Question

Compare and contrast clinical depression with the sadness that may be associated with the normal losses of aging. What factors need to be considered with the population discussed in this chapter that may be different than other age groups?

Answer 1

Depression ranges in seriousness from mild, temporary episodes of sadness to severe, persistent depression. Clinical depression is the more-severe form of depression, also known as major depression or major depressive disorder. It isn't the same as depression caused by a loss, such as the death of a loved one, ageing, or a physical medical condition.

Clinical depression is the most common of mental conditions, which can be treated, but among elderly aging people, it is one of the most overlooked. Sometimes, it’s because physicians don’t recognize the signs and symptoms. Sometimes it’s because of an overall attitude of society that perhaps feeling low is just part of getting old.

Getting old involves loss—loss of friends; loss of spouse; loss of siblings; loss of status; loss of hair; loss of physical mobility; loss of memory; loss of hearing; loss of eyesight; and sometimes loss of financial stability. So, it is not surprising that aging and depression often go together. Feeling sad about these losses is a normal part of life. The sadness associated with loss can often be lessened with time and is different than Clinical Depression.

Loss of enjoyment of things one normally likes is one of the symptoms of clinical depression. Other symptoms include feeling sad for extended periods, loss of appetite, sleeping too much or not enough, eating too much, difficulty making decisions, steady weight loss, or unusual weight gain, irritability, outbursts of temper which are not normal, and withdrawal from friends and family.

So, now we have a good understanding of Clinical Depression and Sadness associated with losses of ageing; let’s look at the factors that need to be considered with the population discussed in this chapter that may be different than other age groups.

If an elderly is just not getting back to the way he/she was, and has an alarmingly long, ongoing period of sad mood and other symptoms, encourage him/her to see the doctor. Many elders are unaccustomed to talking about their feelings. They may lack the basic vocabulary to describe them. The adult child can offer gentle assistance with this difficult area. If unchecked, clinical depression can become a downward spiral with no end. It can become worse and more miserable for the depressed person as time passes.

Late life tends to come with many changes, and these changes can bring up some strong emotions. These physical and lifestyle changes in later life may “give rise to negative emotions such as sadness, anxiety, loneliness and lowered self-esteem”. Chances are, though, that the strong negative emotions associated with life’s transitions won’t develop into clinical depression. As stated previously, most older adults are not clinically depressed. Many individuals will cope with strong emotions by using a lifetime of resilience and experience, positive coping, and social support. They may experience sadness and mourning, without developing depression. If an individual is deeply struggling to cope with life stressors or begins to develop symptoms of depression, their symptoms should not be thought of as “normal” and treatment should be sought.

Changes in the Body

Although, there is evidence that some natural body changes associated with aging may increase a person’s risk of experiencing depression.” For example, there may be a link between low levels of vitamin B9 (folate) and depression in older adults. Yet, the increase in physical risk for depression does not make depression a “normal” part of aging. Regardless of risk-level, depression continues to be a treatable illness rather than an acceptable component of aging.

What sets depression apart from “normal” aging? The Ten Red Flags to look for are:

• Persistent feelings of sadness, hopelessness and emptiness
• Feelings of worthlessness and guilt
• Loss of interest in activities that used to be fun and rewarding
• Lack of energy
• Sleeping too much or too little,
• Eating too much or too little
• Poor concentration and focus
• Irritability and restlessness
• Persistent physical aches and pains, such as headaches, stomach problems
• Wish to die or thoughts of suicide or self-harm

If an elderly loved one experiences any of these symptoms, you should consider consulting with your physician and a mental health provider. Additionally, you can make a difference by offering emotional support. Listen to your loved one with patience and compassion. You don’t need to try to “fix” someone’s depression; just being there to listen is enough. Don’t criticize feelings expressed, but point out realities and offer hope. You can also help by seeing that your loved one gets an accurate diagnosis and appropriate treatment. Help your loved one find a good doctor, accompany them to appointments, and offer moral support.

Hope the aforementioned is free of any ambiguity and is useful to you.

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