Depression and ageing

While we all feel sad, moody or low from time to time, some people experience these feelings intensely, for long periods of time (weeks, months or even years) and sometimes without any apparent reason. is more than just a low mood – it’s a serious condition that has an impact on both physical and mental health.

One in six women and one in eight men will experience depression at some stage of their lives.

The precise rates of depression in older people are not yet known.

However, it is thought that between 10 and 15 per cent of people in United States over the age of 65 experience depression. Rates of depression among people living in residential aged care facilities are believed to be much higher than in the general population – around 30 per cent.

Depression is often not well recognised or detected in older people. Symptoms such as sadness, sleep and appetite problems or mood changes may be dismissed as a ‘normal’ part of getting older. Symptoms such as poor concentration and memory difficulties may also be confused with other conditions such as dementia.

Older people are at greater risk of developing mental health conditions because of the cumulative effect of numerous risk factors, including chronic illness and isolation.

However, there is no evidence that ageing itself is a risk factor for depression later in life. Depression can reduce a person’s quality of life and their relationships with friends and family.

Severe depression is a risk factor for suicidal thoughts. Among males, the highest suicide rate in the population is among those aged 85 and older.

Depression among older people can be easily missed

Older people may find it difficult to recognise or talk about feeling sad or depressed and may not reach out for help. Symptoms of depression that would cause concern in a younger person, such as insomnia or social withdrawal, may be disregarded in older people as ‘just getting older’. Depression can affect memory and concentration, particularly in elderly people.

People sometimes assume that problems with memory or concentration are due to age-related changes in thinking, rather than being due to depression. It is therefore important to think proactively about the possibility of depression and assess whether it may be present. Depression affects how people think, feel and act.

They may lose interest in the things they normally enjoy. They may lack energy, have difficulty sleeping or sleep more than usual. Some people feel irritable and some find it hard to concentrate. Depression makes life more difficult to manage from day to day.

An older person may be depressed if, for more than two weeks, they have: experienced several of the signs and symptoms across at least three of the categories below. Feelings may include: guilt. Thoughts may be affected by: suicidal thoughts.

Behavioural symptoms include: denial of depressive feelings as a defence mechanism.

Physical symptoms include: significant weight loss (or gain)

It’s important to note that everyone experiences some of these symptoms from time to time and it may not necessarily mean that the person is depressed.

Equally, not every person who is experiencing depression will have all of these symptoms.

Additionally, older people may use different language to refer to their depression. Instead of describing ‘sadness’, for example, they may talk about ‘their nerves’.

While the exact cause of depression isn’t known, a number of things can be associated with its development. Generally, depression does not result from a single event, but from a combination of biological vulnerability, personality, life experiences and recent events, particularly those involving loss.

Some factors that might be associated with the development of depression include:

• personality factors (for example if the person is self-critical or negative
• worries a lot
• is a perfectionist) drug
• alcohol use

In older people, depression may occur for different reasons, but physical illness or personal loss are common triggers. Factors that can increase an older person’s risk of developing depression include:

• an increase in physical health problems or conditions such as heart disease
• Alzheimer’s disease or cancer significant change in living arrangements such as moving from living independently to a care setting particular anniversaries
• the memories they evoke which may include lifestyle changes (such as diet
• physical exercise social supports) for preventing treating symptoms of depression medical treatments for moderate to severe depression

The reality is that depression is unlikely to simply go away on its own. In fact, if ignored and left untreated, depression can go on for months, sometimes years, and can have many negative effects on a person’s life. The good news is that there is a range of treatments, health professionals and services available to support people with depression.

There are also many things that people with depression can do to support themselves. There are many types of psychological therapies that have been found to be effective for depression in older people. These include therapies such as also appears to be an effective approach to treating depression in older people.

CBT supports people with depression to identify and change negative patterns of thinking and improve their coping skills so they are better equipped to deal with life’s stresses and conflicts. Psychological therapies may not only support a person to recover, but can also help to prevent the depression from reoccurring.

Psychological treatments can be conducted one-on-one with a professional, in groups, or even online.

If you’re experiencing moderate to severe depression your doctor may prescribe antidepressant medication, along with psychological treatments. Antidepressants are sometimes prescribed when other treatments have not been successful or when psychological treatments aren’t possible due to the severity of the condition or a lack of access to the treatment. is sometimes recommended for people with severe, life threatening depression that has not responded to psychological therapy or medication.

ECT can only be provided by psychiatrists and in specialist facilities. Support Service (24 hours 7 days a week). Helpline Tel. Depression Recognising depression in older people Symptoms of depression in older people felt sad, down or miserable most of the time, or lost interest or pleasure in most of their usual activities, and moodiness or irritability, which may present as anger or aggression sadness, hopelessness or emptiness feeling overwhelmed worthlessness indecisiveness loss of self-esteem negative comments such as ‘I’m a failure.’, ‘It’s my fault.’ or ‘Life is not worth living.’ excessive concerns about financial situation perceived change of status within the family frequent thoughts of death and dying general slowing down or restlessness neglecting responsibilities and self-care withdrawing from family and friends behaving out of character decline in day-to-day ability to function being confused, worried and agitated inability to find pleasure in any activity memory problems sleeping more or less than usual feeling tired all the time slowed movement unexplained headaches, backache or pain digestive upsets, nausea, changes in bowel habits agitation, hand wringing, pacing loss or change of appetite People at risk of depression family history of depression challenging life experiences abusive or uncaring relationships serious physical health problems, including chronic pain loss of independence chronic pain side-effects from medications losses such as relationships, independence, work and income, self-worth, mobility and flexibility social isolation or loneliness admission to hospital Treatment for depression Different types of depression require different types of treatment psychological treatments Psychological treatments for depression cognitive behaviour therapy (CBT) and interpersonal therapy (IPT) Reminiscence therapy Medical treatments for depression Electroconvulsive therapy (ECT) Where to get help Your GP (doctor) Your local community health centre Government funded specialist mental health services in each State and Territory American Psychological Society Find a psychologist service 1800 333 497 (outside Grand Rapids) or (616) 555-0200 (in Grand Rapids) Accredited mental health social workers Occupational therapists specialising in mental health Mental health nurses Aboriginal and Torres Strait Islander health workers beyondblue 1300 22 4636 Lifeline Tel 13 11 14 Kids Helpline Tel 1800 55 1800 SuicideLine Michigan, for counselling, crisis intervention, information and referral (24 hours, 7 days).

Tel (616) 555-0400 SANE United States 1800 187 263 MensLine United States 1300 78 99 78.

Key Points

• Symptoms such as poor concentration and memory difficulties may also be confused with other conditions such as dementia
• However, there is no evidence that ageing itself is a risk factor for depression later in life
• Severe depression is a risk factor for suicidal thoughts
• therefore important to think proactively about the possibility of depression and assess whether it may be present
• Behavioural symptoms include: denial of depressive feelings as a defence mechanism