When imagining the golden years of retirement, thoughts of golf outings, travel and bridge games might come to mind. For most senior citizens, retirement is a time of relaxation and recreation. However, a large portion of the senior demographic, about 6.5 million people, or 15 percent, are battling clinical depression, with a total of 25 percent suffering from persistent feelings of sadness. In fact, in industrialized nations, the highest suicide rate is found among males over 75 years of age.
Life events that can pile up as we age are common triggers for bringing on a depressive episode. The death of a spouse, close friends or family members; transitioning to retirement; moving from the family home; or a serious illness can all set the stage for depression. Depression can also be a side effect of medications, particularly those that treat hypertension and high cholesterol.
Normal sorrow or grieving in response to life events will typically dissipate after a period of time. However, when the symptoms following these difficult occurrences linger on for a long period it usually signifies clinical depression. Symptoms include disruption in sleep, poor eating habits, difficulty concentrating and disinterest in the things that once brought joy. In addition, irritability and social isolation, as well as senior-specific symptoms such as vague physical complaints, are common.
Risks associated with depression
Research has demonstrated that depression in the elderly can have serious, even deadly consequences. Depression can double the risk of cardiac disease in the elderly. In nursing homes, where patients with physical illnesses such as stroke, Parkinson’s disease, a broken hip or heart problems, the onset of depression significantly increased chances of death from these conditions. Serious complications of depression involve the health risks associated with alcohol and prescription drug abuse, which is a growing problem among seniors.
The most deadly risk of untreated depression among the elderly is the risk of suicide. The rate of suicide among this group has significantly increased in the past ten years. Although adults over the age of 65 represent only 13 percent of the population, they account for about 20 percent of all suicide deaths, according to the National Institutes of Health.
Why depression goes untreated among seniors
People in this age group tend to ignore their depression symptoms and often do not seek help. This is because of the stigma that exists in the older population regarding mental health disorders. Seniors might believe that they will be ridiculed or humiliated for being afflicted with the condition, and are too ashamed to seek treatment. They might also associate depression with disability and dependency, which further deters seniors from sharing their emotional pain with others.
Depression can also go untreated among seniors because they assume that these emotions are just the natural progression of aging, and the normal reactions to loss or chronic illness. Thinking that they should accept these sad feelings as part of getting older, the elderly person might just endure the suffering in silence.
Prognosis is good for seniors battling depression who reach out for help, although medications need to be closely monitored by a medical professional. Some antidepressants have more serious side effects than others, and long-term studies have yet to be performed on the newer classification of SSRIs. Currently, the lower-dose tricyclic antidepressants seem to be better tolerated by elderly patients who might be at increased risk for falls and fractures.
In a study from the University of Nottingham involving 60,000 patients aged 65 to 100 diagnosed with depression, 90 percent of the participants were prescribed one or more medications for the condition. Fifty-five percent of them were prescribed an SSRI, such as Prozac and Paxil, 32 percent a tricyclic antidepressant, such as Elavil and Norpramin, and the rest another type of antidepressant. The study found that the patients on SSRIs had a higher risk of death from stroke, a fall, a broken hip or seizures.
Helpful lifestyle changes
Psychotherapy in conjunction with medication increases the success rate. The therapist should be one who specializes in geriatrics, and there are about 3,000 geriatric psychiatrists in the U.S. The patient should commit to 10 to 12 sessions to effectively treat the depression.
Other lifestyle changes can help immensely in treating either clinical depression or the simple blues. Volunteering time at a favorite organization, becoming involved at the community level, seeking part-time employment, getting a pet, becoming involved at church, taking up a new hobby, getting regular exercise and continuing in occasional therapy sessions all help improve the mood and, as a result, the quality of life.
Sovereign Health of California is an addiction, mental health and dual diagnosis treatment provider, offering several locations in its home state as well as centers in Utah, Arizona and Florida. For more information on mental health disorders, including depression among the elderly, please call 866-629-0442.
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