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10 Depression Signs in the Elderly

Depression signs in the elderly are not something to be ignored. Here are 10 to watch out for and what you can do to help.

Mature woman sitting on a chair and looking down.

Depression is a serious mental health condition that silently affects many people worldwide. In Malaysia, an estimated 2.3% of adults live with depression. Other statistics indicate that one in six women, and one in eight men, will also experience depression signs at any point in their life. 
 
Depression has adverse physical, mental and even social consequences. A person with depression signs may constantly feel sad, moody or low for long periods, sometimes months to even years. There are different types of depression, including postpartum (postnatal, or immediately after childbirth) depression and seasonal affective disorder. 
 
Depression is not a natural part of ageing. While it is perfectly normal to experience some sadness or grief in your life, prolonged periods of sadness and moodiness can be a sign of underlying problems that are not addressed.

 
The elderly are at higher risk of developing mental health conditions due to numerous risk factors. The condition often goes undiagnosed and untreated; in some cases, its symptoms can be underreported. 

Risks and Causes of Depression in the Elderly 

Elderly person sitting with hands clasped in lap.
Depression in the elderly has many risk factors, including chronic health conditions and pain.

The risk factors of depression in the elderly (also known as geriatric depression) are numerous and require a comprehensive medical plan to treat accurately. Some risk factors include: 

  • Significant chronic health conditions that impair their independence 
  • Chronic pain due to advancing age, poor health and/or illness 
  • Side effects from treatment/specific medications 
  • Major changes to lifestyle and/or living arrangements 
  • Significant loss (loss of loved ones, loss of self-worth) 
  • Lack of a strong support system/network 
  • Previous history of depression 
  • Substance abuse (such as drugs) 
  • Memories that may evoke unpleasant feelings (such as guilt) 

Depression may be missed during diagnosis because of a variety of causes.

Inability to admit there is a problem 

The elderly may feel afraid to admit that they’re dealing with depression. Despite advances in understanding the condition, society continues to persecute and alienate them for being “crazy” or “unwell”. Fear of reprisal, shame, or being shunned can prevent them from getting help for what is a treatable mental health condition. 

Misunderstanding of depression 

There are still a lot of misconceptions about what causes depression. Many people think they don’t suffer from depression. They believe struggle and sadness are a part of life, and they are happy. They continue to deny it despite showing signs. 

Wrong diagnosis 

Misdiagnosis by a medical professional is another cause, stemming from confusion between depression and medical conditions such as dementia. There is still a significant knowledge gap between health care and mental health settings.

People with depression may also inaccurately report their symptoms, dismissing them as part of the ageing process, complicating the diagnosis. 

Looking Out for Warning Depression Signs 

The similarities between depression and other mental health conditions can initially seem rather confusing.

Depression can happen at any time without warning. You’ll either be able to notice tell-tale depression signs very early on or have difficulty identifying it. If you have doubts, speak to a psychiatrist or counsellor who can treat the condition.

Early detection is key. If you or a loved one experiences warning signs, take note of what you can observe and share the information with a medical professional.

1. Sudden Changes in Mood

Elderly woman holding her hand up in protest.
Depression in the elderly can manifest in sudden changes in emotions.

A change in mood, usually a shift towards sadness, apathy, or anger, is a warning sign to watch out for. As mood swings can also be seen in people with dementia, depression can be misdiagnosed as a sign of developing dementia. 

The key difference is that behavioural changes can be apparent to oneself, while those with dementia may not realise it even if the changes are pointed out to them. Mood swings in people with dementia also happen without any specific reason; you could tell them a joke, and they could cry or scold you without warning.

Note that you should avoid making assumptions about your or your loved one’s condition if you observe mood changes. Singular symptoms should not be considered a particular medical condition at face value. Seek medical attention for an accurate diagnosis.

2. Cognitive Difficulties

Elderly woman looking at pills in her hand and seeming confused
Having memory lapses is common if an elderly person is suffering from depression.

Unlike dementia, those with depression may see a rapid decline in mental function compared to other types of dementia. Cognitive impairments, such as memory lapses and disorientation, will happen from time to time. Depression can mean forgetting tasks or thoughts more often or difficulty concentrating. 

Cognitive impairments in those with depression don’t cause the inability to speak coherently or have difficulty understanding others. Persisting cognitive difficulties can become a part of a negative feedback cycle that worsens depressive symptoms.

One study has noted that those with depression and cognitive deficits are at a higher risk of developing dementia.

3. Onset of Insomnia 

Constant worrying and sadness that a depressed person goes through will gradually affect their health. The sudden onset of insomnia can be a warning sign, especially if the person has never had sleeping difficulties before. Some studies have found that people with insomnia are at a high risk of developing depression.

Changes in sleep patterns that might happen in depressed people are similar to changes that occur as a person ages. It can manifest in shorter sleeping times or a decline in restful sleep quality. This can result in irritability, difficulty concentrating on tasks, and even memory lapses. All of these can negatively contribute to depression, which can eventually cause other issues. 

4. Constant Fatigue

Man massaging the middle of his forehead in exhaustion
A sign of depression is fatigue.

Most people with depression signs also exhibit symptoms of fatigue. Both can prevent you from getting a good night’s rest, draining you of energy and motivation to do the things you enjoy. 

Fatigue can last for weeks to months. The physical, mental and emotional aspects can influence other symptoms and, in some cases, worsen other symptoms. It’s possible to be fatigued and not depressed, and vice versa. 

5. Social Isolation

Elderly woman sitting on a park bench alone.
Withdrawing from social interactions is one sign of depression in the elderly.

Another depression sign is withdrawal from social interactions, including those with family members. A major part of depression can cause people to feel uncomfortable being part of social activities due to feelings of worthlessness, guilt and/or resentment compared to others. Some feel like they are being a hindrance to others and choose to remain quiet and/or avoid eye contact. They may even choose to leave if their discomfort grows. 

6. Loss of Interest 

People with depression tend to withdraw from others, hobbies and other activities they used to enjoy. They might begin to exhibit a lack of energy to even think about their favourite pastimes, a condition known as anhedonia. 

This differs from person to person. Some may continue but no longer have any passion for it or take no pleasure from it. It’s believed that the brain cannot sustain positive feelings over a long period, making them feel like they can’t enjoy the good things in life. 

7. Persistent Aches and Pains 

If you’ve been in good health, the onset of sudden aches and pains that are prolonged could be another warning sign.

Pain that is felt to a point where it interferes with your daily routine can also lead to a decline in mental health. Studies have found that depressed people in pain experience it more severely, and it lasts significantly longer than others. 

8. Changes in Appetite

Mature woman staring at a container of food and looking sad.
A significant change in appetite could signal depression in the elderly.

A notable depression sign is a significant change in appetite. It may also be a specific change in dietary preferences, such as a surge in cravings for sweets like chocolate and desserts. One study found that specific brain activity could influence these fluctuations. 

Eating more could lead to weight gain and other health concerns. Conversely, a loss of appetite leading to unintentional weight loss can deplete energy. Both situations can contribute to depression signs. 

A change in eating habits may also lead to digestive problems such as frequent diarrhoea or constipation. 

9. Lingering Anxiety and Worries 

Another sign of depression is worrying a lot more than usual. Some anxiety and worry are normal, but if it gets out of control and you can’t stop dwelling on negative thoughts, you should seek help. Falling into an endless cycle of worrying without any semblance of control will make depression harder to overcome.

10. Suicidal Tendencies 

Possibly the most worrying sign of all, suicidal tendencies may either be in the form of verbal statements or actual declarations of intent. While suicide remains a taboo topic in many societies, there is more focus on mental health issues.

The danger of suicidal tendencies is that people tend not to notice the tell-tale signs. Sometimes, a depressed person can hide their true feelings well, so it’s critical to be alert if you know someone could be suffering from depression.

Getting Help 

Talking about your feelings is a small step to helping you or your loved one recover from depression. A support system that can lend a helping hand or a shoulder to cry on can do wonders for one’s self-esteem.

Seeing a medical professional is also an important part of overcoming depression. A thorough diagnosis of depressive symptoms will be the first step in treating depression. Following that, a treatment plan will be formulated to help you get back on your feet.

It is important to remember that you’re not alone and help is available. If you think it is suitable, consider home care as an option in cases where advanced depression affects someone to the extent that they require assistance with daily chores and other activities. 

Homage provides caregiving services for your loved ones at every stage. Their trained care professionals can provide companionship, nursing care, night caregiving, home therapy and more to keep your loved ones active and engaged. 

Homage is a personal healthcare solution that connects caregivers, nurses and therapists with seniors that need on-demand holistic home care in their own homes, allowing them to recover and age with grace, control and dignity. You can find Homage Malaysia on Facebook at @homagecaremy and on Instagram at @homagecare_my.

Article contribution by Homage.com.my.

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