Seniors and Depression
Depression is not a normal part of aging, and studies show that most seniors feel satisfied with their lives, despite increased physical ailments. However, when older adults do have depression, it may be overlooked because seniors may show different, less obvious symptoms, and may be less inclined to experience or acknowledge feelings of sadness or grief.
Depression can and does occur out of the blue, for no obvious reason, or it can occur as a response to adverse life circumstances, such as the loss of a spouse, a job, good health, or any other significant thing or relationship. Regrettably, the nature of depression is such that affected persons, as a result of being depressed, are actually unlikely to realize that they are depressed, and even more unlikely to seek help for themselves. This is related directly to the nature of the symptoms of depression which we will discuss momentarily. The implication of this fact, however, is that healthy relatives and friends of older people should be on the lookout for signs of depression among their older relatives and friends, so they can assist them to obtain treatment.
In addition, older adults may have more medical conditions such as heart disease, stroke or cancer, which may cause depressive symptoms. They may be taking medications with side effects that contribute to depression. Some older adults may experience what some doctors call vascular depression, also called arteriosclerotic depression or subcortical ischemic depression. Vascular depression may result when blood vessels become less flexible and harden over time, becoming constricted. Such hardening of vessels prevents normal blood flow to the body’s organs, including the brain. Those with vascular depression may have, or be at risk for, a co-existing cardiovascular illness or stroke.
Although many people assume that the highest rates of suicide are among the young, older white males age 85 and older actually have the highest suicide rate. Many have a depressive illness that their doctors may not detect, despite the fact that these suicide victims often visit their doctors within one month of their deaths.
The majority of older adults with depression improve when they receive treatment with an antidepressant, psychotherapy, or a combination of both. Research has shown that medication alone and combination treatment are both effective in reducing the rate of depressive recurrences in older adults. Psychotherapy alone also can be effective in prolonging periods free of depression, especially for older adults with minor depression, and it is particularly useful for those who are unable or unwilling to take antidepressant medication.
Depression at any age can be effectively treated by a combination of medications and psychotherapy. Psychotherapy can be used when the individual who is depressed is open to talking to a professional. Most modern psychotherapy is goal-directed and time-limited, and covered by government health or insurance plans. Antidepressant medications can be used when the clinical depression is more severe, and a person needs more immediate symptom relief.