How to deal with the blues in retirement. Depression in older people: why they occur, symptoms, treatment methods

From this article you will learn:

Why does depression occur in older people and what are the risk factors?

How does depression in older people differ from dementia?

How to Diagnose and Treat Depression in Older Adults

What are the consequences of depression in older people?

Old people... They are always dissatisfied, they grumble, you can’t please them. Sound familiar? But few people realize that our relatives simply need help. Depression in older people is not a condition of everyday life, but a mental illness, and the most common one today. One thing is good: she can be defeated, she will retreat with proper treatment. What can you do to prevent depression from affecting you or your elderly relatives and friends? What to do if signs of this disease appear? Could what we are seeing be depression? We hope our article will help you get an elderly person out of this state.

Why depression occurs in older people

“Not my day”, “a bad streak”, “I didn’t have a good morning”... There are many more excuses for the onset of depression. This is what psychologists began to call a long-term mental state of gloomy hopelessness. This mental disorder manifests itself in the loss of adequate perception of reality. Everything seems dreary, the mood is at zero. What used to make you happy is now annoying. You pushed your beloved dog away, were rude to your friends, you don’t want to move, everything is in black, pessimistic thoughts arise, crosswords, embroidery, violets on the window are abandoned, self-esteem is so low that you can only feel sorry for yourself. Some try to find solace in alcohol or other psychotropic substances.

What is associated with depression in adulthood? What pushes a person towards it?

Let's start with the fact that older people react very painfully to everything. But this is not harmful, as many people think. What caused mild annoyance in youth can provoke depression and nervous breakdown in adulthood. Stress, severe fatigue, situations that cause various breakdowns greatly deplete the reserves of all body systems. He has difficulty adapting to stimuli. An elderly man has difficulty hearing, he has to constantly ask again, half of the words in a conversation pass him by. Finally, he begins to avoid communication and withdraws into himself.

How will you feel if something constantly hurts or bothers you? Not fun, right? People of mature age, unfortunately, accumulate a lot of somatic pathologies. When visiting a doctor, an elderly person often hears: “What do you want? Age!". Illness, poor health, the attitude of doctors and others - all this can trigger the mechanism of depression. There are also pathologies in which older people are at increased risk. These are cerebrovascular diseases, diabetes mellitus, abnormalities in the thyroid gland, and arterial hypertension.

Many people look forward to approaching retirement age with fear, but it is not physical weakness and illness that scares them. They are afraid of social isolation, since upon completion of their work activity the usual way of life changes sharply, and a feeling of unfitness and loss appears. It’s as if you fell out of a fast train at full speed and were left standing on an empty platform, watching the disappearing bright, noisy train. It was as if the illnesses were waiting and appeared immediately. Here, depression can overtake those who spent most of their lives at work or in their careers, and most often men. Elderly women adapt more easily to their new free status, finding themselves in dacha care, next to their grandchildren, and traveling.

Another problem of mature people is loneliness. Only recently in the evenings your place was noisy and crowded: work problems were discussed, children demanded care and attention, plans were made for the weekend with friends. But now the house is empty, the grown children have their own families and interests, and no one is waiting at work. Friends, also elderly people, are busy with their illnesses, remind of themselves less and less often, and some are no longer there at all. The social circle is narrowing, loneliness with gloomy thoughts is approaching. Elderly women endure this condition more difficult, since they are the center of the universe called “Family”. Single women, divorced or widowed, suffer from emotional emptiness.

How tempting it can be to cure ailments with one pill! This opinion also exists in the treatment of depressive conditions. You feel sad - take the medicine, and now you are cheerful and full of strength. Such a dismissively easy solution to problems with depression only strengthens the disease. Taking medications, even as recommended by a doctor, can trigger another wave of distress. And even more dangerous is the use of antidepressants on the advice of grandmothers at the entrance or a neighbor in the country. Severe cases are known when treated with antihypertensive drugs (dicogsin, methyldop, beta blockers), corticosteroids (prednisolone), analgesics, and sleeping pills.

Depression in older people: who is first at risk?

Who is not at risk of depression, and who among mature people should think about:

Elderly women. Men turned out to be stronger and more resistant to depressive disorders.

Lonely people, because they sorely lack the attention of others and the care of loved ones.

Alcohol abusers or those with experience of taking narcotic drugs.

People who have suffered a serious illness or stressful situations, for example, a change of place of residence (they moved their old mother to the city, who had worked all her life in the countryside), who have lost relatives and friends.

Having suicidal attempts.

Sick elderly people. The focus is on hypertension, heart attack, diabetes. Such patients need to be given special attention.

Those whose relatives suffered from depression of various types, or they themselves struggled with this disorder in the past.

Elderly people with disabilities who have some visible defect.

If you have discovered the presence of at least one sign, then this is already a reason to think about it. If there are several of them, it is necessary to act so that your elderly relatives are not left without attention and care, alone in the face of a terrible disease.

How does depression in older people differ from dementia?

Externally, depression and dementia are very similar conditions, the main difference being that the first disease is reversible and therefore requires treatment. However, they can and should be able to be identified. Let's start with depression. It can affect memory, causing an elderly person to become absent-minded and lost in space.

Dementia (dementia) is a serious disease that affects the brain. By saying “of sound mind and sound memory,” we emphasize that it is absent. Indeed, for an elderly person it is important that with age, speech, attention, and the ability to accumulate, retain and reproduce existing knowledge and skills remain at the same level. Otherwise, his life will become very complicated: his habits will change (what he previously liked will cause disgust), his restrained character will become hot-tempered. Such people have difficulty caring for themselves and very often fall into depression.

Below is a table that gives a clear picture of the similarities and differences between dementia and depression (L. J. Cohen, 1999).

Parameters of mental state for which comparison occurs in parallel	Depression	Dementia
Affect (intense and short-term outburst of emotions)	Depressed (withdrawal). Deepening, soul-searching, escapism from reality. Severe subjective distress (destructive effect on the body).	With a violent manifestation. Labile, losing nuance (reacts sharply to both positive and negative stimuli). Lack of concern about one’s condition (a person does not care who he is or what he is).
	Fast, stormy. Can be precisely defined, contrasting. History of depression and other mental disorders (controlled).	Gradual, increasing. The temporary assessment is not defined, it moves from one state to another. The disorder was noted for the first time.
	Short, repetitive. Rapid development of symptoms after the first case.	Long-term, gradual. Slow development with regression.
Behavior	Indifferent, does not respond to stimuli. Absolute passivity, so any action requires effort. Indifference to memory lapses. Refusal and loss of social contacts. Intensification of attacks in the evening and at night is not typical. There is no loss of cognitive function (memory, attention).	With a predominance of distractibility, preoccupation, head in the clouds. Fussiness, aimless performance of actions. The failure of memory is compensated by notes. Social contacts are preserved, but with changes. Attacks often worsen in the evening and at night. The behavior is comparable to the severity of cognitive dysfunction (memory loss, mental weakness).
	There are complaints of cognitive impairment	Complaints of cognitive disorders are often absent

Depression in older people and its types

If we are talking about congenital or acquired defects of the nervous system, then this organic depression.

If the disorders are caused by traumatic events (problems at home, worries at work, loss of a loved one), then we are talking about psychogenic depression.

If depression is detected in elderly people with diseases of the respiratory system, cardiovascular system, vision organs, or oncology, then it will undoubtedly carry somatogenic character. This type of mental disorder manifests itself especially often in medical institutions with long stays.

Hereditary predisposition, internal pathogenic factors, with increased influence of external circumstances on them, give endogenous affective deviations ( bipolar and unipolar depressive disorders).

Long-term use of certain medications may lead to iatrogenic depression. There are opponents and supporters of this theory. In the same vein, we can talk about the body’s reactions to careless medical opinions.

Depression in older people and its signs

Depression in older people varies in symptoms. Older patients do not show emotional manifestations; they are often closed and withdrawn. Older people are more concerned about physical conditions, for example, fear of developing a disorder such as Alzheimer's disease.

Negative emotions, of course, do not disappear anywhere, but they look natural due to the lack of support and care of loved ones, disappointment in people, etc.

Let's try to understand the fears that are the main signs of approaching depression in older people:

The difference between depression in a young person and an elderly person is that the latter lives in the past. If a void has formed around, then it is filled, most often, with negative memories, turning into a mental disorder that torments and torments the patient. The person replays the difficult situation over and over again, returning and multiplying anxiety and anxiety.

Anxiety is an essential component of depression in older people. After comparing the research results, scientists confirmed this assumption. In the group of young people (under 35 years of age), only a third of those surveyed noted anxiety, and in the group of patients over 55 years of age, 70% confirmed the presence of anxiety, fears, and painful forebodings.

It would seem that meeting the sun and the morning hours bring joy, but in the case of depression the opposite is true. The state of depression in elderly patients is especially noticeable in the morning and subsides towards evening.

Depressed patients are characterized by slowness of movement and inhibited thinking. They are focused on themselves, on their inner feelings. It seems that these people are exploring their body from the inside, trying to figure out the problem of the origin of this or that pain.

Indifference to the world around you, alternating with bouts of melancholy detachment are clear symptoms of a deep degree of depression.

What are the clear symptoms of depression in older people?

What should we be wary of, what should we pay attention to?

For a depressed elderly person, everything is bad: prices are rising, cars are only trying to splash mud, the rain is wet, the sun is hot. Constant criticism, irritation, dissatisfaction with oneself, with you, apathy - the patient will explain all these changes in mood reasonably, but will not even allow the thought of a possible pathology of his nervous system.

Going somewhere or doing anything is problematic for an elderly person. A routine routine visit to the hospital causes a storm of indignation in a patient with signs of depression. Another symptom is decreased activity and loss of social contacts.

He gets up at night, wanders around, reads magazines, falls asleep in the morning, frustrated all day. There is no appetite, even your favorite buns with a crispy crust are not delightful. Sleep disturbance and loss of appetite in an elderly person are the third sign of incipient depression.

He has difficulty remembering why he has a pencil and notepad in his hand, why he took a calendar, and does not go to the store without a list of two products. Of course, this can happen to anyone, and perhaps an older person only has senile dementia, but it is also a symptom of a mental disorder.

During periods of depression, older people most often complain of feeling unwell. About 90% of all patients showed signs of deteriorating health.

Even from a closet full of clothes, you will not be able to throw out a single torn sock. You will hear that you are taking away the most necessary things from an old sick person, leaving him in poverty. The acquisition of new useful things also causes indignation and indignation: why buy an electric kettle if you can get by just fine with a jar with a boiler? Pathological hoarding is another sign of depression in older people. But it should not be confused with reasonable frugality.

They opened the window - you want to catch a cold, they closed it - it was stuffy, they asked what should be done - they blamed everything on him, they didn’t ask - no one is interested in his opinion. This is not harmful or a test of your nerves. This is a conversation, attracting attention, an opportunity to spend more time with you. Accusations from an elderly person against their loved ones is a rather acute and conflicting problem. Here you need to be patient, because it is unknown how depression will treat you and how lenient your family will be.

How is depression diagnosed in older people?

Reading these lines, many older people will confidently say: “This is not my case” - and they will be right. Diagnosing depression is very difficult. It appears and disappears again. Doctors cannot determine the presence of this disease using tests; they will only show the physical condition of your body. Therefore, to diagnose depression in older people, a simple but at the same time effective method is used - conversation.

A specialist determines the presence of pathology using several methods:

Hospital Anxiety and Depression Scale.

Beck scale.

For self-assessment, you can use the Zung scale. Tables using this method are filled out by the patient himself, which confirms the accuracy and subjectivity of the results. An elderly person with signs of depression needs to honestly answer questions about the frequency of anxiety, obsessive, difficult thoughts, appearance, and favorite activities. These are simple multiple-choice questions, the sum of which provides an explanation of the condition.

If the severity of the disease requires treatment and monitoring, doctors use the Hamilton Depression Rating Scale (HDRS) and the Manngomery-Asberg Rating Scale (MADRS).

Depression in older people - treatment is possible!

Alleviating the course of the disease in a patient with depression and direct therapy is a rather complex process. Why? Because an elderly patient rarely agrees to admit his diagnosis, but if the pathology is not treated, it will break the person both morally and physically. As a rule, older people are afraid of being branded abnormal and being isolated. Success is possible if a trusting relationship has developed with the doctor, and the patient longs for recovery and is ready to follow all the doctor’s instructions for this purpose. Treatment consists of three components: replacing your lifestyle with a healthy one, medications, and working with a psychotherapist. Many people also add traditional methods here. More about all this below.

Treatment with traditional methods

Some people trust natural herbs, infusions, and decoctions more than synthesized drugs. Of course, folk remedies do not give side effects and are not addictive, but before using them you should definitely consult a doctor. This is very important when treating elderly patients.

Here most popular recipes:

St. John's wort for depression

St. John's wort is an excellent natural antidepressant. Infuse 20 grams of St. John's wort and the same amount of dried oregano into alcohol (250 ml). Add coriander seeds and thyme. After two weeks, take the tincture out of a cool, dark place and strain. We begin to take a drop a day, gradually increasing the dose to a teaspoon, washed down with water.

Calming infusion of mint and lemon balm

You need to mix two types of herbs. Then you need to take a tablespoon of their mixture and pour a glass of boiling water. Let cool and brew. We drink the resulting broth in the morning, afternoon and evening, dividing this glass into three parts.

Motherwort and valerian

These folk remedies are considered leaders in relieving nervous tension. Motherwort and valerian are sold in every pharmacy. The dosage is indicated on the packaging.

St. John's wort, rosemary, lemon balm and blueberry

Four types of grass are taken in equal parts. One tablespoon of this entire mixture is poured with boiling water and brewed for half an hour in a glass. After which the infusion is drunk with honey, like tea.

In addition, decoctions of chamomile, fennel flowers, anise, and lavender have a good calming effect. They can also be purchased at the pharmacy. Brew and drink like tea.

Medications for depression in older people

It’s great if depression has subsided after using folk remedies, but sometimes the use of medications is required. Modern antidepressant complexes are at your service here. These are long-familiar tricyclic and tetracyclic drugs. Improved antidepressants that block side effects have also appeared on the market - selective serotonin reuptake inhibitors and reversible MAO-A inhibitors.

Effective drugs help overcome the disease, but when prescribing them, it is worth taking into account the individual characteristics of each patient. The correct dosage and compatibility with other dosage forms are more than important when treating an elderly person.

The most popular antidepressants for older people today are:

Atarax. This antidepressant is good because it is not addictive or dependent. It is effective for anxiety disorders that occur against the background of neurological and mental illnesses. Supports the functioning of the nervous system.

Leviron. One of the safest drugs for elderly patients. Why? Because it provides a pronounced sedative effect. Can be used for all types of depression.

Melipramine prescribed to increase the mental and general tone of the body, motor activity and mood. Indications are depression, accompanied by apathy, melancholy, sleep and appetite disorders.

Cipramil suitable for use in the presence of concomitant somatic diseases, suitable for long-term use, has sedative and antidepressant effects.

But that is not all. Sometimes doctors prescribe nootropics, antihypertensives and antispasmodics that block panic attacks and unreasonable anxiety.

Another fact confirming the need for therapy under the supervision of a doctor is that, to be on the safe side and out of habit, elderly patients often take Corvalol or Valocordin before bed, which should not be done. These drugs not only interfere with the action of antidepressants, but can also cause a deterioration in well-being.

Psychotherapy

Only in films do we see how a psychotherapist accepts a patient and helps him get out of the crisis. In real life, older people are categorically against such treatment methods, but, having yielded to the persuasion of their relatives, many of them are convinced of the effectiveness of the practical help of a specialist. The consequences of depression are successfully corrected through a whole complex of cognitive-behavioural, interpersonal and family psychotherapy for elderly patients.

Electroconvulsive therapy

What to do when time is lost and neither medications nor a psychotherapist help? Depression destroys an elderly person, there is a threat to life, have there been any suicide attempts? Electroconvulsive therapy, otherwise called electroconvulsive therapy, is a method of psychiatric and neurological therapy in which, in order to achieve a therapeutic effect, an electric current is passed through the patient's brain, which causes a convulsive attack.

Electroconvulsive therapy for the treatment of nervous disorders has been around for a long time. She has been saving the lives of elderly patients with severe depression for more than 70 years. This method of biological stress remains one of the most relevant means and is a worthy alternative to psychopharmacotherapy.

How to help an elderly person get out of depression

Only the comfort and warmth of home will help an elderly person overcome his illness. The attention of the whole family and care, words of gratitude and praise for help in housekeeping are priceless in the treatment of this serious illness. The patient must constantly feel the care and support of adult children and grandchildren, his importance and necessity for people dear to him. Old age can be a joyful period in a person’s life if he sees his importance and feels love from relatives.

Older people need constant encouragement. There is nothing warmer than words like these: “You did some difficult exercises today!”, “What beautiful embroidery!”, “Can I sit next to you and watch?”, “How does this blouse suit you, you look 10 years younger!” Sincere interest in their past has a very beneficial effect on patients. You will discover many amazing facts from your family history. Ask the older person to tell about his relatives, childhood, places where he lived in his youth, past work, interests. You will be amazed at what an amazing, heroic and at the same time humble person lives in the next apartment. Your admiring glance and shown interest can create a miracle. It is very good to look together at old photographs of the places where a person was born, lived, and worked, especially those in which he is depicted in strength, while performing socially significant work. This always improves self-esteem. At the same time, older people must feel your interest.

Depression in older people and its consequences

Not treating depression in older people is inviting disaster. This pathology significantly shortens the patient’s life and can lead to heart attack, coronary heart disease and other cardiovascular diseases. Depression can trigger type II diabetes. Such patients poorly comply with the treatment regimen for the underlying disease and do not maintain close contact with the doctor. Elderly people do not enjoy the new day, they are increasingly visited by thoughts about the end of life, and they find it difficult to concentrate. If depression is left without treatment, relationships with loved ones will deteriorate due to the patient’s increased anxiety. Due to frequent scandals, misunderstandings of the problem, reproaches and worries, it will be bad for both him and his family. In an elderly person, feelings of guilt and loneliness worsen, suicidal thoughts appear, and a desire to rid loved ones of oneself as a burden appears.

What needs to be done to prevent depression in older people

By paying attention to your elderly relatives, you will already postpone the difficult and terrible process of depression. Your concern will not go unnoticed and will be gratefully received. So, prevention of depression very simple and yet very effective:

Physical education gives more than just health. Simple exercises improve your mood, bring joy from movement, normalize blood pressure, and train your heart. In combination with pleasant music (cheerful, like in youth at a parade, or melodious), the load gives calmness and tranquility, and therefore softens the manifestations of depression. Walking with like-minded people in parks, forests, along the seashore will undoubtedly bring moments of happiness and joy. A four-legged friend (an affectionate spaniel or a faithful mongrel) will not let you get bored, he will take the owner out to enjoy the clean morning or evening air.

If you combine two loneliness, there will be no room for depression. Now there are a lot of interest clubs, veteran choirs, dance halls, and universities of the third age. You need to look for like-minded people, conversation partners, checkers friends or lovers of a healthy lifestyle. Loneliness should not leave you alone with depressive thoughts. Let us immediately note that communicating over a bottle of alcohol, no matter how warm it may be, does not eliminate the problem, but only aggravates it.

To prevent serious diagnoses from causing depression, you need to monitor your health. Do not ignore medical examinations and medical examinations, monitor blood pressure, cholesterol and sugar levels, and avoid traumatic brain injuries.

In old age, changing eating habits is difficult, but often necessary. Keep your favorites, but do not overindulge in fatty and sweet foods. A nutritious diet should include cereals and legumes, fish and olive oil, fruits, vegetables and honey. Green tea will not only invigorate you, but also give you the whole range of microelements you need.

Human life, if you think about it, consists of three periods: for yourself, for your family and again for yourself. As you may have guessed, children live easily and simply for themselves. So why are older people missing out on such a great opportunity to return to their carefree, cheerful times? Love yourself, exercise, watch what you eat, and depression will not affect you!

Many people are familiar with the situation when it is difficult to please an older person; he often grumbles and is dissatisfied with something. But only a few realize that depression in older people may be hidden behind this condition. Close people need our help. Therefore, if you have elderly relatives and loved ones, it is recommended to find out in advance how to lift an elderly person out of depression.

This is a serious mental illness and is becoming more common every day. Timely prevention, treatment and assistance are necessary. Depression can be fought if you pay attention to it in time. What to do to prevent the disease from affecting relatives or friends? How to help an elderly person get out of depression and what is needed for diagnosis?

Symptoms of depression in older people

Between 15 and 30% of people over the age of 65 suffer from depression of varying severity. The reasons for this are different, as are the symptoms.

As long as a person works and is in demand in society, he knows that he is needed and can be useful. During this period there is no time to think about your own feelings, problems, illnesses. Realization is one of the important components of our life, since we are busy with something. When you retire, you have more free time and less attention from others. A person does not need to go to work or make important decisions, because of this the number of social contacts decreases. As a result, various diseases appear and worsen, including depression in old age.

Due to lack of implementation, deteriorating health and other factors, the following gradually arises:

sense of anxiety;

• excitement and much more.

If you do not pay attention to this in time and do not help, depression develops in older people. The gender criterion plays an important role: depression is most difficult for older women over 80 years of age. Those who have little contact with other people and live alone are especially vulnerable. For example, unmarried or widowed.

In middle-aged people, the symptoms of the disease are more pronounced than in very elderly people: in the latter, depression can occur unnoticed by an unprepared person. The first characteristic signs are frequent mood swings, lack of any interests, loss of strength and energy. They do not always appear at the same time, but if you notice a similar condition in a loved one, you should think about it and take action. Depression is also characterized by irritability, aggression for no apparent reason, apathy, frequent complaints about problems, and lack of motivation in life.

Some of the most common symptoms of depression in older people include:

complaints about health problems that do not correspond to the current condition;

sadness, despondency, a feeling of anxiety, which old people rarely talk about to anyone close to them;

indifference and decreased interest in the world, life, social problems, communication with other people;

aggression for no apparent reason, tearfulness;

a pronounced decrease in activity, usually immediately noticeable to others;

feeling of guilt for any actions or for no reason, frequent negative thoughts, including about death;

panic attacks, apathy, lack of motivation even when solving important problems;

anhedonia;

periodic complaints of memory impairment;

hysterical state, obsession with other people, unreasonable nagging and reproaches towards other people.

The listed symptoms affect not only the psychological state of a person, but also the physical one. Due to depression, older people often lose their appetite, refuse food, and begin to lose strength and weight. Age-related illnesses are getting worse.

Causes of depression

For effective treatment it is necessary to determine the causes. What factors had a greater influence on the progression of the disease, which provoked senile depression? The main risk factors are the following:

loss of a loved one - people more often think about their existence after the loss of a husband, wife, child or friend, which entails negative thoughts;

change in position in society - what a person has earned for years is lost after retirement, partially or completely, social activity decreases;

financial situation - in the absence of a stable salary, pensioners involuntarily begin to feel unnecessary and deprived, so they often continue to work or do housework;

lack of implementation;

loneliness - children grow up, leave their father’s house and are busy creating their own family, caring, solving problems, while most forget about their parents, meet and communicate much less often;

metabolic deterioration, the occurrence of somatic and psychological disorders, various age-related diseases.

Boarding house for the elderly Residence Third age

The network of boarding houses "Third Age" is a complex of premium-class organizations for the elderly, which are located in ecologically clean areas of the Moscow region and are intended for long-term stays of elderly people who are unable to care for themselves or who require special medical care.

The institutions fully meet the needs and requirements of the elderly - residents are guaranteed to receive:

• five balanced meals a day as prescribed by nutritionists;
• 24-hour medical supervision;
• comfortable apartments;
• adapted space for residents with limited mobility (wheelchairs, bathroom seats, rollator walkers, multifunctional beds, dry closets, etc.);
• varied leisure activities (art therapy, literary evenings, walks in the fresh air, trips to museums);
• psychological assistance for memory training, healing mental trauma and restoring good relationships in the family;
• the ability to constantly communicate with family via Skype or Viber.

The boarding house Third Age additionally provides the following services:

• Halotherapy is inhaling the air of a salt cave, saturated with salt particles -
• Xenon therapy is a complex of xenon inhalations that promotes overall health improvement and accelerates rehabilitation -
• Complex anti-aging therapy using Laennec - a Japanese drug with peptides -
• Balneotherapy - pleasant relaxing procedures carried out in salt water with minerals and aromatic oils -
• Aerophytotherapy is a treatment with air filled with plant essential oils -

The boarding house employs qualified staff who use innovative French techniques when working with the elderly.

Some diseases without adequate treatment become chronic, which increases the likelihood of depression. According to WHO, several common illnesses can lead to mental illness:

atherosclerosis, which affects blood vessels, leading to coronary heart disease, increases the risk of heart attack, stroke and other serious complications;

hypertension;

diabetes mellitus and related problems;

other serious illnesses that cause constant pain;

oncology.

To treat chronic diseases, a person is forced to constantly take strong medications that affect the mental state and contribute to the development of symptoms of depression. If a pensioner has previously suffered from similar disorders, then the risk of re-developing a depressive state increases.

Treatment of depression in old age

Symptoms of depression in older people are rarely very pronounced, so it is more difficult to notice the disease. Relatives often make mistakes when they attribute the above manifestations to dementia and other problems. For this reason, there is no timely medical care, the disease progresses and becomes more difficult to cure.

In some cases, depression is combined with senile dementia; it is impossible to independently determine this pathology. Only a psychiatrist can correctly diagnose and prescribe medication or non-drug treatment. If you notice that your loved one’s condition is worsening and similar symptoms appear, immediately contact a specialist for advice.

Diagnosis is carried out when there is minimal suspicion of depression. There are certain tests that simplify the procedure. If signs of the disease are confirmed, you need to visit a psychotherapist or psychiatrist.

Only a specialist can prescribe medications for depression in old age. Self-medication is prohibited, since the disease often occurs against the background of other health problems. Therefore, intervention without a doctor’s prescription will not bring the desired effect, and may also lead to a worsening of the condition.

Possible complications

People aged with depression often think about suicide because health problems, weakness, limitations in physical and other activities, decreased self-esteem and other factors lead to a feeling of uselessness. Pay more attention to the elderly person, monitor his condition. Sometimes suicidal thoughts are one of the first signs of Alzheimer's disease or vascular dementia.

Sad and scary statistics indicate the following:

patients over the age of 70 are more likely to think about suicide;

every second woman who commits suicide is over 60 years old;

Men over 80 are much more likely to attempt suicide.

Don't forget about your elderly relatives, listen to what they tell you, pay attention to their actions and actions. If there is a trusting relationship between you, then you can directly ask the person about what worries him and what he thinks about, whether he has an interest in life. At the slightest sign of suicidal thoughts, make sure to consult a doctor. Perhaps this way it will be possible to avoid the terrible consequences of depression.

Chronic diseases are more severe if an elderly person suffers from a depressive disorder. The risk of death from diseases of the cardiovascular system increases, and rehabilitation is much more difficult. Due to loss of appetite and refusal to eat, dehydration occurs, the body's protective functions decrease, weight rapidly decreases and the likelihood of infectious diseases increases. To avoid complications, it is necessary to seek medical help in a timely manner.

Drug treatment

For effective treatment, complex therapy is used, which includes not only medications, but also psychotherapeutic assistance.

The safest and most effective antidepressants for an elderly person are:

fluoxetine;

fluvoxamine;

citalopram;

sertraline and many others

All of them belong to the group of SSRIs (selective serotonin reuptake inhibitors). Small dosages are necessary to avoid the development of various side effects that negatively affect the weakened senile body.

To reduce the likelihood of side effects, therapy is supplemented with nootropics and B vitamins. It is imperative to take into account what medications the elderly person is taking to treat other diseases, if any.

When eliminating senile depression, you should not expect quick results. Visible improvements usually take at least 6-8 weeks. After this, the dosage is reduced according to the decision of the specialist; if necessary, the doctor prescribes other medications. This is necessary to prevent a relapse of depression symptoms. It is strictly forbidden to stop taking medications on your own. Cancellation should be carried out gradually, over the course of a year and under the supervision of a psychiatrist or psychotherapist. Do not forget about non-drug treatment methods, which include family and cognitive behavioral psychotherapy.

Prevention of depression in old age

If there are children in the family and an older relative doesn’t mind being with them, then entrust him with some tasks. For example, help with lessons, educational games or something else. This is not selfishness if it happens voluntarily. Your grandchildren will become closer to your grandparents, you will have more free time, and an older person will not feel lonely.

People who have lost a spouse, child or friend need special attention. In this case, the likelihood of developing depression increases. Help and do not abandon elderly relatives. If you have chronic diseases, such as diabetes or heart problems, do not forget to monitor your health. An elderly person sometimes neglects to take medications. A program to prevent depression in a nursing home includes monitoring medication intake and other methods aimed at excluding mental disorders.

Effectively removing an elderly person from depression

The first action when depression manifests itself is to talk with an elderly person about his condition. It is important to explain the need to visit a doctor and the consequences if this is not done. A pensioner must understand that the disease causes serious complications and significantly affects life.

Treatment of depression is possible only under the supervision of a doctor. Follow the specialist's recommendations and be patient. In order to achieve a positive result as quickly as possible, you need to strengthen the body. Help an elderly person, organize walks, entertainment, buy tickets to the theater or cinema. Any little thing that improves mood and distracts from bad thoughts is important for your loved one.

How to overcome spring depression in the elderly

✅Skilled nursing

In boarding houses for the elderly, there are carers and nurses with extensive experience in the field of geriatrics who are able to provide professional assistance and support to people of advanced age.

✅Sincere care and comfortable accommodation

In specialized institutions, older people are never left alone: ​​pleasant communication, an entertainment program and preventive classes help maintain health and a positive attitude.

✅Delicious food and home comfort

Private boarding houses are focused on creating the most comfortable and stress-free conditions for older people.

Depression is a serious mental health disorder that results in persistent feelings of sadness, loss, frustration and anger that interfere with a person's daily life. This condition requires immediate treatment to prevent the risk of disability and suicidal tendencies, which are relatively higher in older people. Knowing how depression affects this demographic will help the elderly person live a full life, and will make life much easier for their family and caregivers.

Why do older people get depressed?

As people age, they often experience significant life changes that increase their risk of developing depression. These may include:

• chronic diseases;
• isolation from society;
• immobility;
• financial difficulties;
• divorce or widowhood;
• death of friends and loved ones;
• approaching the end of life;
• loss of independence;
• retirement;
• moving.

Alcohol or drug use can accelerate the onset of this condition.

Older adults who are lonely and lack social support are at greatest risk of becoming depressed.

Problems of identifying depression in older people

Depression in older people can be difficult to recognize. This is because its symptoms (such as fatigue, loss of appetite, difficulty sleeping, etc.) can also occur as part of the normal aging process.

Often, signs of depression are attributed to the result of some physical illness that occurs at this age, and family members usually ignore these symptoms.

Suicidal tendencies caused by depression and related deaths are higher in older people compared to other population groups. However, men are at higher risk compared to women. The reasons are mainly related to widowhood and divorce.

Older people with depression are at very high risk of developing cognitive impairment and dementia. Their brain function is noticeably impaired and they are more anxious than other groups of people.

Depression is a problem that needs to be given special attention and help an elderly person improve their quality of life.

When a person is already depressed, it is quite difficult to find the motivation to do anything. But even small steps taken to stay healthy can make a big difference in reducing symptoms of depression.

Exercises

Research shows that exercise can be as effective as antidepressants. Take a short walk or do some light housework and see how much you feel better.

Even if an older person is sick or disabled, there are many safe exercises they can do to improve their mood—even while sitting in a chair or wheelchair.

Diet

You need to start by minimizing sugar and refined carbohydrates and instead focus on quality protein, complex carbohydrates and healthy fats.

You shouldn't go too long without eating, it will worsen the mood and make the older person tired and irritable, so do your best to eat at least every 3-4 hours.

Quality sleep

Many older adults struggle with sleep problems, especially insomnia. Normal sleep duration is somewhere between 7-9 hours. To sleep better, you should avoid alcohol and caffeine, go to bed at the same time every night, and keep your bedroom dark, quiet, and cool.

Day walks

Sunlight will increase serotonin levels, improve your mood, and combat seasonal affective disorder. If possible, an older person should go outside during the day and walk for at least 15 minutes.

Communication

It's never too late to build new friendships! Convince your elderly relative to join a group of people with similar interests. This could be a book club, chess club, etc. To overcome depression and stop it from returning, it is important to continue to feel involved and enjoy a new purpose in life.

One solution to problems with lack of communication is a private nursing home for older people: interaction with others facing the same daily problems will reduce feelings of loneliness.

Unfortunately, at present, the overwhelming majority of elderly people suffering from depressive disorders do not come to the attention of psychiatrists, including gerontopsychiatrists, and do not receive specialized care, which leads to prolongation, worsening of the disease, even suicide. I hope this article will help you understand what is happening to your loved ones or to you, navigate the situation and resolve it in the best way.

At the beginning of the disease, patients are disturbed by a depressed mood, they are gloomy, and insomnia is noted. Subsequently, the phenomena of anxiety with motor restlessness and ideational excitation increase, various forms of depressive delirium develop - condemnation, punishment, death, hypochondriacal and suicidal ideas.

Distinctive features of depressive disorder in the elderly:

1. Anxious motor restlessness at the height of the development of the disease reaches a degree of pronounced motor excitement, and can alternate with a state of inhibition in the form of motor numbness, reflecting the fear and despair experienced by the patient. The gestures of such patients are expressive, their behavior is demonstrative and pretentious.
2. Delusional experiences cover almost the entire variety of themes of “guilt” and “punishment.” Hypochondriacal delusions are also characteristic, the content of which is usually focused on intestinal dysfunction and the associated “destructive” consequences for the body (rotting, poisoning, organ atrophy).
3. At distant stages of the development of the disease, the clinical picture stabilizes, becomes more and more monotonous, a state of monotonous anxiety arises with monotonous motor restlessness, decreased mental activity, constant depressed mood and decreased emotional resonance.

After the end of a depressive episode, patients exhibit residual mood disturbances, either in the form of a persistent decrease in the background, or in the form of periodic declines. These disorders are combined with individual somatovegetative manifestations of depression (sleep disorders, appetite disorders).

Late depression is characterized by the development of a phenomenon called “double depression,” when, against the background of a persistent decrease in mood, repeated delineated depressive phases occur.

Symptoms of depression in old age

The complaints of patients are usually dominated by general depression, gloomy thoughts, anxiety, physical decline, sleep disorders, autonomic disorders in the form of diffuse pathological sensations or painful disorders of the functions of individual organs. When observing the patient, little expressiveness of facial expressions, lack of liveliness, an appearance reflecting powerlessness and fatigue, a monotonously muffled voice and anxious restlessness are noted.

Depression in the elderly can be overshadowed by somatic complaints. Such patients focus on the somatic manifestations of the depressive syndrome - loss of appetite, constipation, weight loss, fatigue, headaches, pain in the back and other parts of the body, etc. At the same time, they may deny or sharply downplay the severity of the actual affective disorders.

Causes of depression in old age

When describing the psychological situation, the importance of problems arising in old age, such as “confrontation with approaching death,” “loss of perspective,” “tension and friction with the new generation,” is usually emphasized. When a loved one is lost, the usual way of life and the established order in relationships are dramatically disrupted. Widowhood without subsequent marriage in old age is associated with a high risk of developing loneliness and, as a consequence, depressive disorder. An increase in stress load due to the unfavorable socio-economic conditions of the “era of reforms”, which affected primarily the elderly, as well as due to a violation of their worldview, leads to social maladjustment. Depressive conditions also develop as a result of the dismissal of older people from work (“retirement depression”). They are accompanied by painful feelings of uselessness, lack of demand, while maintaining the need for further professional and social self-actualization. Attempts to belittle and belittle the role of veterans of the Great Patriotic War and home front workers, the significance of their military and labor exploits and efforts cause them moral trauma. There is also information about the pathogenic effect of changing housing. This situation causes a special type of depression - “moving depression”. In addition, depressive states in older people are often triggered by events such as intra-family conflicts.

Prevention of depression in old age

Different types of interventions improve the mental health of older people with varying degrees of effectiveness:

• Exercise provides both physical and psychological benefits, including increased life satisfaction, good mood and mental well-being, reduced psychological distress and symptoms of depression, lower blood pressure, and improved heart function).
• Improving social support through companionship. Older people need encouragement for their actions. It is advisable to more often confirm the correctness of their actions and encourage success. “Today you move more confidently with a cane!”, “How well you sat up in bed today!”, “This jacket suits you very well!” etc. Asking older people about their past has a very beneficial effect on them. Ask the elderly person to tell about his relatives, childhood, places where he lived in his youth, past work, interests. It is very good to look together at old photographs of the places where he was born, lived, and worked, especially those in which he is depicted in strength, while performing socially significant work. This always helps to increase the self-esteem of an elderly person. However, older people should feel your real interest in the events being told, your desire to experience what he once experienced and felt. If he does not believe that you are interested, he will most likely withdraw into himself, and you will lose his trust for a long time.
• Educational work with older people with chronic diseases and their caregivers, meetings to discuss life events.
• Prevention of traumatic brain injury, normalization of high systolic blood pressure and high serum cholesterol also appear to be effective in reducing the risk of dementia.

Diagnosis of depression in old age

Factors to consider when diagnosing depression in elderly people:

Altered symptoms of late-life depression:

1. There are practically no complaints of sadness and despondency.
2. Hypochondriacal and somatic complaints instead of complaints of sadness and despondency.
3. Complaints of poor memory or a clinical picture resembling dementia.
4. Late appearance of neurotic symptoms (severe anxiety, obsessive-compulsive or hysterical symptoms).
5. Apathy and low level of motivation.

Symptoms that are difficult to interpret due to concomitant medical illness:

1. Anorexia.
2. Reducing body weight.
3. Decreased energy.

Causes of depressive episodes of organic origin:

Medicines that can cause organic depression:

Hypotensive:

• Beta blockers.
• Methyl dopa.
• Calcium channel blockers (eg, nifedipine).
• Digoxin.

Corticosteroids:

• Prednisolone.

Analgesics:

• Codeine.
• Opioids.
• COX-2 inhibitors (eg, celecoxib, rofecoxib).

Medicines indicated for parkinsonism:

• Levo-dopa.
• Amantadine.
• Tetrabenazine.

Psychotropic drugs (may cause a clinical picture resembling depression):

• Antipsychotic drugs.
• Benzodiazepines

Somatic disorders that may have an organic cause depression in elderly people:

Endocrine and metabolic:

• Hypo- and hyperthyroidism
• Cushing's syndrome
• Hypercalcemia (primary hyperparathyroidism or carcinoma)
• Pernicious anemia
• Folate deficiency

Organic brain damage:

• Cerebrovascular disease/stroke.
• Tumors of the central nervous system.
• Parkinson's disease.
• Alzheimer's disease .

Latent carcinoma:

• pancreas.
• lungs.

Chronic infectious diseases:

• Neurosyphilis.
• Brucellosis.
• Shingles.

Treatment of depression in old age

Elderly patients suffering from depression, rarely offer psychological treatments. However, for major depressive disorder, a combination of antidepressants and psychotherapy is more effective than either treatment alone, especially in preventing relapse.

Of the medications, almost the entire modern arsenal of antidepressants is used, including well-known tricyclic and four-cyclic antidepressants, as well as “new generation” antidepressants - selective serotonin reuptake inhibitors and reversible MAO-A inhibitors. However, when prescribing certain psychopharmacological drugs to an elderly patient, one should always keep in mind the increased risk of side effects and complications, especially since in later life complications are especially severe. In these cases, it is possible to adjust therapy by changing doses, replacing medications and changing the general treatment regimen.

Psychotherapeutic techniques include cognitive behavioral therapy and interpersonal psychotherapy.

Electroconvulsive therapy remains the most effective and affordable treatment for severe depression and is usually used in cases where malnutrition or suicidal behavior is life-threatening or when antidepressants are ineffective.

Depression is a mental illness. It is accompanied by a decrease in mental activity, as well as a bad mood. Men and women of different ages suffer from this disease. Older people are especially susceptible to depression.

While studying depression, doctors have not yet fully elucidated all the causes of this disorder of human behavior. Many people do not understand the seriousness of the disease. Depression is a hidden illness in which patients experience their “hell” alone.

A suffering person feels all his helplessness; he blames himself for all troubles. Sometimes the illness lasts more than a year. A person withdraws into himself and loses interest in life. The disease most often develops during old age. Depressive disorders are common among elderly patients. Most often the disease appears after 60 years of age. Women suffer from depression three times more often than men.

Causes

The main cause of depression is aging. The feeling of one’s own old age leads a person to apathy and pushes him to suicidal thoughts. Aging is manifested by a loss of former physical strength, the organs of hearing and vision weaken, and it becomes more difficult to take care of oneself.

Loved ones leave, children leave their parents' nest. In retirement you have to forget about work and limit yourself in communication. There is nothing to do and various thoughts come to mind that sadden the soul.

The emotional perception of the world subsides, stubbornness increases. Physical activity decreases, and elderly patients try to find an explanation for this and look for illnesses.

Old people have a lot of free time. Nothing distracts you from thinking and negative thoughts. Lonely old people have no one to care for, there is little to do and they are left to think about their lives. People begin to remember their lives, regret their actions, and suffer. Tormented by remorse and so on.

During the development of a depressive state, a person becomes more grouchy and irritable. He is in a bad mood almost all the time; he can get angry over the usual little things. That's why there are so many old people who are unhappy.

Symptoms

How can you tell if an older person is suffering from depression? If the following symptoms are detected, then it’s time to sound the alarm and seek help from a specialist. Older people often complain about:

• Lack of appetite.
• Poor sleep and insomnia.
• Fatigue.
• Apathy.
• Bad mood.

They all try to stay away from the people around them. Isolated from loved ones. Elderly patients with depression give up their favorite hobbies and stop communicating with friends. This behavior should be cause for concern. These are signs of the disease. Pensioners often lose respect for themselves, and it seems to them that they have become a burden to their children. It is very important to recognize a depressive state in time.

Pensioners perceive public, physical and social aging very painfully. They are lonely and believe that life has already passed them by. With senile depression, people become more suspicious, vulnerable and pedantic. It is especially dangerous when a bad mood turns into anxiety. This can lead to suicide. This cannot be allowed.

Diagnostics

Recognizing depression is difficult, since older people are not inclined to identify themselves as depressed.

The most effective diagnostic method is talking with the patient. To prescribe effective treatment, the doctor learns all the patient’s symptoms. Physiological tests will help determine your overall health. Making a diagnosis is a difficult task. After all, depression manifests itself in different ways. Depression is a very dangerous disorder that affects a person's thoughts, behavior and feelings.

Treatment

Treatment of senile depression is a labor-intensive process. A prerequisite for successful treatment is a conversation with a psychologist. Treatment should be comprehensive; medications alone will not be enough.

The specialist must establish contact with the elderly patient. It is necessary for a person to find new hobbies that will bring pleasure. He needs good communication and proper nutrition. The main thing is to let the person know that they need him.

For progressive depression, medication and psychotherapy are used. Usually, for senile depression, it is recommended to visit a psychologist. Antidepressants are sometimes prescribed, which also help younger patients. If the patient listens to all the doctor’s advice, and he has the support of loved ones, then he will cope with the disease and will again find the meaning of life.

Folk remedies

Herbal tinctures will help relieve symptoms of senile depression.

• Carrot. Raw carrots will help get rid of depression. The daily norm of this vegetable is 150-200g. You can drink a glass of juice.
• Banana. A tasty and healthy banana will help with depression. Thanks to yellow fruits, the hormone of happiness is produced in the body. The fruit contains the alkaloid harman, it contains mescaline, which is what we need.
• Ginseng. An effective herb in treating depression. You need to pour the dried leaves and roots with alcohol 1:10. Leave for about a month and drink 20 drops three times a day. This tincture can be purchased at a pharmacy.
• Flower pollen has a calming effect. It has a beneficial effect on the human psyche.

Complications

The consequences of depression in older adults can be catastrophic. The risk of suicide increases. Depression shortens a patient's life expectancy and can lead to heart attack, coronary heart disease and other cardiovascular diseases.

The patient ceases to enjoy life, he is increasingly visited by thoughts of death, and finds it difficult to concentrate. An elderly patient has disturbances in appetite and sleep. Without treatment, everything will lead to a worsening of the condition.

Prevention

It is very important to support older people. Relatives should provide moral and physical assistance. If necessary, come visit and cook food together, visit the house. A good preventative measure would be walking in the park and affectionate communication. You need to be polite and understanding with older people. People of retirement age need to know that others still need them. Only love, understanding and support will save you from depression.