Clues can be invaluable to the caregiver or professional who is concerned about an elderly individual and they are adamant about not feeling sad. Clues can be both physical and emotional in nature and include aches and pains that are vague or unexplained, seeming to be or expressing hopelessness, helplessness or when the individual shows signs of being anxious or having excessive worries. They can also express a loss of feeling any pleasure in life, are having physical signs of moving slowly without any physical reason for doing so, are irritable, are experiencing memory problems or show any signs of an outward appearance of lacking in personal care (not eating, neglecting personal hygiene, forgetting to take medications).
Ironically, some of the symptoms of depression can make it difficult for the individual to seek medical help. It falls upon caring family members, friends or neighbors to make the suggestion to seek help. Another factor that discourages elderly adults from seeking help is the social stigma prevalent in the age that seniors of today were growing up in. The mental stigma attached to depression or any mental illness was that the individual who had it was weak or had somehow caused the illness. Individuals were institutionalized for having mental illnesses and/or were shunned by society or even feared.
The fact that several of the symptoms of depression are also present in other medical conditions as well as the general aging process makes detecting depression difficult. Fatigue, loss of appetite and sleeping problems are all common elements to other medical conditions and also to major depressive disorder. Depression itself can be a sign of a medical disorder and it can be associated with Alzheimer's disease. Sorting out whether or not symptoms are a because the individual is depressed or if the individual is actually having depression as a symptom of a disease can be like searching for clues in a spy game.
Fear of the consequences of treating depression such as increased financial strain, fear of doctors or of the mental healthcare atmosphere and what may happen to them (electrical shocks that will damage their brains etc.) are very common in the elderly.
Despite the difficulties that one may encounter while making the depression assessment; doing so can mean a great deal of difference regarding the quality of life for the individual. Untreated depression leads to a high rate of suicide in elderly persons.
Complicating matters more is the fact that elderly individuals go through an amazing amount of changes such as moving to a retirement home or community, changes within the family structure due to loss of a spouse to death or divorce and the loss of adult children when they move out of the home or out of the community.
Those who are depressed rarely care enough about what happens to them to seek the help they need. Others are left to make the connection by noticing the absence of these individuals from organizational meetings, social events or volunteer positions. Family members are left to notice changes in eating and sleeping habits, mood or activity level and make the effort to find out why.
Detecting depression in the elderly is dependant on all of these above mentioned factors. The bottom line is that in order to detect depression in elderly one must understand what depression looks and acts like, and how to tell the difference between depression and normal grieving. It is possible for individuals and professionals to detect depression in the elderly, the motivation and opportunity are there, it is up to us to utilize them.
