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Depression and the elderly

Unfortunately many people will suffer depression at some point in their lives, but when it comes to discussing the elderly it’s important to realise that depression is not necessarily part of ageing. Carers need to be able to recognise signs and symptoms of depression and make sure that older people in their care who suffer from depression get the help that they need.  The positive side is that there is more awareness about depression and its treatment today thanks to many fantastic organisations such as beyondblue.

Identifying depression can sometimes be a little tricky because not every individual presents with the same symptoms.  Being “sad” is only one possible sign but there are many to look out for.

Depression: what are the different types?
There are many different types of depression. The most common forms to be aware of are the following:

  • Major depression – this is a severe type of depression that interferes with daily activities such as sleep, work, study, eating and quality of life. For some this may only be experienced once,  for others, they may be less fortunate and experience it several times or often throughout their lives.
  • Dysthymia (or dysthymic disorder) – this is when symptoms last for two years or more but are less severe than those of major depression
  • Minor depression – this type of depression is similar to both dysthymia and major depression but the symptoms don’t last as long and are less severe.

Signs and symptoms of depression
Individuals may present with depression in different ways. Some of the symptoms of depression include:

  • feeling exhausted
  • strange aches and pains, headaches or digestive problems
  • inability to concentrate or remember details
  • sleeping too much, or not being able to sleep
  • over-eating, or not being able to eat
  • feeling irritable, anxious, hopeless or guilty
  • loss of interest in activities or hobbies
  • contemplating suicide or attempting suicide

What causes depression?
It’s important that carers are acutely aware of the causes of depression so that they can prevent or help treat the condition as soon as possible. There are several factors that cause depression and sometimes it is a combination of factors that lead to the condition.

  • Genetic predisposition

Some individuals have a family history of depression which makes it more likely for them to suffer from it than those who don’t. Elderly people that have had depressive episodes when younger are more at risk of developing depression in their later years than those who have never suffered from the illness.

  • Stress

Events such as moving away from the family home, losing a loved one, or any dramatic event may trigger depression for some individuals.

  • Brain chemistry and other physiological changes

It’s thought that those suffering from depression may have different brain chemistry than
individuals that don’t suffer from the illness.

how to treat depression - tips from sageSome ageing individuals who have not experienced depression in their younger years may suffer from the condition due to changes that occur in the brain and body as they age. This does not mean though that everyone will get depressed as they age. For example, ischemia is a condition where blood vessels start to stiffen and prevent normal blood flow to the organs – including the brain. When this happens, it is referred to as “vascular depression.” It’s worth noting that those with this condition may also be predisposed to stroke, heart disease or other vascular conditions.

Depression may also be a symptom of another disease that an elderly person may be suffering. For example, heart disease, diabetes and Parkinson’s disease all commonly present with depression as a symptom.

How is depression treated?
Because depression may be linked with other illnesses, or even medications, it is important that an elderly person suffering depression has a full medical assessment to determine what is causing the illness.  This holistic approach will ensure that the best treatment is provided to manage the older person’s health.

After the doctor has examined the patient and ruled out any factors relating to external illnesses or medications, they may refer the patient on to a mental health professional for further assessment.

Common treatments for depression

Medication
Quite often, antidepressants may be prescribed as an adjunct to treating depression. These can help by balancing out chemical imbalances in the brain.

Psychotherapy
Psychotherapy or counselling may also help treat depression. Therapy can help educate the patient about ways of thinking or reacting to certain situations, and helping her or him change behaviour that may be contributing to their depressive illness.

ECT (Electroconvulsive therapy)
A while back, ECT had a very bad name as it was sometimes poorly executed with devastating results. Today, this type of therapy has been greatly improved and as a result, is regaining some popularity in the treatment of severe forms of depression that do not respond to medication or therapy. There are still some side-effects to be considered such as memory loss or confusion, although these are usually short term.

If you think that someone under your care is experiencing depression, it’s extremely important that you guide them to seek help from a medical practitioner as soon as possible. Depression can become a serious illness that one cannot simply “snap out of”.  The good news is that there is great help that is easily accessible.

Sage Institute of Aged Care – it’s more than a job, it’s a rewarding career.

Reference: National Institute of Mental Health: Older Adults and Depression

Vicki Tuchtan

Vicki Tuchtan

Vicki Tuchtan is the Academic Director at Sage Institute of Education. She oversees learning processes, teaching outcomes, resources and course development. A passionate advocate for bettering standards of training in Australia, she is currently writing her PhD thesis on defining quality training in the Australian vocational education sector.
Vicki Tuchtan

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