How to help an elderly person with depression

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SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.
Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

The service is open 24/7, 365 days a year.

English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.

In 2020, the Helpline received 833,598 calls. This is a 27 percent increase from 2019, when the Helpline received a total of 656,953 calls for the year.

The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.

The service is confidential. We will not ask you for any personal information. We may ask for your zip code or other pertinent geographic information in order to track calls being routed to other offices or to accurately identify the local resources appropriate to your needs.

No, we do not provide counseling. Trained information specialists answer calls, transfer callers to state services or other appropriate intake centers in their states, and connect them with local assistance and support.

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Last Updated: 08/30/2022

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causes, symptoms, diagnosis and treatment

Depression is the most common mental disorder among older people. Every seventh person in old age suffers from depression. According to medical statistics, symptoms of depression occur in 13% of older people. The main factors in the development of depressive disorder in the elderly are traumatic life events, lifestyle and chronic diseases. Symptoms of depression are often hidden under general poor health, health complaints, chronic fatigue and bad mood, so relatives may not realize for a long time that a loved one has a serious problem and they need to see a specialist.

Depression in the elderly is very different from depression at a young age. Older people avoid the demonstrative manifestation of "suffering", do not complain and, for the most part, are not able to recognize the presence of a depressive state themselves. Often the symptoms of depression are disguised as manifestations of other diseases - a person may have a heart or intestines ache, he begins to complain of weather sensitivity or headaches. It is rather difficult for a non-specialist to diagnose signs of a mental disorder in these symptoms.

Causes of depression

The most common problems of older people that can cause depression are the loss of a spouse or other close person, health problems, primarily diseases that limit physical activity and the ability to self-care, diseases of the nervous system, loss of social contacts , financial difficulties.

Long-term use of certain drugs can lead to iatrogenic (pharmacogenic) depression.

Almost half of the elderly population is diagnosed with cerebral ischemia, which in most cases is accompanied by depression. Often, relatives perceive such diseases and the accompanying depressed mental state of an elderly person as inevitable, a normal process of aging and extinction. But gerontologists are convinced that brain diseases should be treated at any, even the most advanced age.

Often the impetus for the development of depression is a stroke or heart attack, as well as the development of diseases associated with the degradation of cognitive functions - dementia and Alzheimer's disease.

Women are more susceptible to depression than men. Also at risk for developing depression in older age are lonely people, the elderly, those who abuse alcohol, or those who have been diagnosed with mental disorders and suicide attempts in the past.

Symptoms of depression in old age

Changes in mood - despondency, irritation, lack of vitality, apathy and general negative mood.
Decreased physical and social activity - an elderly person begins to move little, rarely leaves the house. Any simple task or the need to go somewhere turns into a problem, makes him nervous and causes anxiety. A person closes in on himself, his circle of interests narrows, he stops communicating with friends. Often all activity is limited to trips to the clinic and the store. Inactivity and loss of social contacts cause deterioration of physical and mental health, which provokes a worsening of the depressive state.
Increased anxiety - an elderly person begins to worry excessively about himself and his loved ones, and his fears and anxieties are disproportionate to the occasion and situation.
Sleep disturbance - depression always causes problems with sleep. In old age, these are most often sleep disturbances, insomnia, anxious and superficial sleep.
Appetite disturbance - in the elderly with depression, there is often a sharp decrease in appetite and, as a result, weight loss.
Impairment of memory and concentration.
Deterioration of health. In old age, depression can manifest itself exclusively with physical symptoms - these are constant complaints of deterioration in well-being, constant pain, problems with the intestines, blood pressure, and so on. It is with such complaints that up to 90% of all age-related patients suffering from depression treat. Since people of advanced age always have several diseases at once, acquired at different periods of life, they begin to be actively treated. But with clinical depression in the elderly, no treatment for somatic diseases will help improve well-being and mood.
Feeling of own uselessness, uselessness, blaming relatives for misunderstanding and lack of attention.

Diagnosis of depression

Senile depression is difficult to diagnose. This is due to the peculiarities of the psychology of older people and the widespread attitude towards old age as a period of life associated with illness, infirmity and constant complaints. Symptoms of depression are often mistaken for manifestations of somatic diseases or age-related changes. Therefore, very often depression in the elderly remains undiagnosed and untreated.

Older people go to the doctor all the time for various illnesses, and they only focus on the physical symptoms of the illness. An older person may not be aware that the physical symptoms are associated with a mental state. In addition, people at this age often find it embarrassing and embarrassing to complain about mental problems, so even the most professional doctors can miss the development of depression. Traditional tests also do not reveal the presence of this disease. A special role should be played by caring relatives and the attending physician - those people who are well acquainted with a person and can assess changes in his physical, emotional and mental state and notice the symptoms of a depressive disorder in time. In this case, it is necessary to seek the advice of a specialist - a psychiatrist, clinical psychotherapist, neurologist, geriatrician or gerontologist. Older people rarely admit that they have mental problems and agree to visit a doctor, so you should try to bring an elderly relative to a frank conversation and convince him of the need for treatment.

Treating depression

Not treating depression in the elderly is contributing to a deterioration in their quality of life and a decrease in its duration. Depression in an elderly person can lead to a heart attack, coronary heart disease and other cardiovascular diseases, provoke the onset of type II diabetes and suicidal thoughts. Such patients do not follow the recommendations of doctors for the treatment of underlying diseases, which leads to their exacerbation.

Depression in the elderly is treated with a combination of medication and psychological therapy. Psychological counseling can be obtained in state institutions under the CHI program (limited number of consultations) and for a fee. Experienced geriatricians know that not all medications are suitable for the elderly, that there are dosage features that depend on age, concomitant diseases and other medications taken. Treatment methods for older and younger patients can differ significantly. The sooner treatment is started, the more likely it is to normalize the biochemical processes in the brain.

Pain syndrome is one of the main triggers of depression in the elderly. Many elderly people live with constant pain in the joints, back, headaches. Doctors say that you can’t endure pain, so you need to contact your doctor with this problem and find an effective drug. By eliminating the pain syndrome, you can cope with a depressed state.

Restoring social contacts and physical activity is also important in mild depression. The support and help of the family is very much needed here. It is necessary to involve an elderly relative in common family affairs, find him an interesting activity or hobby, help him solve everyday problems, and not leave him alone.

Prevention of depression in the elderly

Physical activity. Simple exercises improve mood, bring joy from movement, normalize blood pressure, train the heart. An older person can choose the type of physical activity that he likes and suits his physical condition. It can be yoga, Chinese gymnastics, Nordic walking or active walks in the fresh air.
Social activity. Now in many cities there are various programs for the elderly, interest clubs, dance and music classes, art studios, computer classes. Family members of an elderly person can organize joint trips to the theater, to exhibitions, to nature. An active social life gives a sense of involvement and belonging and leaves no room for discouragement.
Health monitoring. It is necessary to regularly undergo medical examinations and medical examinations, monitor blood pressure, cholesterol and sugar levels, and avoid craniocerebral injuries.

How to help an elderly person get out of depression

According to statistics, the manifestations of this disease in varying degrees and variations are present in almost half of the elderly. After all, in old age, the body is subject not only to the development of somatic diseases, but also to the suffering of the mental plan. It's not for nothing that older people are compared to children. They become just as capricious, overly emotional, sometimes extremely selfish. Such conditions are no less dangerous than, say, acute or chronic pathology of internal organs. Women suffer from this disease more often than men. The piquancy of the problem also lies in the fact that such patients themselves do not seek medical help and the symptoms of depressive conditions are detected a second time, when they are treated for some other disease.

Reasons for the development of such conditions

More than others, persons with a labile psyche, emotionally unstable, are subject to such conditions.

There can be a lot of reasons:

1. Factors that leave an imprint on the psycho-emotional sphere. First of all, it is the feeling of one's own aging. A person no longer hears and sees as well as before. It becomes more difficult for him to serve himself. Retirement also has an impact. There is a lot of free time, a person begins to lose a sense of self-respect, sometimes he simply hates himself, realizing the fact that he can become and is already becoming a burden for others.

During this period, there are often situations when close people, relatives, friends go to another world. More and more of him begin to visit heavy thoughts. Children grow up, leave the family and become independent, live separately, sometimes far from their parents.

2. The reason may be due to long-term use of drugs, the side effects of which are the symptoms of such conditions.

3. They can be secondary symptoms of various diseases of the brain and the central nervous system in general, for example, parkinsonism.

4. Decrease in adaptogenic mechanisms caused by the processes of natural aging of the body.

Manifestations of senile depression

The process of development of such states differs in duration. After all, the body does not age immediately, but gradually. However, some kind of psychological trauma, such as the death of a loved one, can accelerate it. There may be a loss of appetite. Patients are very worried, it gives a lot of worries about it. But digestive disorders are not associated with a disease, but with eating disorders.

There is a sleep disorder. Some believe that the elderly need less in order to regain their strength. Nothing like that, old people need to sleep just as much as young people. Lack of sleep, in turn, affects the overall well-being and leads to the appearance of characteristic symptoms.

Heart problems can join, and they, again, are caused by heavy obsessive thoughts of an elderly person. Relatives, of course, try to show it to a specialist and during the examination, as such, no problems with the heart are found. A diagnosis of senile depression is made.

Treatment

It is imperative that a psychologist be involved in the treatment. It is necessary to create conditions for an elderly person that would distract him from obsessive heavy thoughts. It will be useful to restore old ties or, conversely, make new acquaintances. Some take on a new hobby. Someone is actively involved in social work or joins the ranks of members of interest clubs.

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