Degenerative changes in the brain, exacerbation of chronic diseases, decrepitude of the body and physical helplessness often lead to the development of depression in the elderly over 70. At the same time, an elderly person loses the ability to enjoy life. Increasingly focuses on negative events, ignoring the positive aspects of the surrounding reality. Why this happens and how depression is treated in the elderly, you will learn in the following article.
General information and disease statistics
Human life does not consist of continuous joys. Everyone has troubles, problems arise in their personal or professional lives. The psyche of a healthy person is able to cope with this load. After an emotional experience of conflict or grief, she recovers and seeks a solution to the problem. Then he enjoys life again, experiences positive emotions.
Mentally ill people are not capable of such constructive behavior. They experience negative emotions over and over again, “stuck” in negativity for many months or even years. Especially often it can be observed in the elderly (70 years and older). Instead of enjoying a well-deserved rest, the elderly concentrate on the problems, sorrows of the current life and the past.
According to WHO, about 40% of older people worldwide suffer from senile depression. In the CIS countries, the number of depressive patients is even higher. The situation is aggravated by the fact that in the post-Soviet space it is not customary to seek psychological help.
depression in the elderly
Incidence statistics poorly reflect the true state of affairs. Patients are left alone with a dangerous disease, which often ends in suicide.
Bad mood… or behind-the-scenes games of depression
Signs of depression in the elderly can be observed everywhere. The old people in our country do not enjoy the rest from work and the hated alarm clock in the morning, but begin to suffer from their “uselessness” to society. The past is presented to them in a rainbow light. The present and the future are filled with gloomy colors.
Elderly depressive patients fill the time freed from work not with their favorite hobbies, walking, fitness, visiting the theater and exhibitions, but with derogatory soul-searching and condemnation of everything around. The accumulated irritation is splashed out in scandals in public transport, queues for an appointment with a therapist, in the family circle. All this is not a sign of a character suddenly deteriorating towards old age, but of deep depression.
The peculiarity of this state is its totality. A sick person is in a bad mood not occasionally (when there are good reasons for that), but most of the time.
His life turns into a continuous experience of real and far-fetched problems without glimpses of joy and hope.
Causes of depression in old age
Many believe that depression in old age is a direct consequence of a “hard life”, past misfortunes, and an unstable economic situation. Alas, a happy life at a young and mature age is by no means a guarantee against depression in old age. There are many reasons for the development of the disease:
Loss of life goals. After retirement, many people feel like they have nowhere else to go. The children grew up and became independent. You don’t have to go to work. If a person does not have interesting hobbies, hobbies, he does not know what to do at his leisure. A vacuum is formed that simply has nothing to fill. Pensioners feel themselves unnecessary, as if thrown out of the stream of life boiling around.
Confrontation with approaching death. Being in old age, it is difficult not to think about the end of life. Death is a sore subject for most older people. It worries especially acutely pensioners who are not satisfied with the life they have lived, they believe that they have not achieved everything they dreamed about.
Loneliness, loss of loved ones. “They lived happily ever after and died on the same day.” Unfortunately, this can be said about the rare lucky ones. More than 80% of people literally outlive their spouses and are left alone in old age. Loneliness is exacerbated by the fact that children and grandchildren live separately from the elderly. Many move to other cities or even countries, which is why they rarely see their grandparents.
Generation conflict. Even living next to young people, the elderly are not spared the risk of developing depression. Older people lived in completely different social and living conditions than their descendants. They formed principles and views, often running counter to modern ones. This imbalance becomes a source of endless suffering for older people with a rigid psyche who are not able to adapt to new conditions of existence.
Physical helplessness. In old age, chronic diseases worsen and new ones appear. Osteoporosis, vascular disorders, joint problems cause the loss of previous physical mobility. Sick pensioners cannot serve themselves in everyday life. They constantly need the help of strangers. This exacerbates the feeling of helplessness and worthlessness.
Degenerative diseases of the brain. Very often, depression in old age becomes the result of organic lesions of the central nervous system. It is a faithful companion of Alzheimer’s, Parkinson’s, senile dementia and other neurodegenerative diseases. In 65-70% of cases, it also occurs after a stroke with extensive brain damage and loss of physical mobility.
Characteristically, these causes of depression in the elderly are usually observed in combination. The loss of loved ones causes thoughts of one’s own uselessness and imminent death. The severe experience of loneliness leads to prolonged stress, poor health, and problems with the cardiovascular system. As a result, the risk of depression increases significantly.
According to the observations of doctors, depression most often develops in the elderly, who live alone and rarely have contact with relatives. Widowhood or divorce from a spouse with whom they have lived for many years “strikes” strongly on the psyche of an elderly person.
In addition to loneliness, various stressful events and situations are risk factors:
– loss of the former social status;
– economic insecurity, poverty;
– lack of communication with friends, like-minded people, social isolation;
– acute conflicts with neighbors or relatives;
– strokes, injuries, diseases that cause limitation of physical mobility or complete paralysis;
– severe chronic pain;
– taking certain drugs that cause a depressed state of the psyche (beta-blockers, corticosteroids, antipsychotics, etc.);
– genetic predisposition to depression.
Women are more prone to depression in old age due to more developed emotionality. The risk of its occurrence also increases the decrease in the production of sex hormones and the lack of drug correction of this condition during menopause.
Signs of depression in old age
There are a number of signs that clearly indicate a depressive disorder:
– depressed mood most of the time;
– the prevailing feeling of anxiety, constant expectation – “premonition” – of impending disaster;
– chronic insomnia;
– poor appetite or its complete absence;
– total fatigue, impotence, apathy;
– hypochondriacal delusions.
The last sign is expressed in the fact that the patient is constantly looking for new diseases in himself.
He visits all the doctors he can. He is a “regular client” of the polyclinic at the place of residence. During a visit to the doctor, he vividly describes the symptoms of the disease found in himself. However, the examination does not reveal any special deviations, in addition to those that are usually observed in old age (hypertension, atherosclerosis, etc.).
Delirium can be not only hypochondriacal in nature. Some depressed patients are obsessed with ideas of condemnation, punishment, or death. Some older people complain about the harassment they are constantly subjected to by relatives, neighbors or just strangers. Others are waiting for punishment, “punishment” from some evil higher powers.
Stages of disease development in old age
Depression in the elderly develops gradually. At the first stage, it is acute. Long periods of marked depression alternate with bouts of motor excitation. The patient at the same time shows increased anxiety, cannot sit still, constantly concentrates on the negative and actively broadcasts it to others.
As the depression progresses into the chronic phase, the patient becomes more and more withdrawn into himself, becomes apathetic and inhibited. His facial expressions lose their vivacity, become unexpressive. An elderly person feels a breakdown, suffers from somatic disorders: insomnia, lack of appetite, constipation, “wandering” pains in different parts of the body. The patient plunges into despair, more and more often thinks about death.
Diagnosis of the disease
The problem of treating depression in the elderly is that the majority of patients do not trust psychotherapists. The feeling of their uselessness, suspicion and foreboding of misfortune causes them the fear of being forcibly placed in a psychiatric hospital. In many patients, on this basis, the symptoms of the disease worsen.
Relatives of a sick person must treat him with the utmost care and tact. The old man needs to be explained that no one is going to “lock” him in a mental hospital. The doctor and relatives want to help, get rid of negative thoughts and feelings.
Diagnosis of the disease
When diagnosing a disease, a specialist pays attention to the following symptoms:
– weight loss in the absence of diseases that can objectively cause it;
– anorexia, lack of appetite;
– insomnia or poor sleep quality for a week or more;
– depression, apathy, unwillingness of the patient to do anything;
– neurotic manifestations: bouts of hysteria, increased anxiety, a tendency to repeat the same actions (obsessive- compulsive symptoms).
It is characteristic that at the stage of late depression, elderly patients almost do not complain of depressed mood, despondency, sadness.
Instead, they are dominated by hypochondriacal complaints of pain in different parts of the body, some kind of “hidden” diseases, poor memory, bowel dysfunction and other body disorders.
If depressive symptoms are detected, differential diagnosis is carried out. It includes hardware methods for examining the brain, a blood test, a consultation with specialized specialists for the detection of organic lesions. All this helps to separate depression from degenerative diseases of the brain, in which similar manifestations are possible.
How is depression in the elderly treated?
It is important for relatives of pensioners to understand that a depressive disorder is not a temporary “spleen”, but a serious illness that requires medical treatment. With it, the balance of hormones responsible for stabilizing mood after experienced stress is disturbed in the patient’s brain. The body cannot cope with this on its own.
Treatment for depression in the elderly includes antidepressants and cognitive behavioral therapy. Only an integrated approach allows you to stop the dangerous manifestations of the disease, stabilize the psyche, and avoid relapses.
Of the most popular drugs for depression, we can mention Nozepam, Xanax , Aurorix , Piracetam , Seduxen, Phenibut , Alprazolam.
How is depression in the elderly treated?
Attention! The drugs listed are prescription drugs. They are released in pharmacies only according to a certified by the seal prescription of a psychotherapist or psychiatrist. It is impossible to “prescribe” and take such medicines on your own! This can lead to a deterioration in the patient’s condition, even lead to his death.
In combination with drug correction, work with a psychotherapist also shows good results (by itself, it is not effective in the case of a depressive disorder). At the doctor’s appointment, the patient “speaks out”, gets rid of the negative. He also learns to track the deterioration of his condition, to cope with fears and anxieties.