Perfectly Awesome Life

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*information from Mood Disorders Canada

• it is estimated that 5% to 10% will experience a depressive disorder that is serious enough to require treatment. And the rate of anxiety and depression dramatically increases to 30% to 40% for seniors living in institutions.

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How do I know if its depression? 
 
A depressive illness is more than just feeling sad. Depression affects the whole person including their feelings, thinking and physical health. It also lasts a long time. It's important to know what to watch for. Anxiety and slowing of thoughts are common symptoms. For many seniors depression is often expressed through many vague complaints of physical aches and pain. The most common symptoms of depression include:  

Physical changes 
 
• Changes in appetite - with a resultant weight loss or weight gain. 
• Sleep disturbances- with trouble falling asleep, staying asleep or sleeping too much. 
• Sleep, when it comes, does not restore and refresh. People often report feeling worse in the morning with the mood lifting as the day goes on. 
• Decreased energy, with feelings of weakness and physical fatigue. 
• Some people experience agitation with restlessness and have a need to move constantly. 
• Phantom pains, headaches, muscle aches and pains, with no known physical cause. 
• Stomach upsets - constipation. 
 
Changes in thinking 
 
• Thoughts may be confused or slowed down which makes thinking, concentrating 
or remembering information difficult. 
• Decision-making is difficult and often avoided. 
• Obsessive ruminations, a sense of impending doom or disaster. 
• Preoccupation with perceived failures or personal inadequacies leading to a loss in self-confidence. 
• Becoming harshly self-critical and unfairly judgmental. 
• In extreme cases, there can be a loss of being in touch with reality, perhaps hearing voices (hallucinations) or having strange ideas (delusions). 
• Persistent thoughts of death, suicide or attempts to hurt oneself. 
 
Changes in feeling 
 
• Loss of interest in activities that were once a source of pleasure. 
• Decreased interest in and enjoyment from sex. 
• Feelings of worthlessness, hopelessness, and excessive guilt. 
• Deadening or an absence of feelings. 
• Sense of overwhelming or impending doom. 
• Loss of self-esteem. 
• Feeling sad, blue and down in the dumps that may be worse in the morning lifting as the day goes on. 
• Crying for no apparent reason. 
• Irritability, impatience, anger and aggressive feelings. 
 
Changes in behaviour 
 
• Withdrawal from social and leisure activities. 
• Failure to make important decisions. 
• Neglecting duties such as housework, gardening, paying bills. 
• Decrease in physical activity and exercise. 
• Reduced self-care such as personal grooming, eating. 
• Increased use of alcohol or drugs (prescription and non-prescription).

 

Why is it important to treat depression in the elderly? 
 
• Depression throws a dark cloud over our emotional well-being, draining away pleasure and robbing people of hope. Depression can lead seniors to further isolation and despair. 
• Depression tends to last much longer in the elderly and can result in unnecessary or premature placement in institutional care. 
• If depression is not managed, it can compromise the treatment of other conditions and can increase the risk of prolonged disability or early death. 
• Untreated depression can also leave seniors more vulnerable to developing other serious health conditions such as heart disease, infections and immune disorders. 
• Depression can make people feel angry, irritable and anxious. This can rob families of the pleasure of their loved one’s company and place an additional burden on care providers. 
• The risk of suicide in elderly is high and it is particularly high for depressed elderly men. 
 
What factors can increase the risk of depression in the elderly? 
 
• The presence of other illnesses which compromises your ability to get around and be independent. 
• Some medications or the interaction between medications are associated with depression. 
• Living with chronic or severe pain. 
• Living alone without a supportive network of friends and family. 
• The recent death of a loved one. 
• Fear of death. 
• A previous history of depression. 
• A family history of major depressive disorder. 
• A past history of suicide attempt(s). 
 
Illness increases the risk of depression 
 
There are a number of medical conditions that are associated with depression in the elderly. Some are: 
 
• Heart problems including having a stroke 
• Low thyroid activity 
• A lack of vitamin B12 or folic acid 
• Low blood pressure 
• Rheumatoid arthritis 
• Cancer 
• Diabetes 
 
Many commonly prescribed medications are associated with depression or making depression worse such as: 
 
• Blood pressure medications 
• Beta-blockers 
• Steroids  4
• Digoxins 
• Sedatives 
 
If you are being treated with any of these medications, it is important to talk with your doctor to rule out their use as the cause of your depression. Don’t stop your medications without advice as a sudden discontinuation can have serious health consequences when your body struggles to adjust. 
 
Medication 
 
Usually relief is felt within a few weeks of starting medications, however it can take longer for older people to feel better. Sleep and appetite are usually the first to improve. Don’t expect a complete recovery right away. It usually takes about ten to twelve weeks to lift out of depression. Often those close to you who will see an improvement in your mood before you begin to feel it. 
 
Build social supports 
 
The paradox of depression is that at a time when you most need to draw people close - you may want to avoid contact with others. However, most people find that the support of family and friends, participation in a self-help group or talking with a professional counselor can be very helpful in overcoming depression. 
 
Dealing with social isolation is an important part of healing and can help prevent further episodes of illness. Lots of studies show us that being part of a supportive family, being part of a religious group or being active in your community is an important part of health, wellbeing and improved quality of life. Consider joining a support group for depression as part of your recovery. 
 
Talk therapy 
 
Psychotherapy can be very helpful in dealing with losses, solving challenging problems or dealing with the social impact of depression. Cognitive therapy can help you look at your thought patterns which may be negative and self-criticizing. It will also help you make the connection between your thoughts, feelings and behaviours. What you think affects how you feel and how you behave.