Depression and Senior Adults

Signs and symptoms of depression in the elderly

Older adults don't always fit the typical picture of depression. Many depressed seniors don’t claim 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 headaches that have gotten worse, are often the predominant symptom of depression in the elderly. Older adults with depression are also more likely to show symptoms of anxiety or irritability. They may constantly wring their hands, pace around the room, or fret obsessively about money, their health, or the state of the world.

Signs and Symptoms of Depression in Older Adults
•    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; 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 Without Sadness: 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
•    Hopelessness
•    Helplessness
•    Anxiety and worries
•    Memory problems
•    Loss of feeling of pleasure
•    Slowed movement
•    Irritability
•    Lack of interest in personal care (skipping meals, forgetting medications, neglecting personal hygiene)

Adapted from American Academy of Family Physicians

Helping a Depressed Senior Adult
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. With such roadblocks, assistance from others can mean the difference between suffering and recovery.
If a senior citizen 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.