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Depression in Older Adults: Signs & Symptoms - Aging Wisely

The changes and losses of aging can lead to depression in older adults. It is important to note, however, that depression is not a normal part of aging. Untreated depression can take not only a heavy emotional toll, but also harm physical health. According to the National Institutes of Health, of the 35 million Americans age 65 or older, about 2 million suffer from full-blown depression. Another 5 million suffer from less severe forms of the illness.

Older adults at highest risk are those with a personal or family history of depression, failing health, substance abuse problems, or inadequate social support.

Causes and risk factors that contribute to depression in the elderly include:

• Loneliness and isolation – Living alone; a dwindling social circle due to deaths or relocation; decreased mobility due to illness or loss of driving privileges.
• Reduced sense of purpose – Feelings of purposelessness or loss of identity due to retirement or physical limitations on activities.
• Health problems – Illness and disability; chronic or severe pain; cognitive decline; damage to body image due to surgery or disease.
• Medications – Many prescription medications can trigger or exacerbate depression.
• Fears – Fear of death or dying; anxiety over financial problems or health issues.
• Recent bereavement – The death of friends, family members, and pets; the loss of a spouse or partner.

Grief and depression may seem closely related, but grieving is a normal and healthy process in response to loss. There is a difference between the healthy grieving process and unrelenting or overwhelming sadness that may be indicative of major depression. Talk to your loved one’s medical provider if you are concerned about a loved one or contact us for resources and assessments.

Recognizing depression in the elderly starts with knowing the signs and symptoms to watch for, including:

• Sadness
• Fatigue
• Abandoning or losing interest in hobbies or other pleasurable pastimes
• Social withdrawal and isolation (reluctance to be with friends, engage in activities, or leave home)
• Weight loss; loss of appetite
• Sleep disturbances (difficulty falling asleep or staying asleep, oversleeping, or daytime sleepiness)
• Loss of self-worth (worries about being a burden, feelings of worthlessness, self-loathing)
• Increased use of alcohol or other drugs
• Fixation on death; suicidal thoughts or attempts

Memory loss or trouble concentrating/thinking may also be caused by depression and screening for depression is an important part of a thorough diagnostic process for dementia/memory loss. There are additional clues to look for in older adults who deny feeling sad or depressed:

• Unexplained or aggravated aches and pains
• Hopelessness
• Helplessness
• Anxiety and worries
• Memory problems
• Loss of feeling of pleasure
• Slowed movement
• Irritability
• Lack of interest in personal care (skipping meals, forgetting medications, neglecting personal hygiene)

*Adapted from American Academy of Family Physicians

It is important to get a good diagnosis and treatment for depression. This can be challenging as the older adult may not recognize the symptoms as depression or may be reluctant to admit such feelings. The very nature of depression can make seeking help difficult, so it may be imperative for loved ones and friends to assist. Because some of the signs in an older person may be different than traditional depression symptoms, family members and even medical professionals do not always recognize the cause as depression and may initially think the problem is simply age-related or due to Alzheimer’s Disease (especially when memory or concentration issues occur).

If you have concerns about an elderly person you feel may be depressed, contact us for more information or to schedule a consultation or assessment. We can help with options, how to approach a loved one and a comprehensive analysis/assessment. Our expert, professional care managers have specialty training in aging, mental health concerns and community resources for elders.

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