Depression and the Elderly

Depression affects more than 6.5 million Americans who are 65 years or older. In Massachusetts, roughly 161,000 seniors deal with depression.

Most older people with depression have been suffering from episodes of the illness during much of their lives. For others, depression has a first onset in late life. Depression in older persons is associated with dependency and disability, and causes great suffering for the individual and the family.

Depression is not a normal part of aging. Many older people and their families don't recognize the symptoms of depression, aren't aware that it is a medical illness, and don't know how it is treated. Others may mistake the symptoms of depression as signs of dementia. Also, many older people think that depression is a character flaw and blame themselves for their illness and are too ashamed to get help. Others worry that treatment is too costly. Older persons with depression rarely seek help.

Untreated depression has fatal consequences in terms of both suicide and non-suicide mortality. The highest rate of suicide in the U.S. is among older white men. Depression is the single most significant risk factor for suicide in that population. Many elders who commit suicide have reached out for help: 20% see a doctor the day they die, 40% the week they die, and 70% in the month they die.

Depression in older people is often characterized by memory problems, confusion, social withdrawal, loss of appetite, inability to sleep, irritability, and delusions and hallucinations. Older depressed individuals often have severe feelings of sadness, but these feelings frequently are not openly shown. When asked if they are "depressed", the answer from persons suffering from depression is "no". Some general clues that someone may be suffering from depression in such cases are persistent and vague complaints and help seeking, along with frequent calling and demanding behavior.

Clinical depression doesn't go away by itself, and lasts for months. It needs to be treated professionally. Any unresolved depression can impact the immune system, which makes the depressed individual more susceptible to other illnesses. This complication is often found in older individuals. Older women are at a greater risk because women in general are twice as likely as men to become seriously depressed. The stresses of maintaining relationships or caring for an ill loved one and children also fall more heavily on women, which could contribute to depression. 80% of clinically depressed individuals, including older persons, can be effectively treated by medication, psychotherapy, and other approaches.

Depression is a chronic disease. Getting well is only the beginning of the challenge, staying well is the real goal. The Aging Information Center at Somerville-Cambridge Elder Services can connect older individuals, their families, and caregivers with mental health and other aging resources in the area. Call 617-628-2601 ext. 3151 for more information.