Seniors at risk

Everyone feels sad or discouraged at some points in life; for many, it becomes something much worse.

Dr. Jennifer Hodges-Crowder is a scientistpractitioner in counseling psychology and is a licensed addiction counselor with experience in the geriatric eld.

“Clinical depression in older adults is common but is not a normal part of aging. Depression affects about 6 million Americans ages 65 and older,” she said. “The rate of depression in older adults who live at home is estimated to range from 1 percent to 5 percent of the population. This number rises to 14 percent in those who require home health assistance or placement in a retirement community or nursing home.

“Depression is a medical illness with a variety of symptoms that interfere with daily life. There are several different types of depression, all of which become a problem when symptoms become overwhelming,” she said.

“When this happens, clinical depression is diagnosed by a medical or mental health professional when a person has at least ve distressing symptoms at the same time for at least two weeks.”

The symptoms Hodges-Crowder listed are:

• Sad mood most of the day,
• Loss of energy,
• Feelings of worthlessness,
• Poor concentration,
• Diminished interest in activities,
• Sleep disturbances (sleeping too much or not enough),
• Sudden weight gain and
• Excessive feelings of guilt or recurrent thoughts about death.

“These symptoms cause signi cant distress and interfere with one’s ability to maintain daily responsibilities, sometimes even preventing concern for self-care and hygiene activities such as bathing or wearing clean clothes,” she said.

“Older adults are at risk of developing depression because it often occurs with other medical illnesses that impact older adults such as heart disease, chronic pain, strokes, thyroid disease and cancer,” Hodges- Crowder said.

“Older adults are also at risk of developing depression due to a number of common life changes that increase the likelihood of depressive symptoms,” she said.

“Normal late-life changes such as moving from home to a retirement facility, the death of close friends or a spouse, loss of independence through inability to drive or increased physical problems can contribute to feelings of sadness and other symptoms of depression.

“Unfortunately, because some depressive symptoms – such as low energy levels, sleep trouble and decreased appetite – can be symptoms of aging or other illnesses, depression often goes undiagnosed in older adults. Unfortunately, older adults also show increased thoughts of death and thoughts of suicide as symptoms worsen.

“Low moods and depression are natural reactions to grief and loss. Sadness is common when a loved one dies or when life does not go the way we expect. Most of the time, we are able to adjust to change and move forward. Sad feelings do not overwhelm daily life under most circumstances.”

Hodges-Crowder said that distinguishing depression from other medical illnesses that impact older adults, such as dementia, is done through medical and psychological evaluation.

“The rst step of diagnosis is to treat any medical illness that might be causing the symptoms,” she said.

“Blood testing and imaging tests can help rule out some other conditions such as infection or brain dysfunction. Additionally, physicians will often discontinue any medications that may be contributing to symptoms. Once the medication gets out of the system, symptom severity can be assessed to see if removing the medication had any impact on the problem,” she said.

“Physicians may decide to begin treating the symptoms as if it is depression to see if symptoms subside. This includes the use of antidepressant medications and/or referrals for therapy with a counselor. Sometimes, a physician may also refer one for others tests including neuropsychological or psychological evaluation to determine if symptoms are indeed depression or another illness like dementia.”

“It is important to be supportive and let them know that you are concerned about these depressive symptoms,” she said.

“It is especially important to be persistent and assist your loved one in obtaining help because sometimes depressed individuals have thoughts of suicide. Depressive symptoms can become a life-and-death situation especially in older adults. Older adult males have a high rate of suicide, especially after age 80.

“It is often dif cult to get an older adult to discuss mental health issues such as depression because of the stigma associated with mental illness,” she said.

It is important to remind your loved one that depression is a medical disease and must be treated just like diabetes or cancer.”

– Michael Stone