Being Depressed is Not a Normal Part of Aging

A friend of mine recently asked about what to bring someone in a nursing home who “had a breakdown” following the death of the partner.  One of my replies was; “bring yourself”.  Aging doesn’t grant us immunity from depression, life happens and we suffer losses.  These situations often lead to feeling blue or depressed.  That would be true for any age group.  However, our society equates age with being depressed. We need to advocate for a change in that viewpoint.

Why do older people often seem depressed?

1. Older people may have other health problems that have depression as a symptom.
2. Older people may take medications, some of which have a depressive side effect.
3. Depression may accompany certain health issues such as heart attack or stroke.
   

When these things occur, does medicine consider treating the depression? More than once I have heard medical personnel begin their discussion with the words, “Well this person is elderly.” Age is a stage of life, not a disease. A person who suffers from depression is no different than a person who suffers from anything else. We should be looking for the causes at any age. Patients who receive treatment for depression do better on recovery from physiological conditions than those whose depression is ignored.

Depression can lead to other losses. Another senior told me his friend had finally married a long-time girlfriend. He had a heart attack and they got a divorce. The senior did not see the connection but I did; an untreated depression could have contributed to the marital problem.

What about antidepressants? Sometimes they work and sometimes they don’t. Medications are tested people who are under age 65. If your senior is 75, 85, or 95+, they are in a different place physically than they were earlier in life. Think about this in terms of yourself. Consider your age, and think back 30 years. What were you doing? How was your health? What was your energy level? Are you the same as you were then? Why do we expect medications to work the same way on seniors who might be 30+ years older than the test group? Thus, it was no surprise to me that the friend in the nursing home also had “struggled with her antidepressants”.

What about other forms of intervention? A senior who has lost a spouse might benefit from Cognitive Behavioral Therapy. What grief support groups were brought to this person? Notice I said “brought to”. When depression hits, it may sap the sufferer’s ability to get themselves to the group. Support/help to get a person to the group might be necessary at first.

CAUTION: When you hear statements like “ending it all, no use in living, hopeless, or thoughts on death”; call for help. This level of depression requires more drastic intervention. While emergency situations call for drastic measures, those should not be the only ones employed.
What other things could you do to help a person suffering from depression?

1. Bring yourself to them.  It’s not always necessary to DO something.  Just being together might be enough. 
2. Regular social contact is helpful.  A short visit while discussing their favorite team’s scores or their usual hobbies might help. Loud, places, large groups, or extended experiences might be too much.
3. Bring in the living things; plants, pets, or some small children.  (Note, some children are too noisy or too young to understand that this person is struggling. While others are almost as sensitive as special pets.)  A visit from a dog or bringing a bird to their room may help.  Sometimes plants change the atmosphere in a room.  I am always surprised that nursing home rooms do not contain plants; why not?
4. Get them outside or over to a window.  We evolved out of doors.  Until recently, we received much more sunlight and fresh air than we do now.  Even in winter, if the doctor allows, they could be bundled up and taken outside for a short time.  When indoors, consider sunlight spectrum lamps in the room.
5. Music is proving to be helpful in all kinds of ways.  It triggers memories even in the demented patients.  It can lift moods in people of all ages.  What are this person’s favorite musical pieces?  Can you get them onto a tape?  Listening to music they love will comfort them.
6. What role did food play in their life before?  What foods are special for them?  If the diet allows, bring something in and EAT TOGETHER.  It’s one of the oldest forms of social gathering.
7. Speaking of diet, what were they eating?  Were they eating at all?  Was their diet balanced? Poor teeth, limited foods, fewer fresh foods can damage a diet which damages health.

In my decades of work with seniors, I look at the person first; who were they? What used to matter to them? What would help them restore a part of their life to what it was? Then, I look at many ways to respond. I consider what makes the suffering person better, not what makes it convenient for the staff. Giving a pill and walking away won’t do it. Bring yourself; the present of your presence is the best medicine.