Hiding in the Golden Years: Depression in the Elderly

The “Golden Years” are often described as an idyllic time of retirement and fulfillment. Yet, the aging process is not always so benign. Chronic illness, loss of friends and family, and the loss of abilities can be a heavy burden on emotional well- being.

An older adult can experience a loss of control over his or her life due to changes in eyesight, hearing, memory, or other physical changes, as well as a deteriorating financial condition. These losses can often result in negative emotions such as sadness, anxiety and loneliness. These can, in turn, lead to isolating behavior and hopelessness.

A more serious consequence is chronic or recurrent depression. Chronic depression has both emotional and physical consequences. These may exacerbate an older adult’s existing health issues or cause new problems. There is some evidence that the changes experienced with age, such as reduced folate levels, increase incidence of depression and dementia. Research has also pointed to an increased rate of depression in individuals with hypertension, diabetes, heart disease and stroke.

15 to 20 percent of older adults have been shown to experience significant depressive symptoms. But, a significant percentage of depressed elderly adults are never identified or treated. Mood symptoms are often misidentified as physical illness. Elderly people may avoid acknowledging their symptoms due to stigma associated with mental illness.

Depression in older adults may differ somewhat from symptoms in other populations. Symptoms may include:

• Memory Problems
• Irritability
• Social Withdrawal
• Problems with sleep and appetite
• Unexplained aches and pains

Depression can have serious physical effects on elderly people. Depressed seniors engage in more maladaptive health behaviors including poor nutrition and alcohol use. In addition, older adults have the highest rates of suicide among any age group. This is especially seen to be true among older men. Seniors are also at an increased risk of accidental injury since depression can lead to a reduction in cognitive function.

We all age. Depression does not need to be a part of older age. Early identification, diagnosis and treatment can prevent the emotional and physical consequences of depression.

Both cognitive behavioral therapy and medication can help. However, it is important with an elderly population to be aware of their special needs. At Counseling Associates we take care with the following:

• Be aware of health issues. We counsel older adults to check in with their primary care physicians before changing their diet or starting any new physical activity.
• Respect the individual needs of clients. As we age we may become less flexible and willing to change. At Counseling Associates we help tailor a therapeutic strategy to the needs of the individual client. One size does not fit all.
• Be tactful. Elderly clients may be quick to resent offers of assistance or may feel easily defeated. At Counseling Associates we can help clients as well as friends and family members to deal positively with these issues.

Susan Borchert, Ph.D. is a founding partner at Counseling Associates and a licensed psychologist. Her areas of clinical specialty include lifespan development and senior issues, couples therapy, anxiety and depression, women’s issues, and work/career counseling.