Depression Among The Elderly

Depression Among the Elderly

Though depression and anxiety are common throughout the life cycle; depression and older age have commonly been associated with one another (Mulsant, 1998). Unfortunately, many elderly people are not satisfied and look at this stage as depressing. After years of planning, dreaming, and expecting the golden years to be the highlight of one's life, the increased number of stressors related to aging causes feelings of depression.

Depression can happen at any age from birth to death. Depression is a "heterogeneous disorder" that can begin early in life and have recurrent episodes later in life, or the first onset may occur late in life (Doris, 1999, p.1369). "It is already said that depression affects about one sixth of the population or more" (Doris, 1999, p.1370). Depression is a very personal illness. The mental anguish of depression can be quite unimaginable to someone who has not experienced it. Depression is not a number, but is the brain's response to either some powerful event in life or even a physiological response to changes that may be taking place. Depression can also be the result of a medical condition or even medication. "Depression is the most prevalent functional psychiatric disorder in late life" (Mulsant, 1998, p.186).

"Depression is defined as a state of despondency marked by feelings of powerlessness and hopelessness" (Coon, 2001, p.89). Some people can mix up depression with just having the blues because of a couple of bad days or even weeks. The cause of depression is still obscure and becoming clear that a number of diverse factors are likely to be implicated, both genetic and environmental. "Some causes are leading stressful lives, genetic factors, a previous depressive episode, and the personality trait neuroticism" (Doris, 1999, p.1369). The National Institute of Mental Health and the Centers for Disease Control (1995) reports depression can appear after a triggering event or for no apparent reason. "Depressed elderly persons frequently have concurrent symptoms of anxiety or comorbid anxiety disorders. Such comorbidity is associated with a more severe presentation of depressive illness, including greater suicidality" (Lenze, 2002, p.753).

"Aging is no accident, longevity far from being the artificial result of science and civilization, is necessary to the human condition, intended by the soul" (Matousek, 1999, p.56). In the elderly, often there is an accentuation of basic personality traits. The intensification of anger and frustration in old age may be related to character, and tied to a sense of injustice. It's almost as if oldness doesn't want to be humiliated (Matousek, 1999). There are many different changes a single person can go through; consequently, it would be impossible to be prepared for any of the number of changes.

"Many changes come with this new time in a person's life and researchers have found that an accumulation of 200 or more life change units in a single year can cause a significant increase in psychiatric disorders" (Minirth, 1985, p.118). One significant change is the loss of self-worth after retirement. Work has always been a central concern in their lives, symbolizing their identities and providing them with self-esteem. For some people life after retirement can be great; the glorified day when one no longer has to get up before the roosters, and tramp out in the cold weather to work (Minirth, 1985).

Yet for some, it can be the worse time of their lives in finding the age of retirement to be depressing, because the lack of substantial activities, like work, to the possibility of the lack of funds to live out the retirement that one had previously dreamed of. The loss of co-workers, and friends that were around on a daily basis, no longer are they there in the same capacity (Minirth, 1985). Retirement should be the ultimate reward for all that a person has conquered in life. The images or daydreams of retirement all show happiness, traveling, and the enjoyment of grandchildren.

The changes that occur to body and mind can change how the elderly choose to live the rest of their lives. When thinking back about their lives, they should feel good, but thinking about the failure in their lives they have feelings of depression knowing it is too late to change anything. Old age deepens our understanding, not only of ourselves, but of aspects of life which may have been avoided (Matousek, 1999).

In some ways loss is a normal part of aging, from personal losses and the loss of others, maybe friends, status, and/or possessions. The National Mental Health Association's report (2001) on coping with loss suggests that one of the big causes of late adulthood depression is related to the "loss of a loved one" or spouse. The loss of a loved one is life's most stressful event and can cause a major emotional crisis. After the death of a loved one, one will experience bereavement, which literally means to be deprived by death. When a death takes place, one may experience a wide range of emotions, even when the death is expected. Many people report feeling an initial stage of numbness after first learning of a death, but there is no real order to the grieving process.

The recent loss of a spouse is a significant risk factor for depression in elderly patients, according to a study published in the October issue of the American Journal of Psychiatry. Some people can continue to have symptoms of depression up to two years after the loss of their spouse (Turvey, 1999). "Loss through death is a common and extremely stressful experience. Bereavement heightens a person's risk of depressive syndromes" (Prigerson, 2001, p.1371).

"A loss of a loved one, the older person will experience bereavement with signs similar to depression such as sadness, loss of appetite, trouble sleeping, passive thoughts of suicide or death" (Turvey, 1999, p.1596). If a preoccupation with the loss continues longer then three months, then a major depression may have occurred. Major depression, whatever the cause, requires evaluation and treatment by a mental health professional (Turvey, 1999).

There are many common symptoms in which everybody looks for, such as unhappiness and disappointment. Symptoms that are different, pervasive, or interfere with normal function are considered to be pathological. "Some symptoms include loss of pleasure in almost all activities, loss of reactivity to usually pleasurable stimuli, significant loss of appetite or weight loss and excessive or inappropriate guilt" (Doris, 1999, p.1369). The commonly believed myth that depression comes naturally with old age is not true. Clinical depression is an illness that needs medical attention just