It is common for old people to suffer from depression. It shouldn’t be taken to be normal. People over 65 years are likely to suffer from depression. However, not all of them can access treatment.
This is probably because old people display symptoms of depression differently. Depression in old people can be confused with the effects of other diseases and medicines used to treat them.
Depression in old people is different from depression in younger people. Depression in younger adults. Depression in older people is accompanied by other disabilities and medical illnesses and may last longer compared to younger adults.
Depression in older people increases their risk of developing cardiac disease and death from illnesses. In addition, depression in older people reduces their ability to rehabilitate. Studies show that old people in nursing homes are likely to die from common illnesses if they are depressed.
Older people with depression are at a high of developing a heart attack that may cause death. It is important to ensure old people are frequently checked for depression, their condition evaluated and treated even if their depression is mild.
Old people may not show symptoms of depression. Instead, old people will:
Doctors use standard questions to check for depression, make a diagnosis and recommend treatment. Doctors treating and caring for the elderly are advised to routinely check for depression in older people when they visit the hospital for a wellness visit or chronic illness.
Depression in old people also increases their risk of suicide. This is common in white men. The rate of suicide is twice as much in old people compared to younger adults. Additionally, as people age, they lose social support systems mainly due to the loss of a sibling or spouse, relocation, and retirement.
It is common for family members and doctors to miss signs of depression due to the changes in the circumstance surrounding older people. This is further compounded by the fact that older people are expected to slow down.
Late recognition of these signs of depression causes a delay in treatment which then forces older people to struggle with depression unnecessarily.
Relationship between depression in older adults and insomnia
One of the symptoms of depression in older people is insomnia. In addition, insomnia is a risk factor for depression that is coming back or new depression mostly in older adults. During treatment of depression in older people, it is recommended to avoid or minimize the use of benzodiazepines or newer hypnotic drugs. These drugs are known to increase the risk of respiratory depression, falls, and impaired alertness.
Instead, experts recommend using melatonin hormone or low dose formulation of tricyclic antidepressant in the treatment of insomnia in elderly people. Other drugs that can also be prescribed include sedating antidepressants such as trazodone or Remeron.
Belsomra which helps with sleeping is also effective and safe to be used in older adults to treat insomnia. If the depression or sleeping disorder does not improve, the psychopharmacologist or psychiatrist can prescribe psychotherapy or medicine or both.
Some of the things that are likely to increase the risk of depression in older people are:
Chronic pain, stroke, atrial fibrillation, hypertension, cancer, dementia, and diabetes are also some of the physical conditions that may increase the risk of depression in older people. Risk factors for depression witnessed in older people include:
Scans done on the brains of people who develop depression in old age indicate spots in the brain that receive an insufficient supply of blood flow which is mostly believed to come from several years of high blood pressure. Cells in these spots in the brain may experience chemical changes that may increase the chances of developing depression that is not linked to any life stress.
People with depression are likely to experience several problems such as:
Treatment for depression in older people includes psychotherapy, medicine, electroconvulsive therapy, counseling, or forms of brain stimulation. If need be, these treatments can be combined.
The type of treatment chosen depends on the severity of the symptoms, past treatments, type of depression symptoms, the overall health of the person among other factors.
Use of Antidepressants in the Treatment of Depression in Older People
Although antidepressants do not help treat depression in younger patients, they are very effective in treating depression in older adults. In addition, it is very important to consider potential reactions and risks of side effects when treating depression with medication.
For instance, medications such as imipramine and amitriptyline are known to cause sedation, confusion and may also cause a sudden decrease in pressure when a person stands up. This can cause falls that may result in fractures and serious injuries.
Today, medications used for the treatment of depression in older people include;
In older adults, antidepressants may take longer to work compared to when taken by younger adults.
Depressed people find that support from family and friends in addition to psychotherapy is very helpful. In addition, being involved in a support group or a self-help group may help. Psychotherapy is very helpful, especially for people who have been through major life stresses.
People who do not want to take medication or those with mild to moderate symptoms can be treated in this way. Psychotherapy also helps people who are allergic to depression drugs, those who cannot take medication due to interactions with other drugs or medical conditions.
In older people, the stigma that is attached to psychiatric treatment and mental illness is more. This increased stigma may prevent older people from admitting that they are suffering from depression and may live in denial.
Also, older people and their families may mistake the symptoms of depression to be normal reactions to the stresses of life or life events such as losses and aging. Older people may also express symptoms of depression as physical complaints instead of symptoms.
All these results in delayed treatment. Older people who are depressed may refuse to report their health condition probably because they believe that there is no help for them. Older people may also refuse to be put on medication due to the cost and the side effects of the medications.
Having other illnesses at the time of depression may interfere with how the antidepressants work. They may not work as effectively as they are supposed to. Substance abuse and alcoholism can cause depression and even worsen it since they interfere with treatment.
Sad life events like the death of friends or family, isolation, and poverty may reduce the person’s motivation to continue with treatment.
People take a different amount of time to heal from depression. It could be anything from weeks, months, or years. However, doctors say that the quicker the person recovers from depression the better.
If depression is left untreated and it worsens to the extent that it interferes with the eating and drinking of the person, he or she may become dangerously ill and may provoke thoughts of suicide.