Depression in the elderly

In both men and women, the rate of depression is much higher between the ages of 40 and 65. The combination of physical and psychological problems hits the hardest in that age group. After that age, this connection becomes even stronger, with one third of depression occurring in men and two thirds in women, which is partly reflected in the higher mortality rates in the group of men over 65 years of age.

Depression symptoms in the elderly

These differ from the general symptoms described in another article. Depression: general characteristics.

The depressive mood is rarely in the foreground. Rather, it is hidden behind physical complaints such as fatigue, headache, stomach ache… Very often the elderly person does not say that he is sad or depressed; He doesn’t complain about it to the doctor either.

What is also an indication of the existence of depression is the fact that these physical complaints have a cyclical character , i.e. they mainly occur in the morning, then diminish and disappear completely in the afternoon. Such signs certainly justify an attempt at treatment with antidepressants , if the condition of the heart allows it.

Worry, restlessness and sleep problems are often much more visible than inhibition (failure or slowing of response), which is much more common in younger depressed individuals. A mixture of inhibition and restlessness can also occur: for example, someone moves with difficulty but his thoughts move extremely quickly, or the reverse: the thinking process works slowly and the person himself is agitated, tormented and restless.

Please note: if there is severe restlessness, it is often confused with senile dementia (a form of mental retardation in the elderly).

Other symptoms are also reminiscent of dementia as well as depression , such as extensive neglect of appearance and cleanliness, forgetting daily tasks, lack of initiative and social loneliness. Yet it is very important that a distinction is made between the two because depression , unlike dementia , can be remedied. Even at an advanced age, depression can be overcome if the diagnosis is clearly made and appropriate treatment follows. To be clear, we can say that the risk of depression is high if:

  • the elderly person has suffered from depression once or several times before.
  • the elderly person complains bitterly about memory loss. Depressed elderly people tend to emphasize this disability strongly, while people who have become demented are little concerned about their memory loss.
  • the conversation with them is slow and difficult, although the memory and train of thought are still good.
  • there is a clear difference between the complaints and the actual performance. For example, the depressed elderly person may complain about the difficulty he has in concentrating and remembering something, when in reality he is telling a coherent story with precise details.

Also note that there is a great correspondence between the actual concerns and the expressed emotions, while in dementia this correspondence is not present. On the other hand, the characteristic symptoms of depression in younger people, such as anorexia, weight loss, constipation, and early waking, are of little significance in the elderly.

Depression treatment in the elderly

Depression treatment in the elderly is very similar to that of the younger adult and consists of anti-depressant treatment and psychotherapy . However, caution should be exercised in the use of antidepressants in the elderly because liver function is delayed, making the absorption of the drug even slower. Moreover, the side effects are more dangerous.

As far as psychological treatment is concerned, it should not be overlooked that a few therapy sessions can already be successful. Contrary to what people too often think in their own environment and also in the nursing environment, the elderly can certainly make progress and adjust certain views if he realizes that they are incorrect or outdated. He can still feel and make himself useful and thus regain meaning in life.