Depression in the Elderly

"My 80 year old Mother has been feeling very blah for about 6 months. She usually comes on vacation with my family in the summer and has many activities with a close group of friends but lately she is not interested in any of this. She has been to her doctor who has done a number of tests and thinks that she is probably depressed. He is considering adding a new medication to see if that could help. My Mother has always been a very upbeat person and even now does not say that she is depressed. Can you give me some information about depression in older adults and some resources in Charlottesville? Thanks."

Depression is an illness that affects many older people. It generally affects their physical as well as their mental well-being. Fortunately, it is a highly treatable illness. Complete, or at least partial improvement, can be obtained in eighty to ninety percent of cases. Depression can occur out of the blue, for no obvious reason, or it can occur as a response to adverse life circumstances, such as the loss of a spouse, the loss of a job, the loss of good health, or the loss of any other significant thing or relationship. It may occur as a side effect of certain drugs used to treat other conditions. It may accompany medical conditions such as Parkinson's Disease, Alzheimer's Disease, and cancer.

Other factors may raise the risk including a family history of depression, alcohol use, and seasonal changes. Regrettably, the nature of depression is such that affected persons, as a result of being depressed, are actually unlikely to realize that they are depressed, like your Mother, and even more unlikely to seek help for themselves. It is often family members like yourself that notice a change and encourage their relative to be evaluated.

Depression in older adults often goes unnoticed. Some of the signs are similar to changes that can occur with aging such as changes in sleep patterns and appetite and so are just accepted as part of growing old. Because older adults experience more chronic health problems, symptoms such as weakness and fatigue may be attributed to their physical problems when in fact they may be related to their state of mind.

The signs of depression can vary from person to person. There is usually not just a single symptom but a cluster of persistent symptoms. Elders do not always have the typical symptoms but may manifest the disease with primarily physical complaints, unexplained aches and pains, sleep problems such as early morning awakenings, sleeping too much or insomnia, loss of or increase in appetite, or fatigue. Common symptoms of depression include:

  • feeling sad and blue
  • loss of interest in work, hobbies, social life, sex
  • persistent pessimism about the present, future, and past.
  • feelings of guilt or worthlessness
  • difficulty making decisions, concentrating, remembering things
  • lack of energy and feeling slowed down or restlessness
  • irritability
  • weight gain or loss
  • thoughts of suicide

Your Mother is certainly on the right course as she has been evaluated by her doctor to rule out medical conditions that may be causing her symptoms. This is a big step in the right direction as it is sometimes difficult to know when to seek help for an older relative. In general, it is good to talk with a health care professional if symptoms last for more than 2 weeks, if they are interfering in the person's daily function, if you think there is a risk of suicide, or if you just think professional help is indicated.

There are many medications that are very effective in treating depression in the elderly and can greatly improve the individual's quality of life. Depression is not a normal part of aging but a treatable illness-I hope that your Mother will be in good spirits very soon!

Adapted from "Elder Action" developed by the National Eldercare Institute on Long Term Care and Alzheimer's Disease at the Suncoast Gerontology Center, University of South Florida.

Resources

UVA Psychiatric Medicine: Geriatric and Dementia Care Clinic
434-243-4646
Northridge, 2955 Ivy Road

Region Ten Community Services
(434) 972-1800: intake line for information or referral to emergency and intake services, adult outpatient, psychiatry, community support and substance abuse services

United Way- Thomas Jefferson Area Information and Referral
(434) 972-1703

Mental Health Association
(434) 977-4673

If there's an Eldercare topic you'd like to see addressed in "Caregiver Query", e-mail Kathy Fletcher at krf8d@virginia.edu . Remember, any information provided is not a substitute for consultation with your health care provider.