Depression and seniors

If you are among those people that doesn’t find pleasure in doing the activities you used to love spending time on, or constantly having feelings of hopelessness, making it hard for you to reach the end of the day – you’re not the only one. Depression can hit us at any time, and at any age, and it doesn’t differentiate between successful and unsuccessful people. However, it doesn’t have to be a part of your life. If you find the right kind of support, treatment, and apply the correct self-help approaches, your emotional health will improve, making it easier for you to enjoy your life and start taking pleasure in the activities and people you want once again.

Do you struggle with depression?

Depression is one of the more common struggles for seniors, and its symptoms can negatively impact almost every part of your life, including vitality, appetite, sleep, willingness to participate in social activities, and go into relationships.

It is distressing that a large number of seniors can’t recognize the symptoms of depression, or if they do – they don’t do anything about it. Some of the reasons why senior depression is left unnoticed are:

• Assuming there’s a reason for feeling under the blue, or that it’s a part of life
• Due or as a precursor to depression, you might be socially isolated, and there isn’t anyone around you that can notice your personality changes
• You might not know that depression can lead to physical struggles
• You might feel ashamed or insecure to talk about your issues or ask for help

There’s no reason not to feel good as a senior

First and foremost, depression is in no way a sign of weakness. Anyone can get depressed, no matter the age, social background, or level of success in life. Even though some things like retirement, death of close friends and family, or poor health can contribute to depression, they are not something that should stop you from enjoying life. Any challenge that life can throw at you can be overcome with strategies that will allow you to be happy and optimistic about life.

How can you recognize depression in seniors?

As with any ailment, depression treatment starts with finding out and recognizing the signs and symptoms. The most common signs and symptoms of depression include:

• Feeling sad or in desperation
• Seemingly unaccountable pains
• Social isolation
• Sudden weight loss
• Decreased motivation and energy
• Sleep disorders
• Low self-esteem
• Careless use of alcohol or drugs
• Suicidal thoughts
• Memory gaps
• Poor personal care, such as not taking medications or poor personal hygiene

Depression in seniors doesn’t equate sadness

Depression and sadness are usually coupled together, however, seniors affected by depression often say they don’t feel sad. They usually say they lack motivation, energy, or physical strength. Such physical complaints are one of the most common symptoms of depression in seniors.

Are they grieving or depressed?

As the years go by, we will inevitably go through many losses, and they are painful every time they happen. And it’s perfectly normal for people to grieve over these loses, as even though these sad feelings might last long, they are also healthy.

It’s not easy to see the difference between grief and depression, as they often have the same symptoms. Luckily, there are some key differences we can use to distinguish between the two:

• While grieving, people will go through a rollercoaster of emotions, with good and bad periods. Even though you might feel sad from time to time, you will still experience happiness and pleasure
• Depression, though, carries constant feelings of sadness and despair
• Grief has no pre-determined time period, but if a person doesn’t start feeling good over time, and constantly feels sad, not responding to jokes or enjoying the pleasures of life, it might be a case of depression

Why causes depression in seniors?

As the years pass us by, more and more changes start occurring, and some of these can add to the chance of developing depression. Some of these are:

• Health issues – ailments and disabilities, pain (chronic or severe), mental decline, or changes to your body due to injury or surgery can all increase the risk of developing depression
• Social isolation – living by yourself, a small social circle, decreased mobility caused to illness or injury can also contribute to depression
• Perceived loss of purpose – while retirement might sound like something that can’t come sooner, it can lead to identity loss, reduced self-confidence, financial security, and status, all of which are depression triggers. Additionally, the inability to do the activities you used to find enjoyable can also reduce your sense of purpose
• Fear – being afraid of dying, or worrying about financial or health issues can also increase the risk of depression
• Loss of loved ones – as we get older, the chances of losing spouses, family members, friends, pets, or partners increase, and this can greatly contribute to depression in seniors.

Health issues that can lead to depression in seniors

You should also know that certain medical conditions might directly cause depression in seniors, or indirectly, as a psychological reaction due to the medical condition. If the medical condition causes pain, a disability, or is especially life-threatening, it can cause depression or further worsen the symptoms of depression. The medical condition that might cause depression in seniors are:

• Parkinson’s disease
• Stroke
• Heart disease
• Cancer
• Diabetes
• Thyroid disorders
• Vitamin B12 deficiency
• Dementia and Alzheimer’s disease
• Lupus
• Multiple sclerosis (MS)

Senior depression caused by medication side effects

People can experience symptoms of depression due to some side effects of a medication. The risk can get higher if you’re on multiple prescription drugs. Even though side effects that affect mood can affect people of all ages, seniors are at higher risk since their bodies aren’t that good at metabolizing and processing medication.

If you start to feel depressed after you started a new medication, you should make an appointment and talk to your primary physician. Your doctor could either lower the dose or propose another medication that doesn’t have this side effect. Medications that have side effects which might cause or worsen depression are:

• Blood pressure medication such as clonidine
• Beta-blockers such as Lopressor, Inderal
• High-cholesterol drugs such as Lipitor, Mevacor, Zocor
• Tranquilizers such as Valium, Xanax, Halcion
• Calcium-channel blockers
• Medication for Parkinson’s disease
• Sleeping pills
• Ulcer medication such as Zantac, Tagamet
• Heart drugs containing reserpine
• Steroids such ascortisone and prednisone
• Painkillers and arthritis drugs
• Estrogens such as Premarin, Prempro
• Anticholinergic drugs used to treat GI disorders

Differences between dementia and depression

It is wrong to assume that mental decline is a normal part of aging. Loss of mental sharpness can be a sign of depression or dementia, which are a common occurrence with seniors. Since these two conditions have similar symptoms, it is a bit difficult to distinguish between them.

Is it depression or dementia?

Symptoms of depression   

• Fast mental decline
• People are able to tell the current time, date, and location
• Difficulties with concentration
• Normal language and motor skills, although slowed down
• People will be able to notice and get concerned about memory issues

Symptoms of dementia

• Slow mental decline
• People will be often confused and disoriented, often getting lost in familiar locations
• Short-term memory issues
• Language and motor skills will be impaired
• People won’t be able to notice and get concerned about memory issues
  
  

No matter the reason behind mental decline, you should make a visit to your doctor as soon as possible. If depression is the cause of the mental decline, your memory, concentration, and energy will be able to come back to normal levels with the help of treatment. While dementia treatment won’t be able to reverse the effects in most cases, your quality of life will certainly be improved.

How can you help yourself with depression?

It is completely false that seniors can’t learn new skills, do new activities, or make any significant lifestyle changes. The nature of the human brain is that it’s ever-changing, and as a senior, your brain is as capable of learning and adapting to new things and ideas just as young people’s brains, and this can help you fight depression.

Experiencing new things that bring you joy, adapting to new ideas, and staying fit and socially active will help in the fight against depression, and make you feel more connected to your loved ones and the surrounding community.

Depression can make taking action and helping yourself a very difficult task to do, and at some times, simply thinking about it can overwhelm you. However, even taking small steps can greatly help you feel better. A short walk is something that you can do at any time, and will undoubtedly improve your general mood. If you continue making small steps on regular basis, the symptoms of depression will lessen and you will notice your mood improve over time, bringing back your energy and optimism. Here are some recommendations you can take to apply self-help and fight depression:

Recommendation 1 – Stay socially active

When you’re depressed, you will find yourself uninterested in doing something or interacting with people. However, social isolation will only make the symptoms of depression worse. When you’re isolated, you will have a difficulty gaining perspective and have a lack of support when you do try to fight depression. This is the reason support works, and because of that, you should try to connect with other people and decrease the time you spend alone. If for any reason, you’re unable to go out and socialize, you can always invite people to come over, or stay in touch with calling them or sending an email. However, digital communication isn’t a suitable replacement for personal contact. Try your best to have face-to-face contact with people every day, and your mood will undoubtedly improve over time.

Go out and give your best to avoid staying at home all the time. Have a walk in the park, a lunch or dinner with a friend, visit the ZOO, or go to the theatre or a concert.

Volunteer. You will find that providing help to other people can make you feel better and have a feeling of purpose, in addition to increasing your social circle.

Join a support group – Consider joining a depression support group, as you will benefit from hanging with other people that are struggling with the same issues you are, and it will also let you socialize. You can also find out how other people are managing their depression.

Take in a pet – Aside from keeping you company, a dog will also make you go out more, letting you exercise and socialize with other people and dog owners.

Take classes or join a club that has activities that you like. Being around like-minded people in a senior center, or a book club will allow you to socialize and have fun.

Foster laughter – Laughter can be a great mood booster, and sharing funny stories and jokes with friends and family is a great way to do that, aside from watching comedy movies, funny clips, or reading funny books.

Recommendation 2 – Find a purpose in life

In order to fight depression and make sure it doesn’t come back, you should focus on staying active with a clear purpose in life. As the years go by, your life will change which means that you probably won’t be able to enjoy things that used to bring you joy, leaving your life without a purpose and meaning. Some of these include retirement, losing loved ones, moving to a new location, financial issues, health issues, and more. While these can negatively affect your mood and sense of self-worth, there are ways you can give life a new meaning and purpose, allowing yourself to once again feel engaged and happy. Some of the ways you go about this are:

Focus in the present – You might be feeling agitated by the fact that you are no longer able to do the activities you enjoyed in the past, or the extent to which you can, or you might be feeling bad about growing older and that’s hurting your self-confidence. These are things that you quite possibly cannot change, so it might be better to focus on the present and do the things that you are able to. If you focus on new activities and experiences, you will notice how much better you can feel about yourself.

Learn and experience new things – Maybe there’s something that you used to want to learn or do, but because of time constraints you weren’t able to. Something like learning to use a musical instrument, a new language, some sport, or a game. You will find that learning new things and activities will make you feel better, both physically and mentally, as your brain and body will stay engage, improving your overall health and slow down or prevent cognitive decline.

Take care of your body – Once you retire, it’s normal to let yourself go and gain a bit weight since you’re no longer as active as you were when you were working. A short workout during the morning will go a long way in improving your appearance, in addition to improving your self-confidence and mood.

Take up travelling – Upon retiring, there’s a high probability that your children would’ve moved out of your house, which means that you will have more time on your hands that you can use to visit the places you always dreamed about. Go on a vacation to a difference country, or visit some place for the weekend. Your travel plans don’t have to include something over the top in order for you to enjoy them. A simple walk to a park, fishing, camping, or going to the gym can do a lot for your mood.

Take up some new skills, like painting or crafts.

The road to a meaningful and purposeful life will be different for everyone, but the idea behind it is to find some activity that brings you joy and relaxation. Taking care of your mental health will benefit your both physically and spiritually.

Recommendation 3 – Live more healthy

Depression can make it very hard to get motivated and start being active, or even taking care about your health. It is important to note that healthy habits have a positive effect on depression symptoms, so, the more time you spend on taking care of your mind and body, the better you will start feeling. Some of the ways you go about this is by:

Being more physically active

Physical exercise is considered to be a highly effective depression treatment. As a matter of fact, several research studies have suggested that exercise can be on the same level of effectiveness as antidepressants. The good part is that you don’t have to do extreme exercises in order to benefit from them. A short walk outside will make you feel better almost immediately. In fact, anything that will make you be more active will be beneficial to your health. If you don’t feel like taking up a bigger commitment, start slow by taking the stairs instead of the elevator, do some housework, trim the garden, or go to the park – you will notice that all of these smaller activities will slowly add up.

In case you’re sick, fatigued, or disabled, lots of safer exercises exist that you can use to increase your strength and improve your mood, no matter you’re doing it on the chair or wheelchair. Your body will tell you when you need to take a break, so pay attention to it.

Control your eating habits

As a senior, small adjustments to your diet will also help you manage the symptoms of depression. Pay attention and try some of these tips:

• Minimize sugar and refined carbs intake. While sugar and comfort food will give you a mood boost, they will hurt you on the long run, as they can disrupt your blood sugar levels
• Eat food full in protein, complex carbs, and healthy fats. Eating quality food will make you feel satisfied both emotionally and physically
• Eat less, but more often. If you the period between each meal is very long, it can negatively impact your mood, making your feel fatigued and more agitated. Therefore, make sure you have a snack in between meals, or eat every 3-4 hour hours.

Get enough sleep

Sleep disruptions, such as insomnia are a common problem for seniors. It goes without saying that sleep deprivation will make your depression worse. You should try to get at least 7 to 9 hours of sleep every day. You can improve your quality of sleep by avoiding drinking alcohol and caffeine, don’t change your sleep schedule, and sleep in a dark, cool, and quiet room.

Go out in the sun

Sunlight has been proven to help increase serotonin levels, which improves your mood, and help you deal with Seasonal Affective Disorder. Therefore, whenever you get the chance during the day, you should go outside and enjoy the sun for at least 15 minutes a day. Instead of drinking your coffee in your living room, drink it outside or near the window, do some gardening, or take a walk. You can also try out some social activities such as hiking or playing golf with friends. If you live in an area that doesn’t get many sunny days, especially during the winter, you can always try out a light therapy box.

The link between alcohol and depression in seniors

Emotional and physical pain can make it tempting to consider drinking alcohol as a way to cope with the issues you’re having. While it might help you in the short run, making you take your mind off whatever’s troubling you, alcohol can worsen the symptoms of depression on the long run. Alcohol also impairs brain function and can have adverse effects when mixed with many types of medications, antidepressants included. Don’t forget that even though alcohol might help you fall asleep more easily, it will also decrease the quality of sleep you will get.

Recommendation 4 – Seek professional help when you need it

Treating depression is as effective and important for seniors as it is for younger people. What’s different, though, is that because depression in seniors is caused or made worse by a life change or difficulty, the treatment plan will need to take care of that issue as well. For example, if the reason behind the depression is loneliness, medication won’t do much on its own.

Risks of antidepressants

Seniors will react more to the side effects of various medications, and they are more likely to interfere with some other medication they might be taking. Some studies have shown that SSRIs like Prozac can lead to rapid bone loss, and an increased risk of bone fractures and falls. Because of this, seniors that are taking antidepressants need to be monitored.

Therapy and some lifestyle changes, like physical exercise, have been proven to be on the same level of effectiveness as antidepressants, and, as a cherry on top - they don’t have negative side effects.

Counseling and therapy options

Therapy is a good treatment option for depression as it focuses on the root cause of depression, not only the symptoms. The ways these treatment options help are:

• Supportive counseling can include religious and/or peer counseling. The way this type of treatment can help is by minimizing the effects of hopelessness and loneliness by helping people find new meaning and purpose in their lives.
• Therapy works by helping you cope with stress in life, recover from personal loss, and manage difficult periods and emotions in life. Therapy can also help with negative thoughts and come up with effective coping skills.
• Support groups that focus on depression, ailments, or loss of loved ones can help you connect with other people that are coping with the same issues, making it easier to open up. These support groups can provide a safe haven for people to share their thoughts, experiences, and provide motivation to each-other.

How to help a senior with depression?

Depression is hard to treat because it makes it hard for the person affected to ask for help, drains them of their energy, and self-confidence. Depressed elderly people were raised during times when mental illness was stigmatized and largely misunderstood, which makes treatment increasingly more difficult, which is compounded by the fact that some seniors don’t event believe in depression, or are too ashamed or proud of themselves to ask for help, and some are afraid of adding burden to their families.

If you have a senior that is depressed, you can provide help by giving them emotional support, and start by carefully listening and having patience and compassion. You are not required to do anything and try to “treat” their depression, as only being there for them can be very helpful. When thee depressed person opens up, refrain yourself from criticizing their feelings, and provide hope. Another way you can help is by making sure they get properly diagnosed and treated. You can do this helping them find a good doctor, take them to their scheduled appointments, and provide moral support.

Additional recommendations for helping people with depression

While the recommendations we provided can prove to be quite useful, there are many other ways that you can provide support for a loved one with depression. Here are some of them:

• Invite them to go out together – Depression will be harder to manifest when you’re physically and mentally active. You can offer your loved one to do some activities which they used to enjoy in the past, such as walks, arts classes, theatre, movies, golfing, or anything else that will stimulate their bodies and minds
• Appoint social activities on a regular basis – Social activities such as visits to family members or friends, trips to the local community center will go a long way in fighting loneliness and social isolation. Be gently persistent if your loved one refuses to do this, as even though people with depression might not have the desire, being around other people often helps with depression
• Make a weekly meal preparation – Unhealthy diet can also worsen the symptoms of depression, so you need to ensure your loved one is provided with quality nutrition that includes a good balance of fruits, vegetables, whole grains, proteins and vitamins in every meal they have
• Make sure they are following their treatment plan – It is not unusual for depression to come back if treatment is halted too soon. Therefore, you need to make sure that your loved one is following through with their treatment, and, if the current treatment plan isn’t doing anything to helps them, consider some other medications and treatment plans
• Be vigilant for suicidal tendencies – If you suspect that your loved one is thinking of suicide, waste no time and look for professional help immediately

Additional resources for support and treatment of depression:

Treatment

Older Adults and Depression – Signs and treatment of depression in older adults. (NIMH)
Depression in Older Adults – What it feels like, what the risk factors are, and how you can help yourself. (Royal College of Psychiatrists)
Depression – Diagnosis, treatment and alternative techniques for treating depression. (Mayo Clinic)
Support and hotline
U.S..: Find DBSA Chapters/Support Groups or call the NAMI Helpline for support and referrals at 1-800-950-6264
UK: Find Depression support groups in-person and online or call the Mind Infoline at 0300 123 3393
Australia: Find Support Groups and regional resources or call the SANE Help Centre at 1800 18 7263
Canada: Call Mood Disorders Society of Canada at 613-921-5565
India: Call the Vandrevala Foundation Helpline (India) at 1860 2662 345 or 1800 2333 330
Suicide prevention help
In the U.S.: Call National Suicide Prevention Lifeline at 1-800-273-8255
UK and Ireland: Call Samaritans UK at 116 123
Australia: Call Lifeline Australia at 13 11 14
Other countries: Visit IASP or International Suicide Hotlines to find a helpline near your location