As we transition into retirement and beyond, life presents us with a variety of experiences. Experiences such as terminal illness or death of a loved one, personal health problems, and long-term disability can impact all aspects of our life, and take away the joy in living, temporarily.
Eventually, most of us bounce back into life again, with the exception of a few who develop depression and sink further into despair. Depression has been recognized as a major health hazard among older adults.
Approximately eight per cent to 20 per cent of the community-dwelling seniors have minor/reactive depression and five to 10 per cent have major depression. The rate of anxiety and depression rises to 30 to 40 per cent among those in institutions.
A depressed person usually experiences unexplained fatigue, appetite changes, sleep problems, persistent sad thoughts, loss of interest in personal grooming, and appearance, and withdraws from activities he/she previously enjoyed. They might develop physical symptoms, feelings of worthlessness, and thoughts of dying.
The mood changes and lack of energy associated with depression are often misinterpreted by seniors, their families and their physicians as a normal part of aging process, or as a response to traumatic events in life, and consequently, missed. Sometimes these symptoms could be attributed to other health conditions present in the person.
Another reason for missing depression is that many seniors are reluctant to complain to their physician about how they are feeling or ask for help for fear of being viewed as inadequate. Instead they may discuss depression-related physical symptoms they are experiencing such as sleep problems, memory lapses, and vague aches and pains.
Secondary (reactive) depression, arising in response to significant life events beyond the individual’s coping capability, is more common in the older population. This results from changes in the production of mood-regulating chemicals in the brain, caused by multiple stressors.
Depression can coexist with medical conditions such as stroke, cancer, arthritis, dementia, and heart/lung disease. Conditions such as Parkinson’s disease and rheumatoid arthritis can cause depressive symptoms.
Depression has also been found associated with the use of certain medications such as beta blockers, some blood pressure medications, steroids, digoxin and some sedatives.
The risk for depression is higher if you are a single female, living with multiple chronic conditions, facing financial problems, or if you have a family history of depressive illness, and do not have any social support, or if you are a recent immigrant.
Death rates are almost twice among depressed older individuals compared to their non-depressed peers. Longer hospital stays, longer recovery time for fractures and strokes, increased risk of dementia, higher health care costs, and higher rates of suicide are the other consequences of untreated depression.
The good news is that depression can be completely controlled with medications, and other available therapies. Several classes of medications are available to treat depression. The medication starts acting in a few weeks; however, it might take about ten to twelve weeks for symptoms to fully improve.
Psychotherapy or talk therapy is also a very effective treatment modality and helps a person deal with their thoughts, feelings and emotions. Deep brain stimulation and the non-invasive transcranial magnetic stimulation are both gaining increasing popularity for treating drug-resistant depression. Electroconvulsive therapy (ECT) is sometimes used as a last resort for those individuals who do not respond to other forms of treatment.
Is there anything we can do to reduce our risk of developing depression? Yes. Developing close family and social ties, exercising daily, keeping the brain active, eating a healthy diet, socializing, volunteering, and engaging in yoga and meditation have been recognized as very effective strategies for warding off depression.
Be familiar with the symptoms of depression. If you think that you or a family member might be exhibiting signs of depression, seek medical help.
Padmaja Genesh, who holds a bachelor degree in medicine and surgery as well as a bachelor degree in Gerontology, has spent several years teaching and working with health-care agencies. Contact: padmajaganeshy@yahoo.ca