Depression can happen to anyone and as we age, changes in life such as loss of loved ones and health issues can trigger depression. When you notice a change of mood, behaviours that are out of the norm and signs of depression in the elderly, do not dismiss them. There are various possibilities as to why some elderly are unable to recognise their depression or even if they do, they do not seek help:
- Thinking that depression is part of ageing
- Living alone and no one notices the signs
- Hesitant to ask for help or talk about their feelings (might brush it off as trivial stuff)
- See it as a weakness
Nonetheless, do not ignore them as they can be detrimental to one’s physical health. However, they can still be treated especially if they are detected early. The consequences of depression can affect every part of our life - personal care (appetite, sleep, energy), work, hobbies and relationships.
When an elderly is diagnosed with a serious health issue, it can lead to a psychological reaction in the form of depression. Serious health issues can refer to parkinson’s disease, stroke, heart disease, cancer, diabetes, dementia and more
Medications used to treat other diseases and medical conditions such as parkinson’s disease, high blood pressure, high cholesterol, steroids, sleeping pills and painkillers can trigger or aggravate depression.
Loss of loved ones
Losing a spouse, family member or a friend can be traumatising for some elderly. However, there is a difference between grief and depression. Grief takes place when they are mourning over the death of their loved one over a particular period of time, while depression is usually a feeling they will experience constantly.
Other types of loss
Loss can also happen in the form of independence, mobility, health and career. As we age, our health may decline, we may have difficulties moving around and as a result, we might need to rely on a caregiver or a mobility aid for support. The issue lies on how much the elderly are able to accept this change and reality. Some elderly are not ready to let go of their independence and/or unable to accept that they are incapable to perform the best they can like before.
Isolation & loneliness
When an elderly person loses their spouse or lives alone because they are single and/or divorced, they may experience isolation and loneliness. Other causes can include smaller social circles, decline in mobility and relocation.
Losing sense of purpose in life
When the elderly feel limited in their capabilities due to their physical mobility or financial income as a result of retirement, they may think they no longer have any purpose in life and dwell in negative thoughts.
Old age concerns such as death, health complications and financial problems can arouse negative thoughts and lead to depression.
- Lose interest in favourite activities and socialising
- Change in sleeping habits - too much or too little sleep
- Change in eating habits - loss of appetite, eating little or overeating
- Weight loss
- Withdrawn from social circle, family and friends
- Complaining about aches/pains - physical pain such as arthritis or headaches are major signs of depression
- Cannot concentrate well
- Sudden mood change
- Fatigue, lethargic, lack of motivation/energy
- Constant struggle with negative feelings - sad, despair, moody, down, guilt, worthless, helpless, hopeless, burden, self-loathing
- Slow in movements & speech
- Memory problems
- Relying more on alcohol or drugs leading to excessive consumption
- Signs of suicide
It is reported that about 6% of elderly aged 65 and above go through depression. According to a study by NUS Medicine in 2012, 1 in 5 elderly persons (aged 75 and above) show signs of depression and among them, an estimated 12% seek proper treatment through professional help. The remaining 75% do not treat these signs very seriously and do not see it as a mental disorder. Out of concern that depression is not getting the proper attention and exposure from the public, NUH started the Geriatric Psychiatry Out-Reach Assessment, Consultation and Enablement (G-Race) programme. This programme provides home service for elderly with mobility problems. They will also send occupational therapists to check on the elderly, monitor their mood and abilities as well as engage in interactive activities with them.
If depression is not managed or left untreated, it can aggravate their physical health. For example, it will be more difficult for the elderly to heal from serious illnesses like cancer and heart disease. There are ways to make the senior years of the elderly healthy and happy.
Stay physically and socially active
Join a senior group or participate in senior activities to feel connected with the community. It can help with feelings of isolation and loneliness.
Talk to someone, counsellor, friend or anyone. As long as there is communication, interaction and attempt to connect with people, they will feel less lonely & isolated.
Take up a hobby or adopt a pet
Occupy themselves with an activity that will make them feel more excited or find new things to enjoy. A pet can provide companionship for the elderly.
Help others if it makes one feel better about themselves.
Change of environment
Just getting out of the house to get sunshine and brighten the mood so they can learn to adapt to change.
When consuming antidepressants, be careful of dosage and not to consume excessively.
Note: Take small steps every day, slowly ease the symptoms of depression and see yourself become happier.
For caregivers: What you can do with the elderly together
Invite them for an outing to do activities together
Take initiative and plan activities for them
You can provide a healthy lifestyle and environment for them by preparing healthy meals
If they need treatment, encourage them to go.
Be observant and watch for signs of suicide