For many of us, older age is a time of rest, reflection and opportunity to do things that were put off while raising families and pursuing careers. Unfortunately, the aging process is not always so idyllic. Late-life events such as chronic and debilitating medical disorders, loss of friends and loved ones, and the inability to take part in once-cherished activities can take a heavy toll on an aging person’s emotional well-being.
An older adult may also sense a loss of control over their life due to failing eyesight, hearing loss or other physical changes, as well as external pressures such as limited financial resources. These and other issues often give rise to negative emotions such as sadness, anxiety, loneliness and lowered self-esteem, which in turn lead to social withdrawal and apathy.
Depression: A risk to daily living for older adults
For some older adults, depression can be an unwelcome companion to the aging process. In addition to causing low mood, depression has both physical and mental consequences that may complicate existing health conditions and trigger new concerns. Thoughts of suicide are also more prevalent among older adults because feelings of hopelessness and isolation, especially for those with disabilities or confined to nursing homes, can predominate.
Causes of depression in older adults
As we grow older, we often face significant life changes that can increase the risk for depression. These can include:
- Health problems – Illness and disability; chronic or severe pain; cognitive decline; damage to your body image due to surgery or sickness.
- Loneliness and isolation – Living alone; a dwindling social circle due to deaths or relocation; decreased mobility due to illness or a loss of driving privileges.
- Reduced sense of purpose – Feelings of purposelessness or loss of identity due to retirement or physical limitations on activities you used to enjoy.
- 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.
Medical conditions that can cause elderly depression
It’s important to be aware that medical problems can also 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 (MS)
Elderly depression as a side effect of medication
Symptoms of depression can also occur as a side effect of many commonly prescribed drugs, especially a combination of them.
Medications that can cause or worsen depression include:
- Blood pressure medication (e.g. clonidine)
- Beta-blockers (e.g. Lopressor, Inderal)
- High-cholesterol drugs (e.g. Lipitor, Mevacor, Zocor)
- Tranquilizers (e.g. Valium, Xanax, Halcion)
- Calcium-channel blockers
- Medication for Parkinson’s disease
- Sleeping pills
- Ulcer medication (e.g. Zantac, Tagamet)
- Heart drugs containing reserpine
- Steroids (e.g. cortisone and prednisone)
- Painkillers and arthritis drugs
- Estrogens (e.g. Premarin, Prempro)
Regardless of its cause, depression can have alarming physical effects on older people. The mortality rate for elderly men and women suffering from both depression and feelings of loneliness is higher than for those who are report satisfaction with their lives. Treatment programs for depressed elderly patients suffering from cardiovascular disease and other major illnesses usually take longer than normal – and are less successful.
Other potentially harmful effects can also impact an older adult’s health. Depression can lead to eating habits that result in obesity or, conversely, can cause a significant loss of appetite and diminished energy levels, sometimes resulting in a condition known as geriatric anorexia. Depressed older adults experience higher rates of insomnia and memory loss. They also have longer than normal reaction times, increasing the hazards associated with cooking, driving, self-medication and tasks that require full attention.
What can you do?
While aging is an inevitable part of life, depression need not be. Researchers agree that early recognition, diagnosis and treatment can counteract and prevent depression’s emotional and physical consequences.
Self-help for elderly depression
It’s a myth to think that after a certain age older adults can’t learn new skills, try new activities, or make fresh lifestyle changes. An older adult is just as capable as a young person of learning new things and adapting to new ideas that can help you recover from depression.
As an older adult experiencing depression or a low mood, small steps can make a big difference to how you feel.
Self-help tip 1: Find ways to stay engaged
- Get out in to the world. Try not to stay cooped up at home all day. Go to the park, take a trip to the hairdresser, have lunch with a friend, visit a museum, or go to a concert or a play.
- Volunteer your time. Helping others is one of the best ways to feel better about yourself and expand your social network.
- Join a depression support group. Being with others facing the same problems can help reduce your sense of isolation. It can also be inspiring to hear how others cope with depression.
- 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. Dog owners love to chat while their pets play together.
- Learn a new skill. Pick something that you’ve always wanted to learn, or that sparks your imagination and creativity—a musical instrument, a foreign language, or a new game or sport, for example. Take a class or join a club to meet like-minded people.
- 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.
Tip 2: Adopt healthy habits
- Move your body. Exercise is a powerful depression treatment. In fact, research suggests it can be just as effective as antidepressants.
- Eat to support your mood. Start by minimizing sugar and refined carbs. Sugary and starchy comfort foods can give you a quick boost, but you pay for it later when your blood sugar crashes. Focus on quality protein, complex carbs, and healthy fats which will leave you satisfied and emotionally balanced. And eat something at least every 3-4 hours.
- Get quality sleep. Aim for somewhere between 7 to 9 hours of sleep each night. You can help yourself get better quality sleep by avoiding alcohol and caffeine, keeping a regular sleep-wake schedule, and making sure your bedroom is dark, quiet, and cool.
- Spend time in sunlight. Sunlight can help boost serotonin levels, improve your mood. Have your coffee outside or by a window, spend time gardening, exercise outside.
Tip 3: Know when to seek professional help
Since depression in the elderly is often triggered or compounded by a difficult life situation or challenge, any treatment plan should address that issue. Also, any medical issues complicating the depression must be addressed.
How to help an older adult with depression
- Listen and just ‘be there’. You can make a difference by offering emotional support. Listen to your loved one with patience and compassion. You don’t need to try to “fix” someone’s depression; just being there to listen is enough.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. You don’t need to try to “fix” someone’s depression; just being there to listen is enough.
- 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 movies—anything that provides mental or physical stimulation.
- Schedule regular social activities. 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.
- 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.
References:
- Cornwell B, et al. The social connectedness of older adults: A national profile. American Sociological Review. 2008; 73:185.
- Jamila Bookwala (Ed.). (2016). Couple Relationships in the Middle and Later Years: Their Nature, Complexity and
- Qualls, S. & Abeles, N. (Eds.). (2002). Psychology and the aging revolution: How we adapt to longer life.
- Role in Health and Illness. American Psychological Association, Washington, DC.
- Washington, D.C.: American Psychological Association.
- Yogev, S. (2012). A Couple’s Guide To Happy Retirement: For Better or Worse (2nd ed). McGraw-Hill, NY.
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