimer’s disease 

  lupus

  multiple sclerosis

Prescription medications and depression in the elderly

Symptoms of depression are a side effect of many commonly prescribed drugs. You’re particularly at

risk if you’re taking multiple medications. While the mood-related side effects of prescription

medication can affect anyone, older adults are more sensitive because, as we age, our bodies become

less efficient at metabolizing and processing drugs.

Medications that can cause or worsen depression include:

  Blood pressure medication (clonidine)

  Beta-blockers (e.g. Lopressor, Inderal)

  Sleeping pills

  Tranquilizers (e.g. Valium, Xanax,

Halcion)

  Calcium-channel blockers

  Medication for Parkinson’s disease 

  Ulcer medication (e.g. Zantac, Tagamet)

  Heart drugs containing reserpine

  Steroids (e.g. cortisone and prednisone)

  High-cholesterol drugs (e.g. Lipitor, Mevacor,

Zocor)

  Painkillers and arthritis drugs

  Estrogens (e.g. Premarin, Prempro)

If you feel depressed after starting a new medication, talk to your doctor. You may be able to lower

your dose or switch to another medication that doesn’t impact your mood. 

Alcohol and depression in the elderly

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It can be tempting to use alcohol to deal with physical and emotional pain as you get older. It may

help you take your mind off an illness or make you feel less lonely. Or maybe you drink at night to

help you get to sleep.

While alcohol may make you feel better in the short term, it can cause problems over time. Alcohol

makes symptoms of depression, irritability, and anxiety worse and impairs your brain function. Alcohol

also interacts in negative ways with numerous medications, including antidepressants. And while

drinking may help you nod off, it can impair the quality of your sleep.

Signs and symptoms of depression in the elderly 

Recognizing depression in the elderly starts with knowing the signs and symptoms. Depression red

flags include:

  Sadness

  Fatigue

  Abandoning or losing interest in hobbies or

other pleasurable pastimes

  Social withdrawal and isolation (reluctance

to be with friends, engage in activities, or

leave home)

  Weight loss or loss of appetite

  Sleep disturbances (difficulty falling asleep

or staying asleep, oversleeping, or daytime

sleepiness)

  Loss of self-worth (worries about being a

burden, feelings of worthlessness, self-

loathing)

  Increased use of alcohol or other drugs

  Fixation on death; suicidal thoughts or

attempts

Depression in the elderly without sadness

While depression and sadness might seem to go hand and hand, many depressed seniors claim not to

feel sad at all. They may complain, instead, of low motivation, a lack of energy, or physical problems.In fact, physical complaints, such as arthritis pain or worsening headaches, are often the predominant

symptom of depression in the elderly.

Depression clues in older adults

Older adults who deny feeling sad or depressed may still have major depression. Here are the clues to

look for:

Unexplained or aggravated aches and pains

Feelings of hopelessness or helplessness

Anxiety and worries

Memory problems

Lack of motivation and energy

Slowed movement and speech

Irritability

Loss of interest in socializing and hobbies

Neglecting personal care (skipping meals,

forgetting meds, neglecting personal hygiene)

Dementia vs. depression in the elderly 

Never assume that a loss of mental sharpness is just a normal sign of old age. It could be a sign of 

either depression or dementia, both of which are common in older adults and the elderly.

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Since depression and dementia share many similar symptoms, including memory problems, sluggish

speech and movements, and low motivation, it can be difficult to tell the two apart. There are,

however, some differences that can help you distinguish between the two.

Is it Depression or Dementia?

Symptoms of Depression Symptoms of Dementia

Mental decline is relatively rapid Mental decline happens slowly

Knows the correct time, date, and where he or

she is

Confused and disoriented; becomes lost in familiar

locations

Difficulty concentrating Difficulty with short-term memory

Language and motor skills are slow, but normal Writing, speaking, and motor skills are impaired

Notices or worries about memory problems Doesn’t notice memory problems or seem to care 

Whether cognitive decline is caused by dementia or depression, it’s important to see a doctor right

away. If it’s depression, memory, concentration, and energy will bounce back with treatment.

Treatment for dementia will also improve you or your loved one’s quality of life. And in some types of 

dementia, symptoms can be reversed, halted, or slowed.

Depression self-help for older adults and the elderly 

Dealing with depression

You can’t beat depression through sheer willpower, but you do have some control—even if your

depression is severe and stubbornly persistent. Read Dealing with Depression 

It’s a myth to think that after a certain age you can’t learn new skills, try new activities, or make fresh

lifestyle changes. The truth is that the human brain never stops changing, so older adults are just as

capable as younger people of learning new things and adapting to new ideas. Overcoming depression

often involves finding new things you enjoy, learning to adapt to change, staying physically and

socially active, and feeling connected to your community and loved ones.

If you’re depressed, you may not want to do anything or see anybody. But isolation and inactivity only

make depression worse. The more active you are—physically, mentally, and socially—the better you’ll

feel.

  Exercise. Physical activity has powerful mood-boosting effects. In fact, research suggests it

may be just as effective as antidepressants in relieving depression. The best part is that the

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benefits come without side effects. You don’t have to hit the gym to reap the rewards. Look for

small ways you can add more movement to your day: park farther from the store, take the

stairs, do light housework, or enjoy a short walk. Even if you’re ill, frail, or disabled, there are

many safe exercisesyou can do to build your strength and boost your mood—even from a chair

or wheelchair.

  Connect with others. Getting the support you need plays a big role in lifting the fog of 

depression and keeping it away. On your own, it can be difficult to maintain perspective and

sustain the effort required to beat depression. You may not feel like reaching out, but make an

effort to connect to others and limit the time you’re alone. If you can’t get out to socialize,

invite loved ones to visit you, or keep in touch over the phone or email.

  Bring your life into balance. If you’re feeling overwhelmed by stress and the pressures of 

daily life, it may be time to learn new emotional management and emotional intelligence skills. 

Watch the short video clip and consider following Helpguide’s free Bring Your Life Into Balance

toolkit.

Other self-help tips to combat and prevent depression in the elderly

Learn to manage your emotions

Watch 3-min. video: Developing emotional awareness 

  Get enough sleep. When you don't get enough sleep, your depression symptoms can be

worse. Aim for somewhere between 7 to 9 hours of sleep each night.

  Maintain a healthy diet. Avoid eating too much sugar and junk food. Choose healthy foods

that provide nourishment and energy, and take a daily multivitamin.

  Participate in activities you enjoy. Pursue whatever hobbies or pastimes bring or used to

bring you joy.

  Volunteer your time. Helping others is one of the best ways to feel better about yourself and

expand your social network.

  Take care of a pet. A pet can keep you company, and walking a dog, for example, can be

good exercise for you and a great way to meet people.

  Learn a new skill. Pick something that you’ve always wanted to learn, or that sparks your

imagination and creativity.

  Create opportunities to laugh. Laughter provides a mood boost, so swap humorous stories

and jokes with your loved ones, watch a comedy, or read a funny book.

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Depression treatment options for older adults and the elderly 

Depression treatment is just as effective for elderly adults as it is for younger people.

However, since depression in older adults and the elderly is often the result of a difficult life situation

or challenge, any treatment plan should address that issue. If loneliness is at the root of your

depression, for example, medication alone is not going to cure the problem.

Also, any medical issues complicating the depression must be also be addressed.

Antidepressant treatment for older adults and the elderly

Older adults are more sensitive to drug side effects and vulnerable to interactions with other

medicines they’re taking. 

Recent studies have also found that SSRIs such as Prozac can cause rapid bone loss and a higher risk

for fractures and falls. Because of these safety concerns, elderly adults on antidepressants should be

carefully monitored.

In many cases, therapy and/or healthy lifestyle changes, such as exercise, can be as effective asantidepressants in relieving depression, but without the dangerous side effects.

Alternative medicine for depression in older adults and the elderly

Herbal remedies and natural supplements can also be effective in treating depression, and in most

cases, are much safer for older adults than antidepressants. However, some herbal supplements may

cause interactions with certain medications or occasionally carry side effects, so always check with

your doctor before taking them.

  Omega-3 fatty acids may boost the effectiveness of antidepressants or work as a standalone

treatment for depression.

  St. John’s wort can help with mild or moderate symptoms of depression but should not be

taken with antidepressants.

  Folic acid can help relieve symptoms of depression when combined with other treatments.

  SAMe may be used in place of antideppresants to help regulate mood, but in rare cases can

cause severe side effects.

Counseling and therapy for older adults and the elderly

Therapy works well on depression because it addresses the underlying causes of the depression,

rather than just the symptoms.

  Supportive counseling includes religious and peer counseling. It can ease loneliness and the

hopelessness of depression, and help you find new meaning and purpose.

  Therapy helps you work through stressful life changes, heal from losses, and process difficult

emotions. It can also help you change negative thinking patterns and develop better coping

skills.

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  Support groups for depression, illness, or bereavement connect you with others who are

going through the same challenges. They are a safe place to share experiences, advice, and

encouragement.

Helping a depressed senior

The very nature of depression interferes with a person's ability to seek help, draining energy and self-

esteem. For depressed seniors, raised in a time when mental illness was highly stigmatized and

misunderstood, it can be even more difficult—especially if they don’t believe depression is a real

illness, are too proud or ashamed to ask for assistance, or fear becoming a burden to their families.

If an elderly person you care about is depressed, you can make a difference by offering emotional

support. Listen to your loved one with patience and compassion. Don’t criticize feelings expressed, but

point out realities and offer hope. You can also help by seeing that your friend or family member gets

an accurate diagnosis and appropriate treatment. Help your loved one find a good doctor, accompany

him or her to appointments, and offer moral support.

Other tips for helping a depressed elderly friend or relative:

  Invite your loved one out. Depression is less likely when people’s bodies and minds remain

active. Suggest activities to do together that your loved one used to enjoy: walks, an art class,

a trip to the museum or the movies—anything that provides mental or physical stimulation.

  Schedule regular social activities. Group outings, visits from friends and family members,

or trips to the local senior or community center can help combat isolation and loneliness. Be

gently insistent if your plans are refused: depressed people often feel better when they’re

around others.

  Plan and prepare healthy meals. A poor diet can make depression worse, so make sure

your loved one is eating right, with plenty of fruit, vegetables, whole grains, and some protein

at every meal.

  Encourage the person to follow through with treatment. Depression usually recurs when

treatment is stopped too soon, so help your loved one keep up with his or her treatment plan.

If it isn’t helping, look into other medications and therapies.

  Make sure all medications are taken as instructed. Remind the person to obey doctor's

orders about the use of alcohol while on medication. Help them remember when to take their

dose.

  Watch for suicide warning signs. Seek immediate professional help if you suspect that your

loved one is thinking about suicide.

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Depression in Late Life: Not A Natural Part Of Aging

Initiative on Depression in Late Life 

EVERYONE FEELS SAD OR BLUE SOMETIMES.

It is a natural part of life. But when the sadness persists and interferes with everyday life, it may be

depression. Depression is not a normal part of growing older. It is a treatable medical illness, much

like heart disease or diabetes.

Depression is a serious illness affecting approximately 15 out of every 100 adults over age 65 in the

United States. The disorder affects a much higher percentage of people in hospitals and nursing

homes. When depression occurs in late life, it sometimes can be a relapse of an earlier depression.

But when it occurs for the first time in older adults, it usually is brought on by another medical illness.

When someone is already ill, depression can be both more difficult to recognize and more difficult to

endure.

DEPRESSION IS NOT A PASSING MOOD.

Sadness associated with normal grief or everyday "blues" is different from depression. A sad or

grieving person can continue to carry on with regular activities. The depressed person suffers from

symptoms that interfere with his or her ability to function normally for a prolonged period of time.

Recognizing depression in the elderly is not always easy. It often is difficult for the depressed elder to

describe how he or she is feeling. In addition, the current population of older Americans came of age

at a time when depression was not understood to be a biological disorder and medical illness.

Therefore, some elderly fear being labeled "crazy," or worry that their illness will be seen as a

character weakness.

The depressed person or their family members may think that a change in mood or behavior is simply

"a passing mood," and the person should just "snap out of it." But someone suffering from depression

can not just "get over it." Depression is a medical illness that must be diagnosed and treated by

trained professionals. Untreated, depression may last months or even years.

UNTREATED DEPRESSION CAN:

  lead to disability

  worsen symptoms of other illnesses

  lead to premature death

  result in suicide.

When it is properly diagnosed and treated, more than 80 percent of those suffering from depression

recover and return to their normal lives.

The most common symptoms of late-life depression include:

  persistent sadness (lasting two weeks or more)

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  feeling slowed down

  excessive worries about finances and health problems

  frequent tearfulness

  feeling worthless or helpless

  weight changes

  pacing and fidgeting  difficulty sleeping

  difficulty concentrating

  physical symptoms such as pain or gastrointestinal problems.

One important sign of depression is when people withdraw from their regular social activities. Rather

than explaining their symptoms as a medical illness, often depressed persons will give different

explanations such as:

" It's too much trouble,"

" I don't feel well enough," or

" I don't have the energy."

For the same reasons, they often neglect their personal appearance, or may begin cooking and eating

less. Like many illnesses, there are varying levels and types of depression. A person may not feel

"sad" about anything, but may exhibit symptoms such as difficulty sleeping, weight loss, or physical

pain with no apparent explanation. This person still may be clinically depressed. Those same

symptoms also may be a sign of another problem -- only a doctor can make the correct diagnosis.

IT CAN HAPPEN TO ANYONE.

Sometimes depression will occur for no apparent reason. In other words, nothing necessarily needs to

"happen" in one's life for depression to occur. This can be because the disease often is caused by

biological changes in the brain. However, in older adults, there usually are understandable reasons for

the depression. As the brain and body age, a number of natural bio-chemical changes begin to take

place. Changes as the result of aging, medical illnesses or genetics may put the older adult at a

greater risk for developing depression.

^ Back to top 

LIFE CHANGES

Chronic or serious illness is the most common cause of depression in the elderly. But even when

someone is struggling with a chronic illness such as arthritis, it is not natural to be depressed.

Depression is defined as an illness if it lasts two weeks or more and if it affects one's ability to lead anormal life.

Many factors can contribute to the development of depression. Often people describe one specific

event that triggered their depression, such as the death of a partner or loved one, or the loss of a job

through layoff or retirement. What seems like a normal period of sadness or grief may lead to a

prolonged, intense grief that requires medical attention.

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The loss of a life-long partner or a friend is a frequent occurrence in later life. It is normal to grieve

after such a loss. But it may be depression rather than bereavement if the grief persists, or is

accompanied by any of the following symptoms:

  guilt unconnected with the loved one's death

  thoughts of one's own death  persistent feelings of worthlessness

  inability to function at one's usual level

  difficulty sleeping

  weight loss.

If any of these symptoms are triggered by a loss, a physician should be consulted.

Changes in the older adult's sensory abilities or environment may contribute to the development of 

depression. Examples of such changes include:

  changes in vision and hearing

  changes in mobility

  retirement

  moving from the family home

  neighborhood changes

OTHER ILLNESSES

In the older population, medical illnesses are a common trigger for depression, and often depression

will worsen the symptoms of other illnesses. The following illnesses are common causes of late-life

depression:

  cancer

  Parkinson's disease

  heart disease

  stroke

  Alzheimer's disease.

In addition, certain medical illnesses may hide the symptoms of depression. When a depressed person

is preoccupied with physical symptoms resulting from a stroke, gastrointestinal problems, heart

disease or arthritis, he or she may attribute the depressive symptoms to an existing physical illness,

or may ignore the symptoms entirely. For this reason, he or she may not report the depressive

symptoms to his or her doctor, creating a barrier to becoming well.

DEPRESSION IS TREATABLE

Most depressed elderly people can improve dramatically from treatment. In fact, there are highly

effective treatments for depression in late life. Common treatments prescribed by physicians include:

  psychotherapy

  antidepressant medications

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  electroconvulsive therapy (ECT).

Psychotherapy can play an important role in the treatment of depression with, or without, medication.

This type of treatment is most often used alone in mild to moderate depression. There are many forms

of short-term therapy (10-20 weeks) that have proven to be effective. It is important that the

depressed person find a therapist with whom he or she feels comfortable and who has experience witholder patients.

Antidepressants work by increasing the level of neurotransmitters in the brain. Neurotransmitters are

the brain's "messengers." Many feelings, including pain and pleasure, are a result of the

neurotransmitters' function. When the supply of neurotransmitters is imbalanced, depression may

result.

A frequent reason some people do not respond to antidepressant treatment is because they do not

take the medication properly. Missing doses or taking more than the prescribed amount of the

medication compromises the effect of the antidepressant. Similarly, stopping the medication too soon

often results in a relapse of depression. In fact, most patients who stop taking their medication before

four to six months after recovery will experience a relapse of depression.

Usually, antidepressant medication is taken for at least six months to a year. Typically, it takes four to

12 weeks to begin seeing results from antidepressant medication. If after this period of time the

depression does not subside, the patient should consult his or her physician. Antidepressant drugs are

not habit-forming or addictive. And because depression is often a recurrent illness, it usually is

necessary to stay on the medication for six months after recovery to prevent new episodes of 

depression.

Electroconvulsive therapy (ECT) is a treatment that unnecessarily evokes fear in many people. In

reality, ECT is one of the most safe, fast-acting and effective treatments for severe depression. It can

be life saving. ECT often is the best choice for the person who has a life-threatening depression that is

not responding to antidepressant medication or for the person who cannot tolerate the medication.

After a thorough evaluation, a physician will determine the treatment best suited for a person's

depression. The treatment of depression demands patience and perseverance for the patient and the

physician. Sometimes several different treatments must be tried before full recovery. Each person has

individual biological and psychological characteristics that require individualized care.

SUICIDE

Suicide is more common in older people than in any other age group. The population over age 65

accounts for more than 25 percent of the nation's suicides. In fact, white men over age 80 are sixtimes more likely to commit suicide than the general population, constituting the largest risk group.

Suicide attempts or severe thoughts or wishes by older adults must always be taken seriously.

It is appropriate and important to ask a depressed person:

  Do they feel as though life is no longer an option for them?

  Have they had thoughts about harming themselves?

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  Are they planning to do it?

  Is there a collection of pills or guns in the house?

  Are they often alone?

Most depressed people welcome care, concern and support, but they are frightened and may resist

help. In the case of a potentially suicidal elder, caring friends or family members must be more thanunderstanding. They must actively intervene by removing pills and weapons from the home and

calling the family physician, mental health professional or, if necessary, the police.

^ Back to top 

CARING FOR A DEPRESSED PERSON

The first step in helping an elderly person who may be depressed is to make sure he or she gets a

complete physical checkup. Depression may be a side effect of a pre-existing medical condition or of a

medication. If the depressed older adult is confused or withdrawn, it is helpful for a caring family

member or friend to accompany the person to the doctor and provide important information.

The physician may refer the older adult to a psychiatrist with geriatric training or experience. If a

person is reluctant to see a psychiatrist, he or she may need assurance that an evaluation is

necessary to determine if treatment is needed to reduce symptoms, improve functioning and enhance

well-being.

It is important to remember that depression is a highly treatable medical condition and is not a normal

part of growing older. Therefore, it is crucial to understand and recognize the symptoms of the illness.

As with any medical condition, the primary care physician should be consulted if someone has

symptoms that interfere with everyday life. An older person who is diagnosed with depression also

should know that there are trained professionals who specialize in treating the elderly (called "geriatric

psychiatrists") who may be able to help.

ABOUT AAGP

The American Association for Geriatric Psychiatry (AAGP) is a national professional organization of 

geriatric psychiatrists. AAGP's 2,000 members are the leading researchers, educators and clinical

practitioners in the areas of late-life depression, dementia, schizophrenia, psychosis, anxiety and sleep

disorders and other mental health disorders affecting the elderly.

Depression - elderly

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Depression is a medical illness in which a person has persistent feelings of  sadness,often

with discouragementand a lack of self-worth.

Depression in the elderly is a widespread problem, but it is not a normal part of aging. It is often not

recognized or treated.

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Causes

In the elderly, a number of life changes can increase the risk for depression, or make existing depression

worse. Some of these changes are:

A move from home, such as to a retirement facility

Chronic illness or pain

Children moving away

Spouse or close friends passing away

Loss of independence (for example, problems getting around or caring for oneself)

Depression can also be related to a physical illness, such as:

Thyroid disorders

Parkinson's disease

Heart disease

Cancer 

Stroke

Dementia (such as Alzheimer's disease)

Overuse of alcohol or certain medications (such as sleep aids) can make depression worse.

Symptoms

Many of the usual symptoms of  depression may be seen. However, depression in the elderly may be hard

to detect. Common symptoms such as fatigue, appetite loss, and trouble sleeping can be part of the

aging process or a physical illness. As a result, early depression may be ignored, or confused with other 

conditions that are common in the elderly.

Exams and Tests

The doctor or nurse will examine you and ask questions about your medical history and symptoms.

Blood and urine tests may be done to look for a physical illness.

You may be referred to a mental health specialist to help with diagnosis and treatment.

Treatment

The first steps of treatment are to:

Treat any illness that may be causing the symptoms

Stop taking any medications that may be making symptoms worse

Avoid alcohol and sleep aids

If these steps do not help, medications to treat depression and talk therapy often help.

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Doctors often prescribe lower doses of antidepressants to older people, and increase the dose more

slowly than in younger adults.

To better manage depression at home, you should:

Exercise regularly, if your doctor says it is ok. Surround yourself with caring, positive people and fun activities.

Learn good sleeping habits.

Learn to watch for the early signs of depression, and know how to react if these occur.

Drink less alcohol and do not use illegal drugs.

Talk about your feelings with someone you trust.

Take medications correctly and discuss any side effects with your doctor.

Outlook (Prognosis)

Depression often responds to treatment. The outcome is usually better for people who have access to

social services, family, and friends who can help them stay active and engaged.

The most worrisome complication of depression is suicide.

Men make up most suicides among the elderly. Divorced or widowed men are at the highest risk.

Families should pay close attention to elderly relatives who are depressed and live alone.

When to Contact a Medical Professional

Call your health care provider if you feel persistently sad, worthless, or hopeless, or if you cry often. Also

call if you are having trouble coping with stresses in your life and want to be referred for talk therapy.

Go to the nearest emergency room or call your local emergency number (such as 911) if you are thinking

about suicide (taking your own life).

If you are caring for an aging family member and think they may have depression, contact their health

care provider.

Alternative Names

Depression in the elderly


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