Symptoms And Signs Of Depression Are Common In The Geriatric Population

Depression among the elderly can have many faces. The most common psychiatric diagnosis of older adults is the Major Depressive Disorder which is an illness where symptoms are present for more than a two-week period and may include depressed mood, loss of interest or pleasure, significant weight loss or weight gain, too little or too much sleep every day, greatly slowed or increased activity level every day, fatigue, a sense of worthlessness, diminished ability to think or concentrate, and recurrent thoughts of death or suicidal feelings.

Only a physician can properly determine whether the symptoms are a part of normal aging, a normal bereavement process, a medical condition, a drug reaction, a lifelong personality style, or clinical depression. For example, sleep disturbance, reduced appetite, reduced energy and fatigue, and also impaired memory and concentration are some common complaints of aging adults without clinical depression.

Someone who has recently lost a loved one will experience a lot more depressive symptoms as part of a normal grieving process. Medications like narcotics, antihypertensive agents, and sedatives can possibly cause depressive symptoms. Similarly, certain diseases (for example, Parkinson's disease) can actually give the physical appearance of depression even when it is not present. The physician is most qualified to make a differential type of diagnosis.

A complicating factor is that the depression and also the other medical conditions can coexist. Though the prevalence of depression is about 5 percent in the general geriatric population, it rises to about 30 percent in the elderly with acute or chronic medical conditions such as chronic pain, loss of sight or hearing, or decreased ambulation. Most at risk are the white males who are isolated and in poor health. Their rate of suicide is three to four times more than that of the general population!

Depression can be disguised by a presentation of physical symptoms and complaints. The most dramatic example of this is pseudo dementia in which an elder can appear severely cognitively impaired with poor grooming, a slumped posture, and poor eye contact. Cognitive tests reveal the deficits in memory and reasoning. However, the cause is not neurological but rather a major depressive disorder.

Many people born before 1930 were raised with a very strong work ethic and a belief that feeling lethargic and unhappy was a sign of failure of self-discipline, a sign of weakness. To these elders, a depressive diagnosis is like an attack on their character; they are prone to minimize symptoms. When they understand that depression is clearly an organic illness, they are more apt to accept the treatment.

A doctor, nurse, or social worker can actually explain in a simple way the changes in brain chemistry that may lead to major depressive illness. Once elders see the medication and treatment as a way of correcting the dysfunctional neuron activity, they can participate more positively in treatment. Although a family physician can prescribe treatment as well as medication, a geriatric psychiatrist is most qualified to undertake this task. Whenever possible, an evaluation by this type of specialist is definitely recommended.