Depression in Older Adults - A Review

Introduction

Depression among the older age group often goes unnoticed and is overlooked. However, due to various illnesses and being lonely, it is more common in the older age groups. They keep it hidden owing to the fear of stigma and less access to healthcare facilities. This results in less reporting and treatment by professional doctors. It is a true and treatable medical condition and must be treated similarly. This article intends to explore the topic of depression in older adults, emphasizing the causes, symptoms, and various treatment options available for them.

What Is Depression?

Depression is a common mental health disorder primarily shown as a person who feels hopeless and sad and shows no interest in any activities. Depression affects the overall body, thoughts, emotions, and well-being. It significantly interferes with routine activities and may need professional help for effective management.

Depression is common in older adults, though it is underdiagnosed and not recorded. However, due to fear of being generalized as a crazy person or considering it as a part of aging, the individuals do not seek help and suffer on their own.

What Are the Causes of Depression in Older Adults?

1. Health Conditions: Many older adults suffer from at least one chronic health condition like diabetes, heart disease, or arthritis. These affect their lifestyle and habits. Many develop chronic pain due to these, and it limits their ability to do activities they did when they were younger. Thus, while dealing with these conditions, it is common to face depression as it has a significant effect on mental health.

2. Misdiagnosis or Undiagnosed: Frequently, depression in the elderly remains undiagnosed as it is mistaken for a natural aging process. Sometimes, the patient keeps their feelings hidden and does not seek help.

3. Genetics: People who have a history in their family of having depression are at greater risk of developing clinical depression.

4. Grief: Often, older adults have gone through a series of losses due to death or departure from their lives. It could be family members, friends, siblings, or other loved ones. This leads to sadness and depression, which will be more severe if not addressed.

5. Substance Abuse: Certain older individuals are used to drugs, alcohol, and other addictive substances. Not getting it on time due to family restrictions, financial situations, etc, may also lead to depression.

6. Retirement and Boredom: Some older age individuals may find it difficult to stay at home post-retirement. They may seem to lose their purpose when they stop their job, and this may lead to stress. Also, some degree of movement limitation or functional limitation makes them feel incapable of doing anything. It can also lead to clinical depression.

7. Financial Issues: Many older adults do not have sufficient post-retirement savings or no plan. This if accompanied by an increase in expenses and no one to provide financially, will lead to financial insecurity and crisis. This is also a major reason for feeling depressed in that age group.

8. Loneliness: It is common in old age groups to feel lonely as the children may grow up and leave homes, and friends may get busy with their own lives, which leads to a deep feeling of loneliness. This, in turn, makes them more vulnerable to falling into depression. Studies show that people who are lonely and remain socially separate have the highest rates of depression.

9. Aging Signs: Aging results in a lot of physiological changes in the body such as hormonal changes, and changes in the brain chemistry. All these changes make the person more susceptible to depression.

What Are the Symptoms of Depression Seen in Older Adults?

It is important to know that depression signs and symptoms vary completely in different people. People from different backgrounds may express completely variable symptoms than others.

The common symptoms of depression seen in older adults:

• Sadness.

• Feeling hopelessness.

• Sleep irregularity- excess or insomnia.

• Extreme tiredness.

• Body aches.

• Not able to concentrate.

• The feeling of guilt, worthless.

• Irritability.

• Loss of interest in hobbies.

• Eating too much or too little.

• Sudden weight loss or gain.

• Digestive problems that are persistent.

• Suicidal thoughts.

It is advised not to ignore any signs of depression and seek immediate help. Serious cases of depression lead to suicide and loss of life.

What Are the Various Available Treatment Options for Depression in Older Adults?

1. Healthy Lifestyle: It is highly encouraged to have a healthy and balanced meal, engage in regular exercise or physical activity, get adequate rest or sleep, and have good social engagement.

2. Social Support Groups: It is necessary to involve them in social groups with similar individuals wherein they can share their experiences and positive stories to encourage each other.

3. Medical Intervention

   • Pharmacotherapy: The medications for depression must be taken only on physician advice. Commonly used medications are selective serotonin reuptake inhibitors. It is important to discuss the effects, drug interactions, and side effects with the healthcare provider before starting any medicines.

   • Psychotherapy: Also known as counseling. It can help a person speak out their feelings, emotions, needs, and thoughts. They can speak with a psychologist, a psychiatrist, or any other licensed professional.

   • Therapy: Cognitive behavioral therapy and interpersonal therapy are all forms of therapy to help in coping with depression.

   • Complementary Medicine: Approaches like yoga and meditation might be effective in individuals handling stress.

   • Electroconvulsive Therapy: Electrodes placed on a person’s head. A mild, safe electric current is passed through the electrodes to stimulate the brain. This treatment is to be considered in cases of severe depression.

   • Repetitive Transcranial Magnetic Stimulation: This technique utilizes magnets with the intention of activating the brain. The advantages of this compared to electroconvulsive therapy are there are fewer side effects like tiredness, nausea, or memory loss.

A combination of treatments seems to be more effective in older adults. Treatment preferences differ from person to person and are based on the symptoms that are present.

Conclusion

In older adults, depression is complex and has multiple causal factors. It has a significant effect on their well-being and social life. It is important to understand the various causes and symptoms to help prevent the onset of depression. If suspected, the individual must be encouraged to seek professional help without hesitation, fear of stigma, or shyness. It is a great idea to build social groups of individuals going through similar experiences to share their stories and understand the importance of treatment together.