Depression is a serious condition experienced by more than 20 million Americans of which 6.5 million are over the age of 65. It is more than just a feeling of sadness and effects every aspect of an individual’s life. It affects the individual’s emotionally, psychologically, socially, spiritually, physically, and mentally. The main symptoms seen in older adults are sadness, lack of self- worth and self-esteem, and feelings of constant discouragement. When left untreated it can continue to grow worse, having greater effects on the individual’s life, sometimes leading to suicide. This is a particular risk in individuals over the age of 65 as less than 10 percent of this population ever receives treatment.
What is Late-Life Depression?
Late-life depression is the term used to refer to the type of depression experienced by older individuals. There is numerous reasons depression may occur in older adults. It is a widespread problem however, it is not a normal part of the aging process and should not be considered as such. Unfortunately, many older individuals and those who care for them believe it is normal at this stage of life and therefore, late-life depression is often ignored and left untreated. Late-life depression can be successfully treated allowing the individual to return to a more positive state of mind and enable them to find joy in life again.
Late-life depression may be a relapse to an earlier depressive disorder or triggered by negative changes in quality of life, for example entering a nursing home, another psychological or physical illness, or hospitalization.
It is estimated that approximately 6 percent of individuals over the age of 65 develop depression. Some research has found that women experience late life depression at almost twice the rate of men, however, it has been suggested that this disparity is largely due to a greater frequency of exposure to depression related risk factors. Over 25 percent of older adults with a chronic illness experience depression and more than 50 percent of those who reside in a nursing home.
There are several psychiatric disorders that have high rates of co-morbidity with late-life depression. In particular, disorders found to frequently co-occur with late-onset depression include:
- Generalized Anxiety Disorder
- Panic Disorder
- Avoidance Personality Disorder
- Dependent Personality
- Obsessive-Compulsive Personality Disorder
Co-occurring problems are not unusual in individuals with late-life depression. Additionally, when they exist they can affect the course and severity of depression and increase the level of disability. Given the high rates of co-morbidity and the low rates of people who have late onset depression seeking treatment, this increases the suffering in these individuals.
As with most mental health problems, there is no one cause of late-life depression. Research suggests there is support for several factors that may be causal agents of this problem. These include:
- Genetics – Late-life depression has been shown to run in family
- Biological Factors – There are chemicals in your brain that control your emotions and moods. When these chemicals are at low levels or your brain fails to respond to these chemicals depression may result.
- Immunological Factors – One theory suggests that late-life depression can be caused by certain substances that are secreted by your immune system and result in the variety of symptoms observed in late life depression.
- Alcohol and Substance Abuse – While alcohol abuse can co-occur with depression it can also lead to the development of depression especially late in life, when our bodies don’t metabolize it as well as when we were younger. Similarly, other types of substance abuse can lead to depression. Additionally, many older adults are on a number of medications for a variety of conditions. When some of these are mixed with alcohol or other substances depression can occur.
- Significant Life Changes- Major life changes that often occur in later life, can result in depression. These include moving to a retirement or nursing home, loss of independence, chronic medical illness or pain, and loss of friends and family. While feeling sad in result to these types of losses and changes is normal, if the sadness persists or becomes serious enough it interferes with your normal daily activities or you withdraw from friends and families, speak with your Doctor or call Riverwoods to make an appointment for an evaluation.
If you feel that you are in crisis, or are having thoughts about hurting yourself or others, please call 9-1-1 or go to the nearest emergency room immediately.
Signs and Symptoms
The symptoms of depression can greatly affect your quality of life and ability to function in your daily life. The signs and symptoms of depression in older adults vary widely. They include:
- Sleeping too little or too much – In late-life depression, early morning awakening is a frequent problem
- Eating more or less than usual – In late-life depression loss of appetite and weight loss is more frequent
- Persistent sadness, anxiety or feelings of chronic emptiness
- Fatigue or lack of energy
- Loss of pleasure in event that were once enjoyable – In later life many individuals already have a limited range of interests. Depression leads to the loss of pleasure in almost all previous interests.
- Feelings of restlessness or irritability – Often, older individuals have limited mobility which can worsen the sense of restlessness due to the inability to move around freely.
- Paying attention, concentrating, remembering and making decisions – Sometimes these symptoms may cause people to worry they are suffering from dementia not depression, a treatable condition.
- Guilt, hopelessness, helplessness, or worthlessness – The loss of independence and the ability to earn money to continue contributing to their family often makes older adults experience these emotions. In general, the lack of feeling productive in various areas of life also can become problematic leading to a sense of hopelessness.
- Feeling slowed down
- Exaggerated worries over finances and health
- Social withdrawal
- Chronic physical problems without a discernible medical cause – It is not unusual for older adults to express emotional distress through physical pain or illness. It is not that the physical symptoms are not really being experienced but that the cause is psychological rather than physical.
- Chronic vague physical complaints
- Constant concerns of impending death or suicide – These concerns are more frequent in older adults compared to younger adults. Thoughts of death are not necessarily unusual in older adults but when they are paired with depression the risk of suicide is higher in older adults.
- Help seeking behavior
- Becoming demanding and exhibiting anger outbursts
Effects of Late Life Depression
The effects of late life depression can be difficult to determine due to physical and mental symptoms that are normal to the aging process. Some effects of late life depression that have been determined include:
- Increased sensitivity to physical pain
- Hyper-vigilance related to bodily functions
- Decreasing cognitive functioning
- General functional disability
- Increased use of non-mental health services/Decreased use of mental health services
- Greater frequency of morbidity and mortality
Families and friends should watch for signs of depression in older people in their lives. If any signs are observed they should not be ignored. Call Riverwoods for further information and answers to any questions you may have.