Understanding and Coping with Depression Among Older People and Their Caregivers
Depression is a common experience among older people and their caregivers. In 2010, the highest rate of suicide was among people between the ages of 45 and 64. The second highest rate was among people 85 years of age and older.
As we age, we begin to experience a series of losses, including the loss of our physical strength and flexibility. We get depressed when we recognize that our mental processes are slowing down, when we suffer chronic pain, and when we develop diseases and conditions for which there are no cures. We also struggle to cope with the deaths of our friends, family members and spouses. We grieve the fact that the life and freedom we once enjoyed is now lost to us forever.
As caregivers witness this progressive decline of of a loved one, they also get depressed because their own lives are becoming increasingly more complicated, reclusive, and restrictive as they do everything they can to support and care for the spouse, parent or friend who is suffering.
It’s important to note that depression is more than a feeling of sadness. It’s is a combination of feelings of hopelessness, inadequacy, severe despondency and dejection.
There are two different types of depression that are common to caregivers as well as their care receivers
The first type of caregiver depression is Reactionary Depression, which can be brought on by any number of situations or events. It’s not unusual to get depressed when we receive a bad diagnosis, get fired from a job, have a financial setback or lose a pet. It can also be brought on as a result of stuffing feelings of anger, resentment, and guilt.
In addition to the emotional upset, depression can manifest itself in numerous physical ailments such as headaches, stomachaches, and back pain, as well as changes in appetite and sleeping patterns.
The good news about Reactionary Depression is that it is usually a temporary condition, and with time and effort, you can work your way out of it. If you are experiencing some of the emotional and physical symptoms described above, you might want to consider taking some of the following actions steps:
- Write about your feelings. Describe the people, situations or events that caused you to feel this way. Don’t judge yourself or try to talk yourself out of your feelings. Simply describe what happened and how it has affected you.
- Get involved in a caregiver support group. It will be a safe place for you to express all of your emotions among other people who understand the emotional stress of caring for someone who is aged, chronically ill, demented or disabled.
- Get outside in nature and get some exercise. Combining fresh air with walking, running, or bicycling will release endorphins in your brain and give you an emotional boost.
- Some people benefit from meditation, Yoga, reading, or listening to music. If there is a specific activity or a particular friend or group that has always lifted your spirits, do those things and contact those people first.
- Spending time with children and animals is also a great way to lift you out of a temporary funk.
With some conscious effort, you can work through the feelings and symptoms of Reactionary Depression in a matter of days. It you do not see or feel any improvement within two weeks, you may need medical treatment.
Clinical Depression is different from Reactionary Depression in that it is a medical condition that manifests itself in a mental disturbance. The symptoms are similar:
- Difficulty sleeping
- Total lack of energy
- Change in appetite
- Lack of concentration and difficulty making decisions
- Sense of powerlessness and hopelessness
- Inability to imagine anything positive happening in the future, a sense of “What’s the use of going on?”
- Various physical complaints, including headaches, backaches and various digestive disorders
- Suicidal thoughts that have lasted for more than two weeks
Clinical Depression is different from Reactionary Depression in that is is NOT a condition you can treat yourself
Clinical Depression is a chemical imbalance in the brain, and there is no way you can think, talk, pray, eat, drink or smoke your way out of it. If you are clinically depressed, you need to call your physician immediately.
The first step to overcoming clinical depression is to understand that it is not a personal weakness, a lack of faith, or a failure to control your thinking or emotions. Refusing medication to help manage clinical depression would be like refusing to take medication for high blood pressure.
Please remember that clinical depression is a medical problem, and it requires a medical solution.
Helping an Older Person Cope with Depression
If we want to help older people understand and cope with their depression, anxiety, and other mental disorders, we must first acknowledge that this may be the most difficult stage of life any of us will ever experience.
My mother used to say, “The Golden Years start when your last child graduates from high school, and they end the day your health goes to hell.” I think she was right. There is nothing golden about experiencing ongoing losses and physical or mental decline yourself or witnessing it in someone you love. There can’t be any challenge that will require more courage than facing the our own incapacity and impending death.
We should be honest about this when we have conversations with older people. Trying to sugar coat their situation will not change it, so we should address their concerns, fears and ongoing losses honestly and with genuine empathy and compassion.
We Need to Understand that Older People Don’t Talk About Mental Illness
We need to recognize that people who are now between the ages of 68 and 88 were raised during a time of national crisis when the focus was on survival, not self-actualization. Many of them were children during The Great Depression and some have vivid memories of WWII.
They don’t talk about their feelings, and the idea of posting personal information for the world to see on Facebook or Twitter simply would not make sense to them. We must understand that, from their perspective, people who can’t manage their emotions are weak. In their eyes, emotional weakness is shameful and unacceptable. Even if they acknowledged feeling “down,” it’s likely that they would dismiss their feelings by saying, “I’m just feeling sorry for myself.”
With that in mind, we must strive to recognize their generational uniqueness. We need to be sensitive to their deeply ingrained attitudes toward depression, anxiety, and other mental disorders. We must respect their dignity, their privacy, and their need to feel independent and in control.
We should be very careful to not storm into their lives, make a diagnosis and pronounce their treatment. We should ask questions and then listen carefully. If we let them know that we care, and if we can make them feel safe, perhaps they will open the door a crack and let us in.
If they know they can trust us, we’ll be in a better position to help them access the kind of medical and psychological support they need. We will never be able to restore the life they once had. It will never be possible to recapture their “Golden Years”, but with the right approach and appropriate care, we can help them come to a place of peace in their hearts and minds as we help them negotiate the challenges of their final years.