When Sadness Becomes Despair
In a recent report the State of Mental Health and Aging in America examined depression as a public health issue. They found that depression is the most prevalent mental health problem among older adults. Often times we believe that being sad and experiencing sadness is part of the process as we age. That is a myth.
It is assumed by many caretakers and professionals alike as well as the general population that perhaps the sadness for the aging population is attributed to a loss of independence, physical mobility, failing health, decision making, loss of friends, or control over daily decisions and finances.
While that may be true for some aging adults, it certainly is not true for all. We all know someone well over 60 years old who has tons of energy and vitality and spirit for living well as they age. Many have few health problems because he or she has taken very good care of themselves.
However, for the percentage of aging persons who do experience profound sadness, despair and depression, it is often associated with distress and suffering and can lead to impairments in physical, mental, and social functioning (www.apa.org). Recent CDC Behavioral Risk Factor Surveillance data indicated that among adults age 50 or older, 7.7% reported current depression and 15.7% reported a lifetime diagnosis of depression (American Psychological Association ).
Often caretakers and family members are exhausted by their aging family members’ needs. It is not only manifested in physical conditions and chronic diseases such as diabetes, cancer, heart disease, high blood pressure, arthritis, etc. ; it is also an emotionally disabling condition. The presence of depression often adversely affects the course and complicates the treatment of those being treated for a chronic disease. Additionally, the feelings of hopelessness, despair, and isolation that often trigger thoughts of suicide are more prevalent among older adults, especially those with disabilities or confined to nursing homes (American Psychological Association.)
Our communities continue to struggle with the stigma and “label” of having a diagnosable mental health disorder. I want to believe this is getting better with more campaigns for mental health awareness on social media and family physicians recognizing and supporting persons in seeking professional help. Part of what complicates the accurate diagnosis in the aging population is their denial and/or their misdiagnosis based on what they report. The geriatric population is not so quick to report symptoms that may result in their being prescribed more medication, possibly being hospitalized, and/or having a radical change in their quality of life.
Depression is treatable and able to be managed in the aging population. Aging adults should know there is hope in helping them feel better and get better.
The following are 3 considerations for caring for an aging parent or family member with depression:
- Increase social contact. It is imperative that the older adult not feel neglected or isolated in their struggle with depression and aging.
- Increase physical activity and emotional stimulation. This includes getting outside to get fresh air, doing puzzles, engaging in conversation with peers, etc.
- Be sensitive to their emotional needs and respect individual needs . Because elderly people tend to be less amendable to lifestyle changes, they may be reluctant to adopt new habits or do things their peers find highly enjoyable. The aging adult may not understand what they are going through and may be fearful of speaking with a stranger about their illness. Encourage your loved one to see a professional who can help assess the presence of depression and who can rule out any other co-morbid diagnoses.