By: Alison Weihofen, LCSW, MPH
“Good news” and “depression” are not usually found in the same sentence. However, here’s the first piece of good news: The vast majority of adults aged 65 and over is not depressed. The United States Centers for Disease Control (CDC) estimates that only 1% - 5% of older adults living independently in the community suffer from depression. The numbers are less encouraging for those requiring home healthcare (13.5%) and for older hospital patients (11.5%). Still, the fact remains, depression is not a normal part of aging. Despite the relatively small percentages, mental health remains a salient issue. Members of this age group are at increased risk when compared to other age groups. Additionally, older adults may be undiagnosed and, as a result, the CDC numbers may be an underestimate. Regardless, depression is a serious condition that can have serious effects on an older adult’s health. This condition is also relatively treatable, and older adults can improve with time and professional treatment.
What Causes Depression in Older Adults?
Depression in older adulthood can stem from many possible causes. It can come from a single event, such as the loss of a loved one, or changes in brain chemistry as the body ages. Depression is also linked to serious and chronic diseases. Recent studies suggest depression may be associated with lower concentrations of folate in the blood and nervous system. Additionally, new studies explore a possible link between depression in late life and Alzheimer’s disease. The American Psychiatric Society reports that depression is more common in older adults with chronic health conditions, as well as other illnesses such as heart disease and cancer. Eighty percent of older adults have one or more chronic health conditions, and 50% have two or more. In addition, depression can seriously affect the health of older adults by increasing their mortality rate, and exacerbating physical health conditions such as cardiovascular disease. In other words, being sick can make you depressed, and being depressed can make you sick.
Finally, genetics can also play a role in causing depression. Older adults whose parents also suffered from depression are at an increased risk, and people who suffered from depression when they were younger are more likely to experience a reoccurrence later in life. It is difficult and important for healthcare providers to assess the difference between an older adult’s normal life reaction and a person who is actually depressed. In addition, older adults’ belief that their suffering is normal often prevents them from seeking help.
How Can We Prevent and Treat Depression?
More good news: more treatment options exist for older adults with depression than ever before. Prevention methods for older adults are similar to methods individuals can take throughout their lifetime. According to the National Institute on Aging, maintaining close friendships for support and companionship is extremely important. Friends can help during times of sickness, or following the loss of a spouse. It is also important to maintain a regular exercise schedule. Local organizations may offer classes specifically geared towards aging clients. Scientists have found that any physical activity like walking, gardening or playing with children provide mental and physical benefits. It is also good to switch activities to avoid boredom, and remember that even 15 minutes a day can make a difference. Along with physical fitness, maintaining a healthy diet, finding a fulfilling hobby, and maintaining contact with family are also important.
Many older adults will only experience short bouts of depression. They may exhibit depressive symptoms in relation to a life change, but slowly recover with time. However, a small number will suffer from chronic depression, which rarely goes away on its own and can have grave physical and mental consequences. If symptoms persist and do not get better with time, it is important to consult with a mental health professional for a proper screening. Older adults with chronic depression can get better with professional help e.g. group and/or individual therapy and/or medication. There is no reason to suffer alone when so many solutions exist. Finally, as the stigma around seeking mental health care eases slightly, older adults may be encouraged to access much needed care.
About the author: Alison Weihofen is a Licensed Certified Social Worker in the State of Massachusetts. She has an additional degree in Public Health. She lives in Zürich with her Swiss husband and currently works as a Scientific Assistant at the Swiss School of Public Health at the University of Zürich.