Would You Recognize The Signs of Depression in the Elderly?

Depression is a common but serious medical illness. It negatively impacts sufferers’ emotions, thinking, and behavior and can strike anyone, at any time. While depression is more openly acknowledged today, one population is often overlooked: the elderly. Geriatric depression is a bit trickier to diagnose and treat. The consequences can be tragic and deadly.

Yet, when identified, depression is highly treatable. If you’re concerned about an older loved one’s mental health, read on to learn about geriatric depression, including what to look for, why it’s so hard to diagnose, and how to help your loved one.

Get to know the common signs of clinical depression. There are approximately 3 million cases in the United States each year. The cause is thought to be a combination of biological, psychological, and social distress that alter how the brain is wired. Common signs of depression include:

·       Sleep problems

·       Changes in appetite or energy level

·       Concentration issues

·       Loss of interest in once-enjoyed or daily activities

·       Increased use of alcohol and drugs

·       Self-esteem issues

·       Suicidal thoughts or behaviors

A major depressive episode lasts at least two weeks and is severe enough to interfere with daily activities, nearly all day, every day. The sufferer may stay in bed, cry often, act sullen, cease participating in activities, or retreat physically and emotionally from others.

Seniors are at increased risk for suicide. There’s always a risk of suicide with major depressive disorder. You may be surprised to learn that people aged 85 and older have the second highest suicide rate in the U.S. Previous suicide attempts are the biggest risk factor, but many completed suicides are a first-time attempt. If your loved one shows signs of suicidal thoughts or behaviors, seek help for them immediately.

Common signs of elderly depression. An older person may show the typical signs of depression or their symptoms might look completely different and non-typical. Commonly overlooked signs for senior depression include:

·       Irritability and agitation

·       Unexplained physical problems

·       Slowed thinking, speaking or body movements

·       Help-seeking and/or demanding behavior

Knowing the often-missed indicators of geriatric depression is a first step, but it’s also critical to understand the reasons why seniors, their doctors, family members and loved ones often miss the cues.

Why don’t many seniors seek diagnosis or treatment?

●      They believe that a depressed mood is a normal part of aging. We all experience sadness from time to time. It’s normal to feel distraught after major life changes including losing a spouse, changing homes, or facing health issues. The elderly may experience these types of life changes more frequently and in a shorter period of time than other populations. For this reason, it’s often incorrectly assumed that depression is just a part of aging. This misconception is shared by older adults themselves who fail to see that they can feel better with proper treatment.

●      They don’t know the signs of depression. According to Mental Health America, approximately 68% of adults aged 65 plus and know little to nothing about depression. Yet, American Journal of Psychiatry reported that noted that 26% of seniors assessed by aging services providers met the criteria for major depression and 31% had symptoms of depression that had the potential to develop into clinical depression. Seniors with untreated depression often need more assistance with self-care and daily activities, are more vulnerable to infections, and take longer to recover from illness.

●      There’s a stigma. The stigma associated with depression, anxiety disorders, and other mental conditions is one of the top reasons that sufferers don’t seek help. So, even when older adults know about depression, they may be less likely to seek help. Admitting to a mental health disorder would be akin to admitting they are “crazy” or “unfit” to run their own lives. Yet, receiving a mental health diagnosis can be healing, especially when the taboo is lifted through peer support. A 2018 Stigma and Health study found that depressed seniors who met with a peer-educator-led-group for four sessions or more felt less stigmatized by their disease.

●      They live in isolation or social circles are small. Seniors living alone are less likely to get help for their depression. Often, loved ones will take a notice of a change in the older family member’s personality or activity level. This can also happen if a senior keeps to themselves rather than joining in social activities or interacting with friends. They may feel that their desire for solitude is the reason that they feel depressed and not vice versa.

●      Cost. Worrying about the price of doctor visits, medications, and treatment is a very real hurdle for many fixed-to-low-income seniors. Basic Medicare covers inpatient mental health treatment, Medicare B offers additional coverage, and Medicare C helps with medication costs. Medicaid covers many inpatient and outpatient mental health services for psychiatric treatment, counseling, and prescriptions. Check with your local Medicaid or Medicare office for specifics.

Depression can look very different in the elderly than it does in other populations.

●      Physical complaints are common. The elderly are more likely to complain about physical ailments over emotional or mental ones.  If a senior complains about stomach aches, the doctor may run tests, find nothing, and wait for the problem to resolve on its own. However, gastrointestinal complaints are a sign of depression in the elderly, along with other aches and pains that have no medical explanation.

●      Depressive mood is seen as a part of aging. Like the elderly, we incorrectly assume that depressive moods are a natural part of getting older. When a senior becomes needy or overly dependent, we may attribute the cause to age-related mobility issues. Losing a spouse, moving, and/or health issues might explain why an elderly loved one is frequently sad, agitated, or easily frustrated. We can fail to link the personality changes to depression.

●      The symptoms are attributed to other illnesses and medications. Seniors with other illnesses are more likely to experience depression. As a result, we can either fail to see that depression is also present or we confuse the signs of geriatric depression for another disorder. To the untrained eye, the signs of dementia and geriatric depression can look very similar. Slowed processing can be attributed to medications that they may be taking. Because of these other “explanations,” we can fail to see depression as part of the puzzle.

There is hope. Here’s what you can do:

●      Offer your support without trying to “fix” the problem.

●      Attend doctor visits and/or help find a qualified mental health professional.

●      Encourage your loved one to stay active, socialize, and remain engaged with life.

●      Recognize and reinforce that depression is a real and treatable condition.

●      Seek immediate assistance if you suspect suicidal thoughts or actions. Contact 911, your loved one’s doctor, and/or the National Suicide Prevention at 1-800-273-8255.

Helping a loved one with depression can be challenging, but despair doesn’t need to be permanent. We all deserve to enjoy life at every phase. At Vaughn Greene Funeral Services, we treat you and your loved ones like family. If you have concerns about you geriatric depression, please reach out us. Our compassionate staff members are always here to receive your call.

About Vaughn Greene Funeral Services: For more than 20 years, Vaughn Greene Funeral Services has been providing a ministry of care to Baltimore’s African American community. As a leading local, minority- and family-owned provider, we promise to provide our highest level of service and respect to families who entrust us to honor their loved one. For more information, please call us at 410.655.0015 or visit us online at https://vaughncgreene.com/.