Holiday Blues – Depression in the Elderly

November 14, 2008
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The holiday season is quickly coming upon us. If you are a caregiver for an elderly loved one, you may notice a change in your loved one’s mood as the holidays approach. Perhaps you are one of many who visit their elderly parents and family during the holidays who live some distance away. When you visit, you may notice that loved ones are not as physically active as on prior visits, that they show symptoms of fatigue or sadness, or that they have no interest in the holiday or in their surroundings.
According to the National Institutes of Health, of the 35 million Americans age 65 years or older, about 2 million suffer from full-blown depression. Another 5 million suffer from less severe forms of the illness. This represents about 20% of the senior population – a significant proportion.
Depression in the elderly is difficult to diagnose and is frequently untreated. The symptoms may be confused with a medical illness, dementia, or malnutrition due to a poor diet. Many older people will not accept the idea that they have depression and refuse to seek treatment.

What causes depression in the elderly?

It is not the actual holiday that causes depression, but the fact that holidays tend to bring memories of earlier, perhaps happier, times. Additional contributing factors that bring on depression may be the loss of a spouse or close friend, or a move from a home to an assisted living facility, or a change in an older person’s routine.
Depression may also be a sign of a medical problem. Chronic pain or complications of an illness or memory loss can also cause depression. In addition, diet can also be a factor when proper nutrition and vitamins are lacking.
As an example, Selma’s husband died a few months before Christmas. Her family lived close by and would call or drop in often to check on her. Selma seemed a little preoccupied and tired, but this was to be expected as she had been the caregiver for her husband for many years. When the family noticed that her holiday decorations were not out, and that she had abandoned her annual routine of sending Christmas cards, they began questioning her mental and physical well-being.
A trip to her physician confirmed depression, caused by not only the loss of her spouse, but also a vitamin B12 deficiency. There were both mental and physical reasons for her depression.

Symptoms to look for in depression might include:

  • Depressed or irritable mood
  • Feelings of worthlessness or sadness
  • Expressions of helplessness
  • Anxiety
  • Loss of interest in daily activities
  • Loss of appetite
  • Weight loss
  • Fatigue
  • Lack of attending to personal care and hygiene
  • Difficulty concentrating
  • Irresponsible behavior
  • Obsessive thoughts about death
  • Talk about suicide

How do you know if it is depression or dementia?

Depression and dementia share similar symptoms. A recent article on Helpguide.org gives some specific differences:
In depression there is a rapid mental decline, but memory of time, date and awareness of the environment remains. Motor skills are slow, but normal in depression. Concern with concentration and worry about impaired memory may occur.
On the other hand, dementia symptoms reveal a slow mental decline with confusion and loss of recognizing familiar locations. Writing, speaking and motor skills are impaired, and memory loss is not acknowledged as being a problem by the person suffering dementia.
Whether it is depression or dementia, prompt treatment is recommended. A physical examination will help determine if there is a medical cause for depression. A geriatric medical practitioner is skilled in diagnosing depression and illnesses in the elderly. If you are the caregiver of an elderly person it may be beneficial for you to seek out a geriatric health care specialist. For more information on senior health services go towww.longtermcarelink.net/about_senior_health_services.htm.

Treating depression in older people.

Once the cause of the depression is identified, a treatment program can be implemented. Treatment may be as simple as relieving loneliness through visitations, outings and involvement in family activities. In more severe cases antidepressant drugs have been known to improve the quality of life in depressed elderly people. Cognitive therapy sessions with a counselor may also be effective.
As a caregiver or family member of a depressed elderly person, make it your responsibility to get involved. The elderly person generally denies any problems or may fear being mentally ill. You can make the difference and remove the Holiday Blues from seniors suffering from depression.
The Geriatric Mental Health Foundation offers a “Depression Tool Kit.” To read more about this tool kit and depression in the elderly, go towww.gmhfonline.org/gmhf/consumer/depression_toolkit.html.

Ask Allie

O&H: Allie, I understand that your readers provided some feedback for last week’s column on the potential First Pet.
Allie: Yes, I received several e-mails with suggestions on the First Pet. One reader suggested a West Highland Terrier. She said “they are devoted, loving, bullheaded and a real challenge. They think of what they want and are so cute with those oversized ears, standing so tall when they are inquisitive, flopping down when at ease. No one knows the love of a dog until they own a westie, or should I say until they own your heart.” Another reader suggested that the Obamas find a good way to tame the allergies, and adopt two cats, one for each daughter, and the cats would be able to train any dog that they would adopt. (I like that idea!) This reader was also kind enough to say, “I appreciate your light-hearted column, and it is really a bright spot after reading about aging issues. Keep your weekly messages coming.” That is a good boost for my job security…. Well, it’s time to start napping in preparation for Thanksgiving dinner. I hope you all have a wonderful holiday!
Please feel free to e-mail your pet and animal-related questions to Allie at:allie@oasthook.com .

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