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Depression in Seniors: Myth vs. Truth

Did you know that people over age 65 have higher rates of depression and suicide than the rest of the population? White men age 85 or older are almost five times more likely to take their own lives than the general population. Studies show that up to 75 percent of older adults visited their doctor within one month of taking their own lives. Did they not ask for help? Did no one see the danger? It doesn’t have to be this way. “Seniors are more likely to suffer from depression and their depression is more likely to go unrecognized,” says Gary Kennedy, MD, director of geriatric psychiatry at Montefiore Medical Center in Bronx, New York. “There are many reasons that seniors get depressed including changes in the brain associated with aging, chronic illness, chronic pain and isolation.”

Is Depression A Normal Part Of Aging?

“Loss of a loved one or a sudden loss of independence due to illness can disrupt a senior’s social rhythms and add stress that leads to depression,” explains Dr. Kennedy. “Examples would be a hip fracture that leads to loss of mobility or a stroke. Studies show that about 25 percent of people develop symptoms of depression following a heart attack.” The stress of illness or loss is a normal part of aging and it is normal for seniors to react with sadness and grief, but prolonged depression is not normal and it is very dangerous. “The two big myths about depression in the elderly are that depression is a normal part of aging and that it is more difficult to treat. Depression in the elderly may be more common, but it is certainly not normal and it can be treated just as successfully in seniors as in anyone else.”—Gary Kennedy, MD

Common Triggers for Depression in Seniors

Life changes introduce stress that increases the risk for depression. Seniors with a history of depression, a family history of depression, serious health issues, substance abuse issues and poor social support systems are at the highest risk. Here are some common triggers:
  • Loneliness
  • Other illnesses
  • Medications
  • Bereavement
  • Relocation

Is It Really Depression Or Something Else?

Common symptoms of depression include sadness, hopelessness, withdrawal, changes in appetite and sleep patterns and thoughts about death. Seniors may be less likely to express their feelings because they believe that depression is a sign of weakness, something to be expected or because they do not want to be a burden. Depression may also be confused with medication reactions or symptoms of diseases associated with aging like Parkinson’s or Alzheimer’s. Here are some clues to help identify depression in the elderly:
  • Normal sadness or grief gradually gives way and has periods of relief. Depression is relentless and life is joyless.
  • Seniors may complain about lack of energy or their physical symptoms, or seem to worry excessively instead of expressing the common feelings associated with depression.
  • Medications that can have side effects mimicking depression include steroids, pain relievers, hormones, tranquilizers and other medications given for heart disease, arthritis, cancer or high blood pressure.
  • Diseases that cause mental changes in seniors that can mimic depression usually come on more slowly and can cause disorientation, loss of motor skills and short-term memory loss. Seniors may seem to be unaware of these changes. Depression has a more rapid onset, may slow down motor skills and cause confusion, but seniors are more aware of these changes and are concerned about them.

Final Tips for Seniors and Caregivers

“Often the first person to notice the signs and symptoms of depression is a family member or caregiver,” says Kennedy. Here are some final tips from Dr. Kennedy for recognizing depression in seniors:
  • Pain that seems out of proportion and is not relieved by medication
  • Changes in mood including irritability, apathy and being argumentative
  • Loss of interest in social activities
  • Unexplained weight loss
If you suspect depression, talk to your doctor. Depression is treatable and treating depression can change a senior’s life. Studies show that 80 percent of seniors recover from depression with some combination of psychotherapy and antidepressant medication. If a senior or a caregiver suspects that there is a danger of suicide, call 1-800-273-TALK. The National Suicide Prevention Lifeline is available 24 hours a day.