Signs And Symptoms Of Depression In The Elderly
Getting older: It is a natural part of life, sometimes considered a reason to celebrate, enjoy one’s later years, and spend time with loved ones. However, aging may not always be easy, particularly for those who experience mental health challenges later in life.
Before getting into the reasons depression might affect older adults, it may be worth reviewing what depression is and how it may manifest.
Common symptoms of depression
- A persistent feeling of sadness or emptiness
- A loss of interest in previously enjoyed activities
- Trouble concentrating, making decisions, or remembering things
- Feelings of hopelessness or worthlessness
- Feelings of restlessness or anxiety
- Trouble fulfilling daily responsibilities
- Insomnia or oversleeping
- Changes in appetite, such as over- or undereating
- Weight fluctuations
- Muscle aches or unexplained pains
- An increased use of alcohol or drugs
What are the different types of depression?
- Major depressive disorder: Commonly associated with the more general term “depression,” major depressive disorder refers to depression that persists for an extended period of time (typically two or more weeks) and can affect day-to-day functioning.
- Postpartum depression: Sometimes referred to as PPD, postpartum depression is a form of depression that may affect new parents.
- Seasonal affective disorder: Seasonal affective disorder, also known as SAD, is a form of depression that can cause mood changes based on the seasons, with depressive symptoms often occurring in the fall and winter months.
- Persistent depressive disorder: Also known as PDD or dysthymia, persistent depressive disorder is a form of mild to moderate depression that may last for a prolonged period of time (typically two or more years).
Regardless of the type, depression can have a range of impacts on one’s mental and physical health. Because depression can impact a person’s lifestyle — for instance, their eating, sleeping, or exercise habits — it may have the potential to lead to weight gain or inflammation. This, in turn, can raise the risk of conditions like diabetes and cardiovascular disease. A long-term study published in 2020 also found an association between depression and dementia, a category of diseases that tend to be more common among older adults.
Possible causes of depression in the elderly
- The loss of loved ones
- Reduced self-reliance and independence due to lower mobility, strength, or balance
- A lack of exercise (physical activity has been associated with a reduced risk of developing depression)
- Stress, whether due to family matters, financial challenges, or other factors
- Chronic pain, which has been associated with an increased risk of developing depression, or other health conditions such as heart disease
Additional factors that may cause depression in the elderly
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Managing symptoms of depression in older adults
- Staying socially connected, whether through phone calls, video calls, or in-person visits
- Offering social and emotional support
- Participating in enjoyable activities alongside loved ones who are elderly
- Encouraging elderly loved ones to seek treatment for concerning symptoms
- Providing support in following treatment plans
Additionally, for older adults who are experiencing depression, the following strategies may be helpful for managing symptoms and tending to overall wellness:
- Getting physical exercise, whether through walking, swimming, attending aerobics classes, or participating in other activities
- Eating a healthy diet
- Getting enough sleep
- Staying connected with loved ones, either in-person or remotely
- Engaging in social activities, such as group classes, community events, or volunteer work
- Seeking treatment from a medical provider or mental health professional
- Seeking support from friends, loved ones, or other trusted sources
Treatment and support for depression and other mental health conditions
For those who need extra support when it comes to managing the effects of depression on themselves or their loved ones or the different stressors that can be part of aging, therapy can also be a useful resource. A licensed therapist may be able to provide a safe space for discussing emotions or to offer suggestions for tending to one’s mental health and overall well-being.
That said, commuting to a counselor’s office for in-person therapy may not always be practical — for example, for older adults who might be experiencing reduced mobility. In these cases, online therapy through platforms like BetterHelp may be a helpful alternative as it offers the option to attend counseling from the comfort of home via voice call, video call, or in-app messaging.
Effectiveness of online therapy as a treatment for various mental health conditions
Online therapy has been found to be an effective form of treatment for a variety of mental illnesses, including depression. For example, a 2017 study found that internet-based cognitive behavioral therapy was useful for treating and managing depression, anxiety, panic disorder, phobias, and more.
Takeaway
Strategies for managing depression later in life may include eating a healthy diet, getting regular exercise, socializing with others, and seeking treatment from a health care provider such as your primary care provider or a therapist. Therapy, either in-person or through an online platform like BetterHelp, can also be a helpful resource for those in need of additional support.
What are five common symptoms of depression in older adults?
The symptoms of depression can often be similar for individuals of all ages. For example, five depression symptoms in older adults may include:
- Loss of interest in previously enjoyable activities
- Chronic fatigue
- Sleep disturbances
- Poor appetite or overeating
- Mood swings
These symptoms may also be experienced by younger people, including middle-aged adults, young adults, adolescents, and children. However, the causes of depression in older adults may differ from other ages. For instance, elders are often isolated, which may increase the risk of developing depression.
What is the best antidepressant for older adults?
According to the British Columbia Medical Journal, several classes of antidepressants are safely used to treat depression in the elderly. These include bupropion, mirtazapine, venlafaxine, moclobemide, and selective serotonin reuptake inhibitors (SSRIs). Of the SSRIs, sertraline, citalopram, and escitalopram are considered to have the best safety profile. This is due to their low potential for drug interactions when compared to other SSRIs such as paroxetine, fluvoxamine, and fluoxetine. However, it's important to note that the best antidepressant will vary based on the opinions of one's doctors and personal experience. It's also essential to speak with a doctor before changing or beginning any medication.
What is the best first-line treatment for anxiety in the elderly?
In many cases, the first-line treatment for anxiety in the elderly is antidepressant medications. These medications often include selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs). Both have been shown to be effective and well-tolerated by older individuals. Other medications like buspirone can be effective for the elderly, but more research may be required before they are considered a first-line treatment. In addition, therapeutic approaches like cognitive behavioral therapy can be effective for individuals of all ages, including the elderly.
What is a good anxiety medication that can be taken daily?
Only a medical care professional can recommend what anxiety medications are effective or appropriate to take. It's essential to inform your doctor if you are taking any medications, whether they be for anxiety or any other other condition. Common medications prescribed for anxiety may include selective norepinephrine reuptake inhibitors (SNRIs) like Cymbalta and Effexor, selective serotonin reuptake inhibitors (SSRIs) like Lexapro and Paxil, and benzodiazepines like Xanax, Valium, and Ativan. However, not all of these medications are recommended for daily use, nor are they effective for everyone.
Is depression in the elderly common?
While older people can develop depression, research suggests that individuals over the age of 65 may have some of the lowest prevalence rates of depression at 14.2%. However, this doesn’t mean that depression isn’t a common and serious condition that can pose a risk to the well-being of the elderly. If you or a loved one are experiencing depression, it's essential to reach out for support. This may involve contacting a mental health professional, talking to your primary care physician, or speaking with friends and family members about depression-related struggles.
How can I treat anxiety without medication?
While it's important to see a medical professional in order to treat anxiety, there are several non-pharmacological approaches and healthy lifestyle changes that may help a person cope with their symptoms, including:
- Therapy: Talk therapy approaches like cognitive behavioral therapy (CBT) can be an effective way to treat anxiety. With the help of a therapist, individuals may be able to address anxiety-associated thought patterns and learn healthy coping mechanisms to improve their quality of life.
- Exercise: Physical activity and exercise can help to distract someone from negative thoughts, reduce stress, and overall lower the impact that mental and physical symptoms may have. One of the reasons that exercise is beneficial is due to its ability to release endorphins, which can positively affect mood.
- Meditation: Meditation and mindfulness may help to clear your mind and stop the negative thought patterns often associated with anxiety. Meditation can also be an effective stress reliever and help to foster a more positive sense of well-being.
What is MDD in older people called?
Depression in the elderly is commonly referred to as geriatric depression, a mood disorder that may affect as many as 7 million adults aged 65 years and older. A number of lifestyle changes and situations experienced by older individuals can contribute to geriatric depression, including more frequent health conditions, increasing levels of social isolation, the death of partners or loved ones, and an overall lack of stimulation. While a different term is used, the symptoms of geriatric depression are typically similar to those of depression in other age groups. These symptoms may include fatigue, sleep disturbances, feelings of worthlessness, a lack of interest in previously pleasurable activities, and mood swings.
What is the most common cause of depression in the elderly?
While there can be a variety of causes for depression in the elderly, one of the main sources may be a decline in physical health. As we age, humans may experience more frequent short-term or chronic medical conditions. This may reduce a person’s ability to enjoy their day-to-day life and could result in pain, loss of independence, financial hardship, or frequent thoughts of one's mortality. These effects, combined with the stress that older individuals may experience, may increase the likelihood that a person will develop depression.
What are coping skills for elderly people with depression?
Older individuals who experience depression can cope through several activities, including:
- Exercise: Physical activity, specifically exercise, has been shown to be an effective treatment for major depression in adults. While exercise can pose a risk of physical injury to the elderly, there are numerous low-impact activities (like walking and swimming) that may be beneficial.
- Socialization: Elderly individuals may be at a higher risk of isolation, which is one of several risk factors for severe depression. Joining support groups and socializing with others can help to create more positive thought patterns, establish a sense of self-worth, establish a healthy social network, and enhance the community’s overall public health.
- Adult Education: Older individuals experiencing depression may benefit from adult education courses, as these can provide mental stimulation and a sense of purpose. In addition, adult education can help these individuals improve their memory and maintain a functional level of cognition.
How common is depression in the elderly?
The rates of clinical depression in older adults can vary based on their living situation, experiences, other mental health conditions, and economic status. According to the Centers for Disease Control and Prevention, anywhere from 1% to 5% of older people may be experiencing major depression. However, that number climbs to 11.5% for older individuals who are hospitalized, and as high as 13.5% for those who require home healthcare. In addition, the elderly may also be subject to a comorbid condition that could worsen their depression symptoms, such as substance use disorder (sometimes incorrectly referred to as “substance abuse disorder.”)
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