Depression in Elders: Symptoms, Triggers and What to Do

Carol Bradley Bursack | Oct 19th 2016 Apr 10th 2017

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Depression in the elderly is not unusual, and can be brought on by any number of factors, ranging from physical issues or cognitive issues to life events. Spouses, adult children, and friends can take steps to help. These steps include:

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Awareness and empathy

Be cognizant of the fact that the person would reverse the depression if he or she could. Assist the person in seeking professional help. Continue with your own education about depression and how to approach treatment for a loved one. Before getting the proper treatment, here’s how to recognize the signs and symptoms of depression:

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Signs and symptoms of depression

The National Institutes of Health (NIH) lists some common signs and symptoms of depression in elders as:

  • Feeling sad or empty
  • Feeling hopeless, irritable, anxious, or guilty
  • Loss of interest in favorite activities
  • Feeling very tired
  • Not being able to concentrate or remember details
  • Not being able to sleep, or sleeping too much
  • Overeating, or not wanting to eat at all
  • Aches or pains, headaches, cramps, or digestive problems
  • Thoughts of suicide, suicide attempts
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Medically recognized triggers

According to the NIH, depression may be caused by:

Genes: People with a family history of depression may be more likely to develop it than those whose families do not have the illness. Older adults who had depression when they were younger are more at risk for developing depression in late life than those who did not have the illness earlier in life.

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Brain chemistry

People with depression may have different brain chemistry than those without the illness.

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Stress

Loss of a loved one, a difficult relationship, or any stressful situation may trigger depression.

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Combined effects

It also can occur concurrently with other serious medical diseases such as diabetes, cancer, heart disease, and Parkinson’s disease.

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Additional triggers for elder depression

After decades of elder care and communicating with elders and their caregivers, I’ve developed my own list of triggers which, of course, includes the triggers already mentioned. In addition to those mentioned, I would add loss of driving privileges, chronic pain, disability and/or death of friends, loneliness, and perceived and often real ageism in society and family.

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Too much of a good thing

Another trigger is “heavy-handed” adult children who seemingly take over the elders’ lives, restricting their daily routines, including taking away their freedom to drive. These changes are typically meant in the elders’ best interest for safety and health reasons, but can be difficult for the elder to accept.

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What’s next?

This, too, is not an exhaustive list, but these are things which are possible causes if you witness depression in your elders. If this occurs, here’s what’s next when considering treatments.

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Medically recognized treatments

The NIH lists the most vital steps for securing treatment for depression that should be first on anyone’s list:

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First defense

The first step to getting appropriate treatment is to visit a doctor. Certain medications or conditions can cause symptoms similar to depression.

A doctor can rule out these factors by doing a complete physical exam, interview, and lab tests.

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A second opinion

If these other factors can be ruled out, the doctor may then refer you to a mental health professional, such as a psychologist, counselor, social worker, or psychiatrist. Some doctors are specially trained to treat depression and other mental illnesses in older adults.

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Caregiver empathy can help

I’d suggest that family caregivers, as well as professional caregivers, consider the more subtle issues that I suggested previously and take them seriously. Loss of driving privileges is a tremendous loss to a senior, but if safety is an issue, the only thing a caregiver can do is help their elderly loved one find transportation when needed.

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Offering perspective

Disability and/or death of friends is another issue that a caregiver can do little about. However, when these and other issues occur, a caregiver can offer empathy and understanding. Think about how you would feel if you suffered these losses, one after another.

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A sign of support

Keeping this in mind can help you offer your loved ones the kind of love and understanding that, while not a cure, can show them that you are there to help.

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Caregiver insight can help

Loneliness in the elderly may be alleviated in obvious ways, such as including the elder in more social events, but no caregiver can replace the empty feeling of losing a spouse or dear friend. So there are variables as to how much you can help with this. However, the two often related issues of ageism and perceived taking over of an elder’s life can be managed.

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Reflect on your actions

Look carefully at your own behavior when it comes to these issues. Are you being respectful? Are you presenting choices, no matter how small, or are you directing the agenda without input from the other person? Are you listening to your elder and understanding what is behind what is being said?

Are you remembering that you are helping your parent, not raising a child?

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The takeaway

Depression at any age can be hard to treat, and elder depression can be even harder considering the losses most elders face over time. As many of the causes of elder depression cannot be changed, even doctors will be limited in how much they can help. Doctors can sometimes prescribe medications,  and for some elders who don’t yet have dementia – many can benefit from Cognitive Behavioral Therapy.

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A 360 view

Make certain that physical, emotional, and cognitive issues are professionally addressed. Then examine your own role as caregiver and see what can and cannot be changed. You may have to accept that your elderly loved one isn’t going to be the happy person he or she once was. Would you be full of cheer under similar circumstances?

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Putting their happiness first

Discount your own discomfort about not being able to cure your loved one and remember that the situation is not about making you feel better, it’s about your loved ones’ reality. Grieve with them. Love them. Accept them, depression and all.