People make many assumptions about the aging process. One of those misguided assumptions involves older adults and depression. The following three points are vital to understanding how the aging process can affect the mental health of this population, and that depression in older adults—like in any other age group—is a treatable condition.
1. It is often assumed that depression is a normal part of aging, and that sadness is the inevitable result of loss and change.
The reality is depression is not a normal part of aging, and is a treatable illness. The losses and changes associated with aging may result in temporary sadness, but feelings of hopelessness and worthlessness that last more than two weeks are not normal or inevitable. At highest risk for depression are frail, homebound older adults.
Jewish Family Service of Metrowest (JFS) has recognized that depression in older adults is an important mental health issue. Trained social workers screen for depression, provide education for prevention, link to medical professionals, and work with depressed older adults to make behavioral changes.
2. It is often assumed that the depressed older adult cannot do things they enjoy until they feel better, and that nothing can be done to help.
Actually, research shows that there is a significant link between mood and activity. To stop the negative depressive cycle, it is necessary to encourage the older adult to engage in pleasurable activities and take action before they feel motivated. Older adults should feel in control of improving their mood, while the social worker provides support and encouragement.
3. It is often assumed that older adults talk openly about their depression to medical professionals or family about how they are feeling, and the depressive symptoms will be obvious.
The reality is that older adults often feel shame or embarrassment when they are unable to make themselves feel better. These feelings are exacerbated by the stigma that a person who feels depressed is crazy or out of control, when in fact depression is a treatable illness caused by many factors. Also, depressive symptoms are often experienced somatically by older adults, who present with physical symptoms, such as pain and fatigue.
It is important for the older adult to be assessed medically to rule out any medical problems. Poor nutrition can result in lethargy, as can cardiac problems, and even a urinary tract infection can change behavior significantly. Once medical problems are considered, an antidepressant may be prescribed to alleviate feelings of sadness. Today there are medications used specifically for older adults that work better and have fewer side effects.
The reality is, depression is treatable in older adults. A JFS client, 78, remarked that she knows that she is depressed “but there is nothing that can be done.” Once on the right dose of medication, she worked with her social worker on behavioral goals. In a short time, after feeling better she was excited to “see her social worker’s face” to share the progress she made.
Jewish Family Service is committed to helping older adults who are experiencing or at risk for depression through screenings, education and ongoing intervention. JFS of MetroWest can be reached at 973-765-9050.
Depression does not have to be the reality of aging.
By Lee Dagger, LSW and Liz Levy, LSW, Jewish Family Service of MetroWest