Neglected emotions: depression in the elderly

Author: Jiang Jielian, West China Fourth Hospital, Sichuan University

Gong Jian West China Fourth Hospital, Sichuan University

Reviewer: Song Zhigang, deputy chief physician, Ziyang Central Hospital, Sichuan

70-year-old Grandma Li's children have been working away from home for a long time, and the old lady lives alone. In recent months, the old lady has become more and more taciturn, and has lost interest in activities she used to like. She just sits at home and stares blankly every day. The children thought that the old lady had just become withdrawn due to old age, but they didn't know that the old lady had fallen into the dilemma of senile depression. Grandpa Zhang is a retired teacher. After his wife passed away, his mood gradually became depressed. He used to be cheerful, but he became reluctant to communicate with others, and his appetite also decreased significantly. His family thought that he was sad because he missed his wife, and did not realize that this might be a manifestation of senile depression.

Elderly depression not only causes the quality of life of the elderly to plummet, but also brings a "heavy" burden to the whole family. Elderly depression is like "hide and seek", the deeper it hides, the slower it develops, and the consequences should not be underestimated. Elderly depression is easily misdiagnosed and has become a "big problem" that affects the physical and mental health of the elderly. Both patients and their families are under tremendous psychological pressure and financial burden.

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1. What are the symptoms of depression in the elderly?

The main manifestations of depression in the elderly are persistent low mood; loss of interest, no interest in anything; self-blame and guilt, always feeling that they have done something wrong; as well as sleep disorders, changes in appetite, etc.

2. How does depression occur in the elderly?

As they age, the function of the "old machine" of the elderly body gradually declines, and the neurotransmitters in the brain begin to "fight", which can easily lead to depression. At the same time, the elderly may face "sad events" such as the death of a spouse, the departure of their children and becoming "empty nesters", lack of friends, etc., plus they may face financial difficulties, illness and other problems, which lead to great psychological pressure on the elderly and induce depression in the elderly.

3. Can depression in the elderly be detected and prevented early?

Of course! If you can find the "clues" of senile depression early and understand its causes and characteristics, you can prepare in advance and intervene in time to effectively prevent the occurrence of senile depression.

1. Psychological Assessment Scale

You can use psychological assessment scales, such as the Self-Rating Depression Scale (SDS) and the Hamilton Depression Rating Scale (HAMD) to preliminarily determine whether you have depression. If the score on the scale is high, you need to conduct further professional psychological assessment and diagnosis, just like playing a detective game to find out the truth step by step.

According to the results of psychological assessment and clinical manifestations, depression in the elderly can be divided into mild, moderate and severe. Mild depression means a little low mood and loss of interest, but the patient can still take care of himself, just like a bicycle with a minor problem, but he can still ride it; moderate depression means even lower mood, loss of interest in life, and obvious impact on sleep and appetite, and the patient needs family care and support; severe depression means extremely low mood and even suicidal thoughts and behaviors, which requires urgent hospitalization.

Elderly depression requires long-term treatment. Even if the symptoms are relieved, you cannot stop taking the medication at will. Stopping the medication may cause the condition to recur or even worsen. Under the guidance of a doctor, you should gradually reduce the dosage of the medication, and combine it with psychotherapy and rehabilitation training to consolidate the treatment effect.

2. How to prevent depression in the elderly?

To stay away from late-life depression, start by caring for the elderly.

① Family members, especially children, should pay more attention to the life and mental state of the elderly, chat with them more often, accompany them to participate in some beneficial activities, and make their lives rich and colorful.

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② If the elderly show symptoms such as depression, loss of interest, and sleep disorders, family members should take them to the hospital as soon as possible for psychological evaluation and examination.

③Old people with chronic diseases, physical disabilities, etc. are more likely to be "targeted" by senile depression, and their families need to give them more love and care.

④ The elderly themselves should also maintain a positive and optimistic attitude, participate in social activities appropriately, cultivate interests and hobbies, and enrich their lives.

In short, depression in the elderly is not terrible. As long as we pay more attention and care to the elderly, we can stay away from the haze of depression, enjoy our later years happily, and let every "old child" smile brightly.