Depression is a serious mental health condition. It can make you feel sad, hopeless, or worthless for weeks on end. You lose interest in doing things you once loved. You can struggle to socialize, maintain relationships, and even care for yourself. You may experience physical symptoms like stomach upset and digestive problems, sleep issues, and generalized fatigue.
While depression is challenging at any age, it hits our older adult population hard. According to a study about depression in nursing homes, approximately 30% of residents experienced depression, the second most common psychiatric disorder in this population. As our population is leaning towards more older adults than ever, depression in older patients is becoming more prevalent. It comes with unique risks, consequences, and treatment challenges.
Depression Risks in Our Aging Population
Loss of Independence
Whether living independently or in a nursing home, older adults can struggle with their diminishing ability to care for everything in their lives. This can harm self-confidence, making depression more of a risk. When forced to move in with family or to a care home, the loss of agency in daily activities, schedule, and diet can allow depression to creep in.
Losing freedoms like driving are common due to aging issues like poor eyesight and slower reflexes. This decreases social interactions. When you depend on friends and family traveling to you or taking you places, you can be stuck in your house for days to weeks without seeing other people. Pride can also play a part since no one wants to ask for help or feel like a burden on their loved ones. Social isolation increases feelings of loneliness and depression.
Complex Health Conditions
Chronic or complicated physical health conditions increase the risk of depression at any age, especially in older adults. Arthritis, diabetes, heart disease, and cancer are just some common diagnoses that can lead to depression. Unfortunately, the extra cost, care, and perceived burden on your loved ones from a health condition can easily result in depression.
As we age, our mental abilities slowly decline. However, dementia and other cognitive and memory disorders speed this process up. Whether from the diagnosis, symptoms, or the disease process itself, cognitive disorders frequently go hand in hand with depression. However, depression can also present as a cognitive disorder, causing similar symptoms such as poor focus or concentration, forgetfulness, and a decline in the ability to care for yourself. Once properly treated, the cognitive symptoms can disappear as quickly as they appeared.
Depression Treatment Challenges For Older Patients
Depression requires prompt treatment to prevent progression, and it can be difficult to diagnose in older patients. Partly due to other health conditions or attributing it to cognitive decline, depression often goes undiagnosed in aging populations. This leads to delayed, inadequate, or no treatment at all. Stigma plays a part as well, as many older generations still believe any mental health condition is fake or a sign of weakness. While untrue, this belief leads to less reporting of depression symptoms.
If older adults do get depression properly diagnosed, treatment poses another challenge. With aging organs to process medications, older adults are more sensitive to certain medicines. Likely to already be on prescription medications for other conditions, there’s an increased risk of unsafe medication interactions. Studies also show older adults, especially those 65 and up, are less responsive to antidepressants with a higher relapse rate.
Adhering to medication therapies can also be challenging if there are any underlying cognitive impairments. Some antidepressants require other dietary modifications to remain safe and effective. This can all be too much to manage. Navigating antidepressants can be a minefield, and talk therapy and social support can only go so far. But there are other treatment options.
Additionally, taking multiple prescriptions simultaneously can contribute to an increased fall risk for older individuals. Prescription medications can affect the senses that help us maintain our balance. Adding depression medications to a patient’s daily regime can contribute to dulling their senses and slowing their reflexes, increasing their chances of falling.
TMS: A Safe Treatment Option For Depressed Older Adults
Transcranial magnetic stimulation (TMS) is an alternative depression treatment. Clinicians channel magnetic pulses around patients’ scalps to target brain cells in the regions responsible for mood and emotions. These magnetic pulses help reset the brain to eliminate depressive symptoms and feelings.
This painless treatment can take place in an outpatient clinic. Because it targets the brain directly, there are no systemic side effects or risk of interacting with other medications. Multiple studies show it’s a safe, well-tolerated, and effective medication-free treatment option for depression in older populations.
Because depression can look different for older adults, it can be much harder to diagnose. You should know the signs and symptoms. Instead of sadness being the main symptom, you may simply feel numb and lose interest in once-preferred hobbies or interests. Rather than talking about your feelings, you may pull away from loved ones and not want to visit as much. Where others may visit a doctor for their low mood, you may see the doctor for physiological symptoms of depression: stomach upset, headaches, and other physical aches and pains.
If you are having trouble sleeping, flare-ups of other health conditions, or are acting increasingly irritable or forgetful, it could be depression. It’s important to understand depression is not a normal part of aging, and quick intervention at any age is imperative. While presentation and treatment may look different, there are many treatment options to improve your or your loved one’s quality of life. Don’t let depression get in the way of enjoying your golden years.