Late Life Depression

DEFINITION

  • Late life depression is a mental health condition occurring in people age 60 and above.
  • Feelings of loss, sadness, anger and/or frustration interfere with daily life for more than two weeks.
  • A persistent feeling of sadness results in a loss of interest in the details of life.

FACTS

  • Late life depression affects millions of seniors each year; a low percentage seek treatment.
  • It is not a normal part of aging.
  • Late life depression is associated with a higher risk of cardiovascular disease, including heart attack and stroke, and death from illness.
  • Having depression in younger years increases the risk of having depression in senior years.

SOURCES OF DEPRESSION

  • Medical causes
    • Cardiovascular disease
    • Vascular dementia
    • Diabetes
    • Physical decline
  • Psychosocial
    • History of childhood abuse and/or neglect
    • Social isolation and loneliness
    • Unresolved conflict with others
    • Awareness of running out of time
    • Stress associated with being a caregiver
    • Accumulated grief responses associated with losing others and life not being what was anticipated nor expected

SIGNS AND SYMPTOMS OF DEPRESSION

  • Late life depression does not look the same as depression in a younger person who more often express depression by mood swings, changes in physical appearance, and self-harm activities including alcohol and drug abuse.
  • Signs and symptoms of late life depression are often the same as those associated with other health problems. They are often not recognized as signs of depression.
  • Physical findings
    • Pre-occupation with physical complaints
    • Aches and pains
    • Difficulty sleeping
    • Fatigue
    • Change in appetite, either eating more or eating less
  • Changes in mood
    • May exhibit sadness but this is not as common as when a younger person has depression
    • Feelings of despair (ie hopelessness)
    • Irritability and/or anger
  • Difficulty concentrating
  • Difficulty making decisions
  • Apathy
    • A lack of interest in activities
    • A person may agree to participate in an activity but when the time comes the person will change their mind and not do so
  • Anhedonia
    • Loss of pleasure in activities that were previously enjoyed

SUICIDE AND LATE LIFE DEPRESSION

  • Roughly 10,000 seniors over the age of 65 commit suicide annually.
  • One in four seniors considering suicide are successful compared to one in two hundred in younger age groups.
  • The number is likely underreported because the assumed cause of death is thought to be a medical event.
  • Unlike suicide in younger people, which is often impulsive, suicide among the elderly is considered over a long period of time. Statements about not wanting to live and having a plan are often made.
  • The risk of suicide increases when the person fears running out of money, there is a major change in medical condition or physical capability, and/or the person receives a diagnosis associated with a memory or movement deficit.

STRATEGIES TO HELP MANAGE DEPRESSION

  • There are many strategies to help navigate depression This is not an exhaustive list but are some recommended strategies to help manage depression.
  • Engage in physical activities that increase the heart rate such as walks, jogs, weightlifting, or a sporting activity.
  • Engage in activities to quiet the body such as deep breathing, progressive muscle relaxation and gentle stretching.
  • Practice sleep hygiene
    • See Sleep handout and video in the Take Charge! library
  • Use positive words of affirmation and avoid negative messages. Thoughts control actions which control the path in life.
  • Focus on what is working instead of what is not.
  • With family members and friends, plan routine, scheduled visits.
  • Reconnect with memories of mentors and heroes to bolster strategies for managing current challenges.
  • Gain purpose by reconnecting with others and being interested in their lives.
  • Practice gratitude.
    • Be thankful for pure attachments, security and joy from being human and being among humans, and from being loved and loving others.
  • Medications to control depression may be needed. Common drug classes are:
    • SSRI – serotonin selective reuptake inhibitors
      • Examples are sertraline, escitalopram, and fluoxetine.
    • SNRI – serotonin norepinephrine reuptake inhibitors
      • Examples are duloxetine and venlafaxine.
    • Speak to a counselor and learn techniques to manage depression. This is an important part of the treatment plan.  Medication in combination with counseling is more effective than medication alone.
download for printing
Go to Main Take Charge! Resource Library