The number of elderly people in the population is rapidly increasing throughout the developing world. This is due to satisfactory mental and physical health, enabling continued positive contributions to their families and to society. However, there have also been changes to the family structure that have increased the number of elderly people who live alone.
Depression is a common condition among the elderly, occurring either in isolation or in association with other diseases. The elderly are particularly at risk for developing depressive illness as they are more likely than younger individuals to suffer from impaired health. Depressive illness has a substantial negative impact on the quality of life of patients and their relatives. In addition, a strong link between depression and suicide has been demonstrated.
Depression is a widespread illness throughout the world. Clinical depression is a whole-body disorder, affecting the way you think and feel, both physically and emotionally.
Appropriate interventions for the major mental illnesses of old age are now available and can substantially improve the quality of life of patients and their families. Although depressive illness is common, about two thirds of affected patients do not seek medical help (in addition, depression is often misdiagnosed or inadequately treated). However, when correct treatment is provided, response rates are excellent with around 80 percent of depressed patients deriving much benefit from drug therapy.
While there are many causes of depression, several important contributing factors have been identified:
The range of symptoms of depression in young people is also found in elderly patients.
It is essential to undergo a thorough medical examination in order to rule out other disorders and ensure proper diagnosis. Older people with symptoms of depression often worry that they are becoming “senile”. For example, you may be worrying that you cannot seem to concentrate, or that your memory is not as good as it used to be – if you are actually aware of these changes, it more likely that you have depression rather than dementia.
In addition to medication, psychotherapeutic treatment strategies are important – the recommended therapy being cognitive psychotherapy. Elderly people often have a stiff, negative and illogical train of thought, which may be positively influenced by cognitive therapy.
Cognitive behavioural therapy (CBT) is a type of psychotherapeutic treatment that helps patients understand the thoughts and feelings that influence behaviours. CBT is commonly used to treat a wide range of disorders, including phobias, addictions, depression, and anxiety
Families are very important sources of support for depressed patients. Family members must help the patients to adhere to their treatment programmes and should also be able to understand how the patient thinks and feels.
Society plays an important role, as elderly patients may have no relatives to approach for support. Elderly people living alone often need help to find an activity to occupy their time. It is important that they are stimulated by contact with other people.
Treatment can be complicated as elderly people are more sensitive to toxic drug effects. At present, the drugs of choice are the SSRIs.
Depression is not just a sad mood or a passing phase. It is a serious illness that affects the entire body.
Signs and symptoms of depression include:
For help call the South African depression and anxiety group on 0800 456 789 or visit www.sadag.org
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