Making Your Golden Years Shine: Recognizing Depression in Seniors
For some, depression is a lifelong struggle that emerges early in life. These days, increased public awareness of depression often allows people to recognize their symptoms and seek help in the early stages of illness. However, if you are from an older generation, chances are that you grew up in a culture that didn’t talk about mental illness with the openness and acceptance younger people enjoy, and stigma may have kept you from acknowledging and treating your depression. If you did seek treatment, your options were often limited to unappealing therapies with unacceptably high risk of side effects and low success rates. You may have resigned yourself to living with your condition and are still suffering and increasingly vulnerable to the emotional stressors of aging.
For others, depression takes hold later, often triggered by the aging process and lifestyle changes that accompany aging. Loss of a spouse, isolation, retirement, financial concerns, and physical health deterioration can all have significant psychological effects that set the stage for depressive symptoms. Meanwhile, the natural decrease in important neurotransmitter activity, particularly serotonin loss, that comes with time may predispose you to mood changes while also decreasing your emotional resiliency in the face of experiential stressors.[1. http://www.ncbi.nlm.nih.gov/pubmed/9571651] Admitting that you are suffering may be difficult, particularly if it is at odds with the self you have known for decades; after a lifetime of psychological stability, it can be hard to recognize yourself as a depressed person in need of support. You may explain away your symptoms as the inevitable result of growing older, particularly if those symptoms manifest cognitively and physically, such as loss of concentration, fatigue, poor appetite, weight loss, and sleep impairments. However, depression is not a normal part of aging, it is a serious health condition that can be treated.
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The Dark Side of Retirement
Retirement is often seen as the beginning of the golden years, but what should be a time for celebration and relaxation often becomes the catalyst for depression. Author and psychologist Tamara Chansky says, “Many people who look forward to retirement become anxious and depressed when the moment comes. They wonder why they’re not happy — or ecstatic.”[2. http://www.forbes.com/sites/deborahljacobs/2013/05/10/how-to-beat-the-retirement-blues/] The change may be particularly hard for people who derived a great sense of purpose and identity from working and feel lost without the definition their jobs gave them. Retirement can also strip you of the structure and mental engagement that are vital components of well-being. Many retirees find that they struggle to fill their time and experience disrupted sleep schedules in the absence of regulation imposed by a work schedule, which can wreak havoc on the body’s natural restorative process and also contribute to depressive symptoms.
Loss of a Spouse
Losing a life partner is one of the most deeply painful events you can experience, and profound mourning is a natural reaction amongst even the most psychologically stable. When Laurel Frisch lost her husband of 52 years, she found herself paralyzed by depressive symptoms and struggling to participate in basic life activities. Drained of energy, she rarely left the house and lost interest in simple pleasures that used to bring her joy. Describing her experience of widowhood, she says, “I thought that I had prepared myself for it. Maybe I did, but I’m still feeling devastated. I’m still feeling practically immobile.”[3. http://www.washingtonpost.com/wp-dyn/content/article/2010/08/09/AR2010080904176.html?sid=ST2010080905283] She is far from alone. According to a study published in the American Journal of Psychiatry, 33.3% of bereaved spouses over age 70 had 6 or more symptoms of depression one month following the death of their partner.[4. http://www.webmd.com/depression/news/19991018/loss-spouse-depression] While the natural grieving process and healing elements of time decrease symptoms for many, for others, this loss plants the seeds for long-term depression to take root. For 12.2% of people in the study, depressive symptoms remained after two years.
The Damaging Effects of Isolation
One of the reasons losing a partner is such a powerful trigger for depression is the social isolation it often produces. Isolation is one of the most significant factors in depression for people of all ages, but, as a group, seniors are hit the hardest, not only due to widowhood, but also the loss of family and friends, withdrawal from the workforce, and mobility limitations that often keep you from engaging with the world in the way you once did. As psychologist Amy Fisk says, “Elderly populations in this country have less social support than anyone.” Whereas social interaction was once an everyday part of life, many seniors struggle with loneliness and develop depressive symptoms in response to the loss of social supports. The symptoms of depression can increase your isolation, leading to a damaging cycle of social withdrawal and suffering. Seniors are particularly prone to disengagement as a response to depression; while younger people are more likely to experience obvious symptoms such as explicit sadness, older people “are more likely than younger adults to suffer depression marked by loss of interest.”[5. http://newoldage.blogs.nytimes.com/2010/10/11/depression-incognito/?mtrref=newoldage.blogs.nytimes.com&gwh=9A995929FAB7CF2F5E70497CCA293DB0&gwt=pay&_r=0] You may not spend your time feeling sad, but instead experience a loss of interest and pleasure, ceasing participation in activities you used to enjoy and cutting off vital social contacts. The fact that depression in older adults often doesn’t look the same way as it does in younger people may make you less likely to recognize your symptoms as being caused by depression.
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Finding Effective Treatment
While depression amongst seniors is being diagnosed more than ever before due to increased awareness and screening mechanisms, many are not finding relief from symptoms due to inadequate treatment. A study by Dr. Jürgen Unützer, a geriatric psychiatrist at the University of Washington, found that only 19% of seniors receiving depression treatment experienced marked improvement of symptoms. The reason for this low rate of efficacy can be found in the specific way most older people seek treatment: they see their primary care doctors, “few of whom are able to offer much more than a prescription.”[6. http://newoldage.blogs.nytimes.com/2012/07/25/more-older-people-treated-for-depression/] This is particularly unfortunate since we are living in a time when our knowledge of depression and how to treat it is greater than ever before.
Modern, multidisciplinary depression treatment can help you find lasting relief from emotional, cognitive, and physical symptoms, whether your depression emerged late in life or took hold early. At Bridges to Recovery, we use a wide range of comprehensive, evidence-based therapies that help you investigate the roots of your distress and develop the coping mechanisms you need to regain vitality, stability, purpose, and hope. Our expert psychiatrists work with you to determine whether or not psychotropic medication is appropriate in your situation and design personalized, well-tolerated medication protocols that offer the relief from suffering. However, our program goes far beyond a prescription; our holistic approach addresses the needs of your mind, body, and spirit. In addition to intensive individual therapy, we offer specialized therapy groups like Grief and Loss, Goals and Milestones, and out Timeline Group where you can explore your experiences and emotions with the support of peers who understand what you are going through. Our comfortable residential setting gives you the time and space you need to heal while also immersing you in a warm therapeutic community to break isolation and rejuvenate you.
Depression doesn’t have to rob you of joy in your golden years. With the right treatment and support from compassionate clinicians, you can live a more full, authentic life, free from the pain of depression.
Bridges to Recovery offers innovative treatment for people living depression. Contact us to learn more about how we can help you or your loved one on the path to healing today.