Stop Ignoring Depression in the Elderly

In 2022, the number of depression patients in my country is currently 95 million. Among them, adolescent patients and young and middle-aged patients account for the majority. As society's awareness of depression continues to improve, we are pleased to see that more and more people are beginning to pay attention to mental illnesses such as depression, and more and more people are offering care and tolerance to patients with depression. However, while we pay attention to the trend of younger onset of depression, we often ignore the group of elderly patients with depression. Against the background of increasingly serious aging, elderly depression should also be taken seriously by everyone.

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

Today, elderly depression is a common mental illness among the elderly, with 2% of adults aged 55 and over suffering from severe depression. The prevalence of elderly depression gradually increases with age, and most cases occur around the age of 60. 10-15% of the elderly have obvious clinical symptoms of depression. In the early stages of the disease, elderly depression is often difficult to detect by the patient himself and his family members around him, and it is easy to be ignored, resulting in delays in treatment. So what are the symptoms of elderly depression?

1. Depression: The primary manifestation of depression in the elderly is depression and inferiority. In daily life, it is difficult to feel happy and joyful. Usually, they feel uninterested and depressed, and think that they are a burden to their family and society. They cannot find their self-worth, which leads to inferiority.

2. Sleep disorders: Elderly patients with depression may have difficulty falling asleep and their sleep quality may be seriously deteriorating. Long-term lack of sleep and rest may also aggravate depression.

3. Cognitive impairment: Compared with younger patients with depression, elderly patients with depression are more likely to suffer from cognitive impairment. Patients will experience significant memory loss, a serious decline in their ability to understand and judge things, and some symptoms similar to dementia.

4. Associated diseases: According to research, compared with young patients, patients with elderly depression are more likely to suffer from internal diseases, such as decreased visceral function, cardiovascular and cerebrovascular diseases, etc.

In general, the symptoms of elderly patients with depression are similar to those of young patients, but due to the different physical conditions of the elderly, these symptoms are difficult to take seriously and are perceived as manifestations of depression and thus ignored.

What causes depression in the elderly?

Above we mentioned the high incidence of depression in the elderly today, but what exactly causes the elderly to suffer from depression when they should be enjoying their old age?

As the elderly enter old age, they are prone to low self-esteem and frustration, and their psychology begins to become more fragile. For a long time, if they lack the care and love of their children, the "empty nest feeling" will make the elderly feel lonely and more likely to fall into depression.

Secondly, elderly people with limited mobility will face social difficulties. The drastic reduction in daily social activities makes it impossible for elderly friends to meet their social needs. They are unable to communicate with others for a long time, which is also very likely to lead to the occurrence of depressive symptoms.

At the same time, the elderly who have been troubled by chronic diseases for a long time are also at high risk of suffering from geriatric depression. Due to fear of illness and anxiety about the long treatment process, patients with chronic diseases such as hypertension, heart disease, diabetes, etc., while suffering from the disease physically, are also likely to suffer from depression psychologically.

When people enter old age, they often face the sudden death of their loved ones, which can cause severe mental trauma. If they are immersed in the sadness of losing their partners and loved ones for a long time and cannot relieve their grief, they are very likely to suffer from depression.

Genetic factors and personal character factors are also important causes of depression in the elderly.

3. “Why give up treatment?” Elderly depression is also difficult to treat

Like depression in other age groups, early detection and active treatment are key links in the recovery of elderly depression.

However, insufficient understanding of depression itself and a strong sense of shame have become serious obstacles preventing most patients from recovering.

Most elderly patients have no concept of depression and often cannot associate the symptoms they experience with depression. Even if they have severe depressive symptoms, they are unable to realize that they have a mental illness. Most patients believe that depression is a normal phenomenon of aging, and thus ignore their condition, preventing them from receiving timely and effective treatment.

For many elderly people who realize that they are ill, stigma is an important reason that prevents them from receiving treatment. Most of these elderly people cannot accept the fact that they suffer from mental illness, think that depression is something difficult to talk about, are afraid to seek help from their children, relatives and friends, and always refuse to receive formal treatment, which makes their condition worse.

According to the "2022 National Depression Blue Book", 67% of elderly patients with depression live alone. During the treatment and rehabilitation process, they often have difficulty purchasing medicines. In addition, depression requires regular follow-up visits, and the waiting time required to go to the hospital for follow-up visits is long. Therefore, many elderly patients are unable to adhere to long-term regular follow-up visits, making the treatment unable to achieve the desired effect. The above factors have added many obstacles to the treatment and rehabilitation of depression for elderly patients. Many elderly patients with depression give up treatment halfway or even never choose to receive treatment, allowing the disease to develop, causing themselves to suffer from depression for a long time.

Therefore, when elderly patients with depression encounter the above-mentioned situations and feel physical and mental discomfort, they should receive regular treatment in a timely manner and take antidepressants as prescribed by the doctor, and do not let delay aggravate the condition.

4. Care and communication are the best prevention

After understanding the causes and symptoms of elderly depression, we also need to pay serious attention to how to prevent elderly depression and how we can help our elderly family members and friends get rid of the troubles of elderly depression.

First and foremost, it is important to give the elderly love and care from their families. In terms of family, family members should pay more attention to the elderly, communicate more with their parents and elders, frequently share their life updates with them, care about their parents' emotional state and emotional needs, and let their parents feel that they are loved and cared for.

According to relevant research by the Institute of Psychology of the Chinese Academy of Sciences, participating in more social activities and interpersonal communication, and improving the social participation of the elderly, can help them stay away from depression. The elderly can make friends and meet their social needs by participating in community activities and actively cultivating hobbies, thereby preventing long-term loneliness and reducing the possibility of depression.

From the perspective of the elderly, they should pay attention to their own emotional state, not be afraid to express their loneliness and depression, and express their emotions in a timely and reasonable manner to relieve their emotions. At the same time, they should communicate more with the outside world to maintain a good emotional cycle and a happy life.

Aging is an important trend in China's population today. As more and more people around us enter old age, the number of elderly people increases, and the number of elderly people with depression is likely to rise in the future.

No matter what age you and I are, whether we are young, middle-aged, or already old, we should pay attention to depression in the elderly. "Respect the elderly as our own" means caring for our parents and the elderly around us, so that depression in the elderly is no longer a shameful disease in the corner.

Because we will all grow old one day.

References:

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[3] Ding Y, Chen L, Zhang Z. The relationship between social participation and depressive symptoms among Chinese middle-aged and older adults: A cross-lagged panel analysis. Front Public Health. 2022 Oct 13;10:996606. doi: 10.3389/fpubh.2022.996606. PMID: 36311600; PMCID: PMC9608247.

[4] Penninx BW, Guralnik JM, Ferrucci L, Simonsick EM, Deeg DJ, Wallace RB. Depressive symptoms and physical decline in community-dwelling older persons. JAMA. 1998 Jun 3;279(21):1720-6. doi: 10.1001/jama.279.21.1720. PMID: 9624025.

[5] People's Daily Health Client, Health Times, Depression Research Institute, Lundbeck China. "2022 National Depression Blue Book" [R/OL]. (2022-06-29) [2022-11-09] https://mp.weixin.qq.com/s/F8b3gIpKdFSiILEVWLXp3Q

Medical review: Wang Fang, attending physician of the Department of Psychiatry, Beijing Children's Hospital, Capital Medical University