Recognize depression-in-the-elderly, you may save a life

Depression-in-the-elderly is a common occurrence and is not always recognized. When depression-in-the-elderly is not

recognized, the condition is not treated. This can be serious because depression is a major cause of morbidity and mortality for the elderly. It can result in impaired physical, mental, and social functioning. And depression too often leads to suicide. People aged 65 and older account for 16% of the suicides annually.

Some people think that depression is a part of getting older. Nothing could be further from the truth. Depression is not a natural part of aging. It is not normal to feel depressed all the time as you get older.

Risk factors for depression-in-the-elderly include:

  • Prior episode of major depression
  • Family history of depressive disorders
  • Current alcohol/substance abuse
  • Medical co-morbidity (presence of one or more additional disease processes)
  • Functional disability (especially new functional loss)
  • Loss of spouse or partner
  • Older family caregiver, especially if caring for persons with dementia
  • Social isolation/absence of social support
  • Cognitive distortions, stressful life events (especially loss), chronic stress, low self-esteem and expectations, and no faith. 

The characteristics of major depression are the persistent low mood, discouragement, worthlessness, sleep and appetite disturbances, or thoughts of suicide. How can you recognize depression in yourself, a friend, or family member? Because the affected person may not recognize the symptoms in himself or herself, it is very important for family members or friends to be aware of telltale signs of possible depression. 

Signs of depression-in-the-elderly

  • excessive fatigue;
  • lack of motivation;
  • sleep deprivation;
  • loss of appetite (or overeating);
  • disinterest in appearance and grooming; and
  • disinterest in hobbies, activities, and relationships.

If you, or a friend/family member, exhibit one or more of these symptoms, please talk to them about it and discuss it with your family physician. Family support, faith and strong social ties are very important components of therapy for a person suffering from depression.

A deficiency in serotonin and/or beta endorphin is a cause of depression-in-the-elderly. Without adequate levels of these two key neurotransmitters, chemical deficiencies in the brain can result in anxiety, depression, carbohydrate cravings, mood swings, and sleep disorders.

Serotonin is a brain neurotransmitter that regulates our moods, appetite, and sleep patterns. It enhances our optimism, mental focus, and sense of control. Stress, poor diet, lack of physical activity, and excess caffeine and alcohol consumption can deplete our serotonin stores. Beta endorphin is a natural opiate that acts to ease physical and emotional pain, control anxiety, and reduce anger.

As is the case with all chronic diseases faith, family support, nutrition and exercise play significant roles in prevention and management of depression-in-the-elderly. Drugs like Prozac and Paxil work by prolonging the availability of serotonin to the brain but have several side effects. However, all of these tools should be considered by you and your physician in developing a plan to manage depression. The physician may also recommend psychotherapy or counseling to determine the root cause of the depression. 

Moderate exercise such as walking has been shown to reduce the risk of a heart attack but it does much more including relieving depression. However the exercise must be done on a regular basis. Most of the literature recommends exercising a minimum of 30 minutes per day, five days per week and some recommend a minimum of 45 minutes per day.

Low levels of folic acid, a B vitamin, have been associated with depression. Several studies have shown that supplementation has improved the depression in those with low values. Vitamin B6, folic acid and vitamin B12 act as coenzymes in the synthesis of SAMe. Deficiencies in any one of these vitamins can disrupt the metabolic formation of SAMe. SAMe plays a vital role in brain function and is responsible for the synthesis of several neurotransmitters including serotonin.

Prevention or management of depression-in-the-elderly should include the following:

  • Recognize the signs, discuss with the person involved and consult with a physician.
  • Manage the stress in your life. Maintain an active, upbeat lifestyle.
  • Your nutrition plan should be a low-sugar, adequate protein diet rich in essential amino acids to support production of tryptophan, a building block of serotonin. Turkey, chicken, salmon, tofu and scrambled eggs are all high in tryptophan. A recent study found that blueberries and spinach provide significant protection against brain aging.
  • Drink three cups of tea per day. While black tea is good, green or white tea is better. Tea contains powerful antioxidants that are very beneficial to the brain.
  • Your nutrition plan will depend on your lifestyle. If you have always eaten nutritious foods, engaged in regular moderate exercise, managed stress, and had no chronic diseases then you will need only minimal diet supplementation. I don’t know anyone like that. Most of us need diet supplementation. Your supplementation plan may include vitamins: B complex, C, D, E, CoQ10 and any others recommended by your physician. Always consult with your physician before starting any diet supplementation plan. Nutritional supplements do not cure or prevent illness and disease.  They only give the body the extra nutrition it needs to take care of itself!
  • Develop a forgiving attitude and avoid anger. An unforgiving spirit can lead to a state of almost perpetual anger, poor emotional health and depression.
  • Learn to accept life for what it is and develop an attitude of gratitude. Be thankful for what you have. Accept the things that you can't change. A positive outlook can have a significant impact on your ability to prevent or manage depression.
  • Develop a personal relationship with God. One of the benefits of a personal relationship with the Lord is serenity because even in difficult times you can have confidence that your situation is in His hands. God is always in control.

Although Moses was one hundred and twenty years old when he died, his eye was not dim, nor his vigor abated. Deut. 34:7

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