Depression in the Elderly: Causes, Prevention, and Treatment

Depression affects people of all ages, from children to the elderly. Depression in the elderly may appears different than in other ages. As they age, older people experience many things and are often reluctant to express their feelings during the initial health examination. If geriatric depression is not identified and treated earlier, greater health risks will arise later in life.

Recognizing Depression in the Elderly

Depression is a mental health problem and is not a normal part of the aging process. However, adult people are more prone to depression. There are many factors contribute to the emergence of depression in the elderly, not just feelings of sadness or emotion that are present for a moment due to certain events.

Psychogeriatrics is a branch of psychiatry that focuses on mental health conditions among the elderly, including geriatric depression and depression treatment. This mental health issue is often left undiagnosed, thus the elderly affected by depression have to live with it without standard treatment.

Some of the reasons why elderly depression is so commonly overlooked and as a consequence lack of treatment include:

• Belief that depression is normal as people get older
• There is a denial because they are ashamed of social stigma 
• The elderly often does not experience typical depressive symptoms (masked depression)

One of the health problems linked with depression in the elderly is dementia. There is a tendency for older people with dementia or memory impairment to also suffer from depression. According to a number of studies, depression symptoms are associated with signs of the emergence of dementia.

Causes of Depression in General

The exact cause of depression is unknown, but there are several things that are often linked with this condition. Depression often results from a mix of certain life events and long-standing personal factors.

Certain events

Events of persistent life difficulties are more likely to cause depression than momentary stressful events. Example:

• Long term unemployment/inability to find a job
• Living in an unhealthy/loveless relationship
• Isolated for a long time or feeling lonely
• Daily work pressure

However, a recent event, such as losing a job, can also trigger depression if there have been personal factors or bad experiences in the past.

Personal factor

• Family history: if someone in a family has depression, other family members have a higher risk of depression as well.
• Personality: prone to worry, low self-esteem, perfectionist, sensitive to personal criticism, or often has a negative thought.
• Serious illness: anxiety and stress from a serious illness can lead to depression.
• Drugs and alcohol: drugs and alcohol use can lead to and be triggered by depression.

Causes of Depression in the Elderly

As people age, there are changes in life that may increase the risk of depression in the elderly, such as:

• Chronic illness, disability, or cognitive decline
• Loneliness and isolation, for example because they live alone, limited mobility, or people around them have died or moved, including spouse and children
• Decline in purpose in life, for example entering retirement
• Lack of interesting and fun activities
• Anxiety about certain things, such as about finances or fear of being abandoned by family
• Deep sadness, for example the death of a loved one
• Experiencing abuse either physically or mentally
• Certain drugs that can trigger depression as an adverse effect

How to Recognize Depression

Depression in the elderly often manifest differently compared to younger people. For example, a depressed elderly person may not always show sadness, but constantly feel low on energy and other age-related symptoms. Therefore, family members, doctors, and even the individual themself are difficult to recognize the depression they experienced.

As a precaution, pay attention to their attitudes and behaviours in everyday life that may be symptoms of depression, such as:

• Feelings of hopelessness and/or pessimism
• Feelings of guilt, worthlessness and/or powerlessness
• Short-tempered
• Uneasy
• Loss of interest in activities or hobbies that used to be enjoyable
• Exhausted and lack of energy
• Trouble concentrating, remembering details, and making decisions
• Insomnia, waking up early, or oversleeping
• Overeating or loss of appetite
• Having suicidal thoughts, suicide attempts
• Persistent aches or pains, headaches, cramps, or digestive problems that don’t go away despite treatment

How to Prevent Depression

Depression in the elderly often goes in disguise. Mostly, this case of depression can’t be prevented. But there are a number of ways to improve mental health in the long term.

• Physically active
• Practice a healthy and balanced diet
• Sleep 7-9 hours every night
• Keep in touch with friends and family
• Doing activities you enjoy
• Tell your friends, family, and doctor if you think you might be depressed
• Take part in a certain elderly depression prevention program

What are the therapies?

In psychogeriatrics, there are various types of therapy to treat depression. To determine which one is right, a psychiatrist will first conduct an examination to establish a diagnosis. For example:

• Antidepressant drugs to modify the chemicals level in the brain
• Psychotherapy through conversation or communication with a psychiatrist in therapy sessions
• Cognitive behavioural therapy to identify and shift negative thoughts and behaviours into positive ones
• Electroconvulsive therapy to stimulate the brain’s electricity, usually for major depression

How to Improve Quality of Life in Depression

Depression is a real and treatable condition. Treatment of depression in the elderly is not always easy, but proper treatment can improve the quality of life. Support from the loved ones is very helpful for elderly people who are depressed. In addition to maintaining a healthy lifestyle, the family can encourage the individual to participate in treatment therapy sessions by a psychiatrist to relieve depression.