Geriatric Depression: More Complex Than a Normal Sign of Aging

Mar 01, 2019

Healthline (healthline.com) defines geriatric depression as “a mental and emotional disorder affecting older adults.” The U.S. Census Bureau (census.gov) reported in 2016 that 49 million—15 percent of the American population—were 65 or older. While early onset depression is typically the result of genetics and social environment, geriatric depression doesn’t operate quite the same.

According to Psychology Today, depression manifests itself differently in older individuals than in children and young or middle-aged adults. While the latter may experience sadness, hopelessness, and other emotional symptoms, elderly patients tend to struggle more with cognitive abilities and physical aches and pains.

The National Institute of Mental Health (NIMH) states depression in seniors often goes misdiagnosed or undiagnosed because their symptoms are mistaken for expected signs of aging such as memory loss, agitation, and the inability to care for one’s self. Geriatric depression is also often mislabeled as a side effect of prescription medication.

Psychology Today notes 97 percent of medical students have no specific training in geriatric depression. Though they’re likely schooled in clinical depression as a whole, the disparity in symptoms between age groups must be accounted for and receive special consideration.

The World Health Organization reports geriatric depression affects 7 percent of the world’s older population, but 90 percent of those affected don’t receive proper care—and 78 percent don’t receive care at all. These numbers could be higher due to the lack of understanding surrounding the condition, as some depressed senior citizens never achieve an accurate diagnosis.

The mismanagement and misdiagnosis of geriatric depression not only takes a financial toll on patients but may worsen physical illnesses already present. Subclinical depression, a condition where many of the symptoms of major depression are present but not all, is present in 25 percent of U.S. senior citizens, according to Psychology Today. Undiagnosed or untreated subclinical depression may morph into major depression as time passes.

Depression in elderly adults often co-occurs with physical illness, such as a stroke. The medical condition itself may worsen the depressive disorder. Many elderly patients brush off depression symptoms as something to be expected with aging, not knowing they are experiencing a treatable condition. Depression is not a normal part of aging, nor does it have to be.

Symptoms of geriatric depression can be broken down into three categories: behavioral, physical, and cognitive. Behavioral indicators include loss of interest in things that were once pleasurable, irritability, apathy, isolation, loss of self-esteem, and feeling like a burden. Physical signs present as aches and pains, fatigue and loss of energy, weight fluctuations, sleep irregularities, and slowness in movement. Finally, cognitive manifestations of geriatric depression tend to be memory loss, inattention, pessimism, hopelessness, mental decline, brain fog, and thoughts of death or suicide.

There are several risk factors for developing geriatric depression, according to NIMH. Dealing with chronic medical illnesses, such as cancer, diabetes, and heart disease may strain an individual’s mental health, as well as their physical disability. MentalHealthAmerica.net reports almost 25 percent of people who suffer a stroke will experience clinical depression.

Poor sleeping patterns, loneliness, and social isolation are some environmental factors that put an elderly individual at risk. Additionally, family history of depression, some medications, brain diseases or injury, alcohol or drug abuse, the loss of a loved one, a divorce, or being someone else’s caretaker can contribute to development of the disorder.

There are many ways to treat depression, including talk therapy, medication, or a combination of both. Yoga, exercise, nutrition, and cognitive behavioral therapy are also effective options when cultivating a treatment plan. It is important that an individual cooperate with their doctor to find a unique method, or combination of methods, that work specifically for them.

The Health Resources and Services Administration (HRSA) makes it easy for individuals to find local, affordable to no-cost care through their online data warehouse FindAHealthCenter.HRSA.gov. The Substance Abuse and Mental Health Services Administration (SAMHSA) has a similar map for behavioral health treatment at FindTreatment.SAMHSA.gov/locator.

Becca Levy, a professor in the Department of Epidemiology and Public Health at Yale University, reported in the Journal of Personality and Social Psychology, that those with a positive outlook on aging live longer than those with a negative perception. In fact, Bevy and her colleagues found that optimism toward growing older extended lifespan by more than seven years.

Stereotypes about aging are often acquired in childhood, normalized, and unquestioned. As some individuals grow up and older, aging is deemed so negatively that it inherently erodes their self-image.

Growing old doesn’t constitute a lack of beauty or importance, nor is it a death sentence. Sickness happens at any age, as does death. An accurate perspective about aging has the potential to improve quality of life and allow many older adults, who may feel left behind, to age with dignity and grace. They are not invisible. They are here. They are alive. And their mental health matters.