Age depression

10. January 2020

We have pretty similar aspirations when it comes to life in old age. We want to be fit and enjoy the newfound time in retirement, spend it with family and friends, and enjoy the last stage of life to the fullest. But old age also brings new challenges and can have a strong impact on the psyche. For example, the new stage of life carries an increased risk of developing old-age depression: one in six patients over 65 suffers from depression symptoms (Bickel, 2003: figures from general medical care).

Who can be affected by old-age depression – and why?

From the frequency of occurrence, it can be concluded that basically anyone can develop depression in old age. But what causes the increased risk of disease? To answer this question, as is so often the case in psychology, many factors must be considered. First of all, old age is a time of upheaval for all people, when life has to be reorganized. For example, for many professionals, retirement is a moment that is as longed for as it is dreaded.

Reasons for depression in old age

At such times, the psyche is generally more vulnerable. This phenomenon is also observable in other periods of change, such as starting school, puberty, entering the workforce and becoming a parent. Science calls such change points in life “life events.” During and shortly after such “life events” – which also include retirement – the risk of mental illness increases.

In addition to the thus generally increased susceptibility to depression, there are age-specific risk factors that can promote the development of depression:

  • Physical diseases: depression symptoms can be an accompanying symptom of typical age-related diseases such as Parkinson’s disease, dementia or cancer.
  • Psychological disorders: If other mental illnesses are already present, such as substance dependence, alcohol abuse, anxiety or obsessive-compulsive disorders, the likelihood of old-age depression is increased.
  • Sleep disorders: The quality of sleep decreases with age. This affects the psyche, because healthy sleep is closely related to mental well-being.
  • Medications: Some medications, which must be taken especially in older age, have side effects that can trigger depression symptoms.
  • Psychosocial factors: A particularly important reason for depression in old age are factors that lie in the environment and everyday life of the affected person, whether it is loneliness, the loss of close relatives and friends, less structure in everyday life due to retirement or reduced mobility.

Frequently undetected: Depression in old age
A common problem with depression in old age is that it is not recognized early or even trivialized. For example, the symptoms are not noticed because the main focus in old age is often on somatic complaints. In addition, reduced drive and lack of joy are seen by many as “normal” for advancing age. Often there is simply a lack of information among relatives and those affected themselves. In addition, there is still a taboo surrounding the topic of depression, which is especially true for older generations.

Important: Differentiating depression from incipient dementia is difficult because the symptoms are similar. Depression, for example, can trigger “pseudodementia.” This refers to forgetfulness and confusion that is not due to a reduction in brain volume, but to depression-related lack of drive and motivation. As a clue to distinguish can serve that dementia is accompanied by a spatial and temporal orientation weakness.

Symptoms of old-age depression

What symptoms should relatives or sufferers be aware of? In addition to the typical symptoms of depression, such as listlessness, decreased happiness, feelings of guilt and worthlessness, change in appetite, among others, the following alarm signs of depression can be found in old age:

– Complaints (headaches, joint, heart or back pain) for which no definite physical cause can be found
– neglect of household chores and personal hygiene
– increased thoughts and expressions about dying and death

Difference to depression in other age ranges
Unlike depression in younger adults, depression in old age manifests itself strongly on a physical level. That is, psychosomatic complaints, sleep disturbances, lack of appetite and associated rapid weight loss and inability to move are common and should be taken very seriously in relation to possible depression.

What can family members do?

First of all, it is of great importance to be informed about the topic and to be aware of the increasing risk for depression in old age. If there is an acute suspicion that an elderly family member or friend is suffering from depression, relatives should approach the person concerned about it and possibly seek joint discussion with the family doctor. He or she can then initiate psychotherapy and medication. Older people also benefit from psychotherapy and can gain a lot in terms of quality of life through appropriate treatment.

Relatives can also offer their help, show understanding and encourage joint activities. Relatives can find other important tips for dealing with people suffering from depression in our blog post or at the Deutsche Depressionshilfe foundation. Lastly, it should be said that in dealing with those affected, it is always important that the person, albeit of advanced age, is met with respect and at eye level. After all, “aging with dignity” also includes mental health and support.

References

(1) Adler, G. (2003). Textbook of gerontological psychiatry and psychotherapy. Thieme

(2) Bickel, H. (2003) Epidemiology of mental illness in old age (pp. 11-26). In: H. Förstl (Ed.) Textbook of gerontological psychiatry and psychotherapy. Thieme Verlag, Stuttgart

(2) Wittchen, H. U., & Hoyer, J. (2006). Clinical psychology & psychotherapy (Vol. 1131). Heidelberg: Springer.

Categories: Depression

Friederike Reuver
Autor:in Friederike Reuver
"Die LIMES Schlosskliniken haben sich auf die Behandlung von psychischen und psychosomatischen Erkrankungen spezialisiert. Mit Hilfe des Blogs möchten wir als Klinikgruppe die verschiedenen psychischen Erkrankungen näher beleuchten und verschiedene Therapien sowie aktuelle Themen vorstellen."

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