“Old age ain’t no place for sissies.” Actress Bette Davis said that, and everyone else who has struggled through the difficulties of aging knows what she’s talking about. There is no avoiding the physical problems and emotional issues that come with growing older. They’re enough to make anyone feel, at times, sad, anxious and depressed. But that doesn’t mean clinically depressed.
To be diagnosed with clinical depression, an individual must experience one or more of the symptoms of depression for at least two weeks. These symptoms must be severe enough to interfere with personal relationships or daily activities. Clinical depression is a disease, not “the blues,” and, despite what some may think, it is not a natural part of aging.
[See: Am I Just Sad — or Actually Depressed?]
In fact, the National Institutes of Health’s Senior Health website says “studies show that most older adults feel satisfied with their lives, despite having more illnesses or physical problems.” While acknowledging that seniors are confronted with difficult, stressful and sad life events, such as the death of a loved one, leaving the workforce and adjusting to retirement or coping with a serious illness or illnesses, “After a period of adjustment, many older adults can regain their emotional balance.”
Dr. Susan W. Lehmann, clinical director of the division of geriatric psychiatry and neuropsychiatry and director of the Geriatric Psychiatry Day Hospital at Johns Hopkins University School of Medicine, concurs. “Depression is never considered a normal part of aging,” she says. “While the more of life we live, the more likely we are to experience times of sadness and grief related to loss or change, most people handle these life challenges without developing a persistent depressive disorder.”
Adds Ellen Frank, professor emeritus of psychiatry and psychology at the University of Pittsburgh, “We think depression is inevitable in the elderly, because they have losses of function, illness, they lose friends and partners,” she says. “But in fact, if those who are challenged by many of these things have good social support, depression is far from inevitable.”
Special Concerns for Seniors
Of course, some seniors do develop clinical depression. According to the National Institute of Mental Health, or NIMH, the following characteristics or conditions may put older adults at a higher risk for depression:
— Being female.
— Having a chronic medical illness.
— Having a disability.
— Poor sleep.
— Being lonely or socially isolated.
— Having a personal or family history of depression.
— Using certain medications.
— Having a brain disease.
— Abusing alcohol or drugs.
— The death of a spouse, divorce, caring for someone with a chronic illness or other stressful life events.
A number of medical and neurological conditions have high rates of depression associated with them, including stroke, cancer, diabetes, Parkinson’s disease and Alzheimer’s disease, Lehmann says. “These are all medical conditions which are more common in older adults. A recent study found that 25 percent of people who experience a stroke will develop depression within two years of the stroke, with rates being especially high in the first three months after a stroke,” she says.
The NIMH also notes that those over age 65 may need to be more careful when taking medications than younger adults, especially when they’re taking several medications for different health issues. That’s because older adults may be more sensitive to medication and have a higher risk for bad drug interactions, missed doses or overdosing. However, there are strategies to help, such as getting all medications from the same pharmacy to monitor multiple drugs and their potential interactions, and speaking with the doctor about prescribing smaller and less-frequent dosages if possible.
Depression may affect seniors differently than younger adults. “Many older adults develop difficulty with cognitive and mental functioning as a consequence of depression,” Lehmann says. This typically involves problems with planning, organizing and prioritizing, and can be concerning, especially if they interfere with everyday functioning such as cooking, taking medications or paying bills. “The relationship between cognitive impairment and late-life depression is complex, because up to 20 percent of individuals with Alzheimer’s disease develop depression, and often depression is an early sign of the beginning of Alzheimer’s dementia,” she says. The good news, she adds, is that these cognitive changes typically improve as the depression is treated.
[See: How to Help Aging Parents Manage Medications.]
Late– Life Depression Is Treatable
Depression in later life is highly treatable with antidepressant medications and psychotherapy. “In particular, treatment studies have shown cognitive behavioral therapy, problem-solving therapy and interpersonal therapy to be effective for older adults with depression,” Lehmann says. Professional treatment is essential, she adds, because depression later in life is unlikely to resolve on its own, and it can contribute to physical decline, greater dependency and social isolation.
“In addition, professional treatment is necessary to prevent suicide, clearly the most serious consequence of depression,” she says. “Suicide rates are high in older adults, and are especially high in older Caucasian men, whose risk for suicide is greatest in men over the age of 85.”
[See: 5 Ways to Cope With Mild Cognitive Impairment.]
However, it remains important to know that depression is not normal in later years. “The reality is, aging stinks,” says Dr. Philip R. Muskin, professor of psychiatry at Columbia University. “You lose people, your joints ache, you tend to gain weight, you may be slower in mental processing, your eyesight or hearing isn’t as good — and that stinks. But some people celebrate their age. They realize, ‘I can’t exercise as I used to but I’m as hale and hearty as I can be at 85.'”
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Seniors and Depression: Not a Normal Part of Aging originally appeared on usnews.com
