The difficult changes that many older adults face such as the death of a spouse, loss of independence and health problems can lead to depression, especially in those without a strong support system. But depression is no ordinary process of aging. Symptoms such as aches and pains and fatigue are often overlooked in the elderly. This is dangerous because depression increases the risk of illness, death, and suicide thus early detection is paramount.
What is depression?
It is a common mental disorder that presents with depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration. Problems can become chronic or recurrent and lead to substantial impairments in an individual's ability to take care of his or her everyday responsibilities and harm relationships with friends and family members thus isolating oneself even further.
Psychological Causes:
Unresolved, repressed traumatic experiences
Previous history of depression
Damage to body image
Fear of death
Frustration with memory loss
Difficulty adjusting to stressful/changing conditions
Substance abuse Environmental Factors:
Loneliness, isolation
Retirement
Being unmarried (especially if widowed)
Recent bereavement
Lack of a supportive social network
Decreased mobility
Physical Factors:
Inherited tendencies toward depression
Co-occurring illness
Vascular changes in the brain
Vitamin B-12 deficiency
Chronic or severe pain
Personality Characteristics:
Low self-esteem
Extreme dependency
Pessimism
Depression or Dementia?
Because of many overlapping symptom presentations, depression is sometimes misdiagnosed as dementia. It takes a medical evaluation to distinguish between depression and dementia, but you can think of the difference this way: A depressed individual may have poor concentration and forget where he left the house keys, while a person with dementia does not know what they are called or perhaps cannot remember their purpose and tries to use them for something else.
Depression:
Abrupt onset
Alternating, recurring course
Minimal memory impairment
Affect/mood sad and depressed
Intellect unimpaired
Comprehension good
Abstraction good
Confusion rare
Delusions consistent with affect
Hallucinations rare, possible auditory
Speech slowed
Psychomotor retardation
Personality temporarily regressed
Judgment fair to good
Insight fair to good
Continent
Prognosis good
Dementia:
Gradual onset
Progressive course
Marked memory impairment
Affect/mood labile, may be depressed
Intellect very impaired
Comprehension poor
Abstraction poor
Confused often, worse at night
Delusions mostly persistent paranoid
Hallucinations episodic, auditory
Speech rambling, incoherent, delayed
Psychomotor tremors, rigidity
Personality deteriorated, uninhibited
Judgment poor
Insight absent
Incontinent
Prognosis very poor
Outlook
Depends on the cause and severity of the depression and, to some extent, on personal preference. In mild or moderate depression, psychotherapy is often the most appropriate treatment. But incapacitating depression may require medication for a limited time along with psychotherapy. In combined treatment, medication can relieve physical symptoms quickly, while psychotherapy enables the patient to learn more effective ways of handling his problems. If you suspect someone is suffering from depression or dementia do not delay seeking help or advice.
© G.Peverill
