The best way to approach your older adult is to express it as concern for his or her health. If anger is part of the older adult’s depression, do not bring up the topic during an angry moment but instead later when emotions are calm.
Generally, there are two types of depression – incidental and clinical. The incidental type of depression is normal, periodic and is in reaction to a life occurrence. Clinical depression is an imbalance in a person’s physiology, often referred to as a "chemical imbalance."
Both types of depression can be treated. Sometimes for incidental depression, increased social contact and attentiveness by friends and relatives is all that is needed to get someone out of depression. Physical activity can also reduce feelings of depression. However, if incidental depression lingers over an extended period of time, the personal lifestyle of isolation from others and a negative outlook on life that develops from depression can become a way of life and only medication can help.
It can be difficult to tell in older adults if depression is incidental or clinical. Older adults, simply because of age deal with issues that may cause depression, such as frequent death of people close to them, physical limitations due to pain and chronic illnesses, and mobility and vision problems that may restrict them from hobbies and social activities.
Getting a professional opinion, ideally from a geriatric psychiatrist, is the best way to determine if your older adult has a problem with depression. Because older adults react differently to medications due to having slower metabolisms and special sensitivities, a psychiatrist with training in geriatric care is best. However, if a geriatric specialist isn’t available, at least turn to a psychologist or psychiatrist – not a general physician – for mental health treatment.
With proper medical treatment for depression, an older adult will likely become more socially and physically active. Often medical treatment for depression can result in unexpected improvements in addition to reducing depression, such as increased mental clarity and memory, less pain, less gastronomic and headache problems, and positive changes in other physical disorders.
Interrupted sleep is common among adults age 70 and over. Treatment for depression can also improve sleep and result in greater personal energy for an older adult.
How do you know when an older adult’s depression is a normal part of life or in need of medical attention? Lack of doing normal activities and isolation from social contact are good indicators that there is a problem. Also, often there are specific emotional, cognitive, physical and behavioral symptoms.
The following are symptoms in each category:
Emotional: crying, apathy, lack of feeling or interest, and overall dissatisfaction with life.
Cognitive: memory problems, disorientation, decreased attention span, feeling pessimistic, low self-esteem, hopelessness, difficulty concentrating, suicidal thoughts and dwelling on past failures.
Physical: headaches, weight loss or gain, stomach distress, sleep disturbances, pain and fatigue.
Behavioral: reduced activity, obsessive worrying, hostile, agitation, irritable and restlessness.
In addition to being concerned about your older adult and possible depression, make sure to note if you are having symptoms of depression and get medical attention, if necessary. Also, consider taking a break from caregiving, if it is causing you stress. It may be all you need to regain a positive perspective on life.
Lorna Couillard