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Depression and the older adult

Tom, who’s 68, seems to have lost interest in things he used to enjoy. He doesn’t have much energy and he has trouble paying attention when his daughter, Julia, talks to him. Julia thinks these symptoms are probably just signs of aging. But Tom might be suffering from depression.

Of the approximately 32 million Americans age 65 and older, about five million suffer from depression: 9.4 percent of those age 50-64 and 5 percent of those age 65 and older.  Older adults also have the highest rate of suicide compared to any other age group.

Changing life conditions play a part. As people get older, they have more health problems. Their careers are behind them. They may have lost a spouse or friends and they become more isolated. They’re taking more medications and some of them can cause symptoms of depression.

Older adults are less likely to be correctly diagnosed with depression for many reasons.

  • Signs of depression can mimic signs commonly attributed to aging or to grief.
  • Many older adults are ashamed to talk about their symptoms.
  • Many people mistakenly believe that these symptoms are not treatable or worth treating in older adults.

“Depressive symptoms can have a significant effect on functioning, quality of life and mortality in the elderly,” says Adriana Hermida, MD, assistant professor, Department of Psychiatry and Behavioral Sciences at Emory University School of Medicine and the Fuqua Center for Late Life Depression.

“In older adults, symptoms are less likely to include sadness or crying,” she says, “and more likely to include loss of interest in activities and low energy. Chronic low grade depression, called dysthymia, is common in the elderly. Antidepressants and therapy can be effective treatments, as can ECT if more severe symptoms occur, such as psychosis or thoughts of suicide.”

What can family members do to help?

  • “Be vigilant for changes in mood and sleep patterns, lack of energy and cognitive problems,” says Dr. Hermida. “Don’t assume these are signs of aging.”
  • The Geriatric Depression Scale is a questionnaire that’s accessible online and can help family members identify signs of possible depression, which they should report to each of their loved one’s doctors, not just the primary care doctor.
  • They can try to persuade their loved one that depression is a treatable medical condition and that it’s ok to seek help for their symptoms.
  • Choose a geriatric primary care physician, if possible. Treatment by a geriatric psychiatrist may be needed.

Julia asked her father the Geriatric Depression Scale questions, which indicated that her father was showing possible signs of depression. Together, they discussed his symptoms with his doctor, who prescribed treatment with an antidepressant. He also started seeing a cognitive behavioral therapist.

After a few weeks, Julia and her father were relieved when his mood improved, he began to participate in some activities and he seemed more like himself again.

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