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Depression in Late Adulthood

　　　　Depression can be described as a persistent sadness that engulfs an individual over a long period of time. Depression is common in everyday life, and everyone sometimes feels “blue”. Nonetheless, it is not mandatory that it becomes a characteristic with which one defines old age. Among the aged, it is a problem that arises but which does not always have to. This low mood and persistent feeling of sadness is responsible for the inability of individuals to perform their daily activities. Depression is an illness that is particularly common in the aged. The rate of individuals that suffer from depression in old age as compared to the individuals that suffer depression at a young age is much higher. This particularly reaches an alarming rate for individuals that are aged 80 years and older, with white men constituting a vast majority of these sufferers, as compared to other aged individuals below 80 years. Being a condition that shows no selectivity or bias, it affects people of all ages and races. Depression is also a treatable ailment. However, failure to treat depression in its teething stages results in the escalation of the condition to levels that pose a threat not only to the physical health of the individual but also their mental health. With its prevalence in the aged rising every day, it has become necessary to understand the causes of depression in old age, the different forms that it takes, its correlation to other diseases, the symptoms it portrays, its effects, its treatment and how the affected can be cared for.
Causes of Depression in Late Adulthood

　　　　Depression in any stage of life has its own root causes. However, in late adulthood, there are a number of triggers that have been proven to play a key role in the onset of depression. The first probable cause of depression is a chronic illness. Suffering from a chronic illness for an individual of any age has its fair share of troubles and stress. For the aged, it is a factor that triggers the onset of depression to a great extent. Chronic illnesses that show no signs of reprieve take their toll on the individual and affect among other things, their self esteem. The fact that one is constantly sickly, despite the fact that one takes medication regularly, instills feelings of worthlessness to the aged individual. The individual is constantly worried about their health and this constant worry is responsible for their constant sadness. Chronic illnesses such as Cancer, Alzheimer’s, Parkinson’s disease, stroke and even cardiac complications negatively impact on the life of the individual. By suffering from these illnesses, the individual is mostly confined around medical facilities. The absence from friends, family and activities that one enjoys instills feelings of sadness in the individual. This constant sadness and worry is capable of driving the individual into mild or severe depression, depending on the extent and cause of their sadness.

　　　　Another cause of depression in late adulthood is suffering an emotional upset from a specific event. Events that are largely associated with an intense emotional imbalance are capable of resulting in depression. One such event is the death of a loved one or a lifetime friend. It is inevitable that everyone will have to die at some point in their lives, but the feelings that this loss evoke in most aged people are central in the development of depression. The loss of a loved one or a partner evokes feelings of false guilt, sadness and worthlessness in the aged individual. They feel as though they are responsible for the death of their loved one and, in effect, sink into depression. These losses are also known to make the aged think more about their own death, a factor that could possibly result in suicide. It has been shown that for couples among the aged, the death of a partner in most instances results in the subsequent death of the other partner. This could very well be attributed to the depression that the individual suffers from. Other events that are capable of resulting in depression amongst the aged are loss of employment, death of children or even retirement. All these are leading causes in the development of depression among the aged.

　　　　Another cause of depression among the aged is change in sensory abilities. The importance of the five senses that one is gifted with cannot be overemphasized. Out of all the five senses, vision and hearing have been proven to have the most adverse psychological effect on the aged. In old age it is common to witness the loss of sensory ability and having the individual cope with the loss is vital in preventing the onset of depression. The loss of sensory abilities coupled with the loss of psychomotor ability can trigger the onset of severe depression. This is because the individual feels like he or she is a burden to those around him or her. The feeling that one is no longer able to do something that was once a passion for them also has a detrimental effect on the individual’s moods. This constant sadness experienced by the individual plays a major role in the development of depression. Other changes that are also capable of resulting in depression include constant neighborhood change and even moving from one’s home. Constant environmental change affects the moods of the individual by triggering frustration. The individual feels that they are no longer aware of their surroundings and, if left unattended to, these frustrations can lead to depression.

　　　　Other than these causative agents of depression, sometimes depression occurs without any specific cause. It is not peculiar to hear of cases where an individual who leads a perfectly healthy life, eats well and receives constant medical attention is suffering from depression. In such cases, the depression is usually mild and easily treatable. Everyone at one time or the other feels “blue” and this can result to depression. Most of the times it hides under the guise of other diseases and can go undetected for long periods of time. In cases where the individual suffers from an ailment or chronic illness, the depression brought about as a result of this sickness can very easily go untreated. This, in most cases, only worsens the situation as the individual slowly progresses from mild to severe depression. It is important that depression is treated as a sickness that equally demands medical attention and care, just like other sicknesses. It should be detected early enough and treated well to prevent its advancement into a more serious state.
Different forms that Depression in Late Adulthood takes

　　　　In late adulthood, depression, as common as it is, takes many forms. These many forms depend on the intensity of the causative agent and how severely the individual has been affected. Insofar as depression in late adulthood is concerned, it takes two broad forms; mild depression and chronic or severe depression. In everyday life, one usually feels overwhelmed with the pressures that make up life. This accumulation of pressures ultimately leads to the development of depression. What makes depression mild or chronic, apart from the intensity of the causative agent, is only the approach that one adopts upon the discovery that one suffers from depression. Many people wish depression away by saying “It is just some financial problems” or by saying “I am just stressed”. In order to effectively deal with depression, one must first understand that it is a mental illness that is capable of cure.

Mild Depression
　　　　Mild depression is a less severe and less intense form of depression. It is a fact that everyone has at one time or another suffered mild depression. Mild depression is easier to deal with and can be treated over a short period of time. Usually, taking antidepressant medication is enough to deal with mild depression and in other instances, psychotherapy will suffice. The individual suffering from mild depression usually just feels sadness, with extreme thoughts of worthlessness and helplessness being absent.
Severe Depression

　　　　Severe or chronic depression is a serious ailment that affects the individual in question by keeping them sad and, in the long term, affecting the daily living of the individual. One suffering from severe depression is withdrawn and isolated. He or she is unable to concentrate at work and carrying out simple tasks that made up their basic daily activities becomes impossible. Severe depression requires a more consistent form of medication coupled with keen medical attention. Just like in drug abuse recovery, relapses of this kind of depression are common if the medical calendar prescribed by the geriatric psychiatrist is not strictly adhered to.
Relationship with other diseases

　　　　Depression is an ailment that exists solely on its own but which can also be linked to other diseases that ail the aged in the society. Depression is known to greatly affect the mood of an individual and other ailments that may arise from this include dementia, mental impairment, Alzheimer’s disease and Geriatric anorexia.

　　　　These are all diseases that bear the capability of being fatal if not tended to as they should be tended to. Dementia, for example, was found to be more prevalent in men aged above 80 and who suffered from depression. Most of the men who suffered from dementia as well as depression were also found to suffer from chronic depression and not mild depression. This causal link between dementia and depression cannot be ignored. This is because dementia results from the fact that a depressed individual is withdrawn and, almost always, suffers in silence. The loss of sensory ability and the belief that one’s state of mind is not balanced leads the ailing aged patients into believing that they are crazy. They become afraid to speak out their mind in the fear that they might be labeled as crazy. This imbalanced state of the mind leads to severe cases of dementia among the patients suffering from depression.

　　　　Another disease that affects sufferers of depression is Alzheimer’s disease. This disease is known to affect the aged to a great extent and is also known to be more prevalent among patients of depression. In aged people, Alzheimer’s disease has been found to go hand in hand with depression. A study carried out on aged individuals revealed that the possibility of suffering from Alzheimer’s was greater in individuals that suffer from depression than it is in individuals that do not suffer from depression. Another study that sought to establish the causal link between the prevalence of the two diseases among the aged proved futile. There was no causal linkage established between the two diseases although the prevalence rates among the aged for both diseases clearly disagree.

　　　　Mental impairment is the inability of the mind to function as it should, resulting in a state of mind that is unbalanced, and in which one is unable to control him or herself, their speech and their actions. This is a condition that is witnessed across the age divide but is more widespread among the aged. The number of aged individuals who are said to suffer from mental impairment is high and this fuels the desire to understand the link between mental impairment and depression. An individual suffering from depression is mostly withdrawn and isolated from society and from activities that he or she previously enjoyed. The worry that their state of mind is abnormal further fuels the fire that eventually drives the individuals insane. Mental impairment may also come in a different form whereby an individual is incapable of understanding who they are and what they are doing. The possibility of suffering from mental impairment is significantly higher for individuals suffering from depression than it is for those individuals who do not suffer from depression.

　　　　Another condition that is commonly associated with depression in aged individuals in geriatric anorexia. This is a severe form of anorexia that affects the aged. It is a fact that depression results in the development of gastrointestinal problems among the aged. This poses a challenge to the aged insofar as maintaining a healthy eating habit is concerned. The failure to maintain healthy eating habits provides a window of opportunity for other health related complications to attack the patient. This causes the patient to suffer much more; a development that sinks them further into depression. If left untreated, geriatric anorexia can result in severe health complications and even death.
Symptoms of Depression in Late Adulthood

　　　　Just like any other disease than one may suffer from, depression also has some signs and symptoms that are used to detect the onset of depression among the aged. Although it is a mental illness, a vast majority of the symptoms that are exhibited by patients of depression are of a physical nature. This is a form of serendipity that this disease possesses, seeing that these symptoms make it easier for depression to be detected as compared to if the disease symptoms were purely mental.
　　　　First and foremost, the major symptom that is a characteristic of depressed persons is persistent sadness. The depressed persons are constantly sad for long periods on end. They are rarely happy, and they adopt a sadistic view towards their own life and life in general, as well. This persistent sadness is coupled with feelings of worthlessness and helplessness. The individual in question starts to feel worthless and as though they are not worthy anything good. They start to view themselves in negative light and look down upon themselves. They lose their self confidence and their self esteem hits rock bottom. They feel scared to take on anything due to the fear that they are not up to the task, and that they will do a poor job, even though it could be something that the individual has done repeatedly for years. The individual slows down and adopts a sudden sense of lethargy. They become lethargic in all that they do. This is one of the clear signs that an individual is depressed. When he or she begins to do things that they enjoyed before with a sense of lethargy, then it is possible that they are suffering from depression.

　　　　Another sign that clearly depicts an individual might be suffering from depression is the development of gastrointestinal complications. The development of abdominal pains and experiencing difficulty with simple tasks such as eating and finishing a meal without feeling like throwing up can portend the onset of depression. The individual feels unable to maintain their eating habits and their preferences no longer appeal to them. Severe and persistent abdominal pains are also a common characteristic of depression and especially in late adulthood. Psychomotor agitation can also be depicted by the patient, whereby they are unable to keep themselves still. An urge of restlessness engulfs the individual and in cases where they are unable to overcome the restless through some constructive activity, pacing and fidgeting take over. The individual is seen pacing up and down very frequently for no apparent reason. This pacing and fidgeting is neither triggered by anxiety nor worry, it is just natural. Fatigue is also a common highlighter that an individual might be suffering from depression. The individual usually complains of persistent fatigue that never seems to go away. They are constantly feeling tired even after having long hours of rest. The fatigue is also persistent throughout the day with the individual feeling tired from morning to evening.

　　The aged also experience great difficulty sleeping. Their sleeping habits are adversely affected by the onset of depression. The sleeping habits may be affected either by making an individual more sleepy throughout the day or by inducing insomnia in the individual. The aged are greatly affected by this problem and, at times, even sleeping pills or sleeping medication is not effective in helping them return to their original sleeping habits. Among the aged, depression also results in excessive worrying. A majority of the aged who suffer from depression excessively worry about their finances. This is very prevalent in the aged who are not wealthy. They are constantly afraid that their finances are in danger of being stolen from them. They also worry that they are not rich or wealthy enough to support themselves or any of their dependents. This leads them into worrying excessively about their health. They constantly worry that they are not in good health and often contemplate about when they will die. This excessive worrying about their health affects their daily lives and experiencing frequent thoughts of suicide is not extraordinary. Frequent tearfulness is also a symptom that the individual is possibly suffering from depression.

　　All these symptoms are intertwined since they all affect the normal functioning of the individual suffering from depression. This causes the physical and mental health of the individual to deteriorate drastically and this can lead to fatalities among the aged. The constant fears and worries that are very characteristic of depression, take a toll on both body and mind, draining the individual of mental and physical strength. An overall indicator that an aged individual could be suffering from depression is the feeling of having given up. Depressed persons tend to give up on life, on their health, on friends as well as family and this plays a central role in further deteriorating their condition. The end result of such feelings is a sickly individual who is hopeless and who is simply waiting to die.
Effects of depression

　　　　Depression, like any other ailment, has its fair share of effects on the individual. It is known to disorient the mind of the patient resulting in an imbalanced mental state. In its mild form, depression can result in minor effects but in its severe form, it is known to cause adverse effects on the individual affected as well as the family of the affected.

　　　　The first and worst effect of depression is suicide. Suicide is the act of talking one’s own life. When one becomes depressed, his or her mental ability becomes impaired. This is because the individual lacks the ability to think in a clear and logical manner that will enable them to make sober and conscious decisions. A depressed individual suffers a myriad of problems but the feelings of false guilt, worthlessness, helplessness and persistent sadness have the greatest effect on the mentality of the individual. The individual becomes incapable of making correct decisions. The individual also feels like he or she is not worth living and has become a burden to his or her family. The inability to carry out ADL’s (Activities of Daily Living) such as walking, eating and toileting could very well result in contemplation of suicide. This is because the individual feels that maybe it would be much better for him or her and the family, if they were dead.

　　　　Another effect of depression in late adulthood is withdrawal and social apathy. A depressed individual feels like they are not worthy of living among others in society. This feeling results in the individual shying away from activities that were once pleasurable to the individual out of this fear. The individual withdraws from society and prefers to drown him or herself in their own sorrows. The individual also embraces social apathy and they prefer to live in isolation. This effect is most prevalent in nursing homes where the individuals feel as though they are unwanted by their families by their living in a nursing home. This only aggravates the situation and makes the individual more depressed than they were before they got into the nursing home. The patients take these steps believing that it is in their best interests, yet they continue to affect their recovery.

　　　　The social isolation that one grants himself or herself is only made worse by the fact that society is ignorant on the situation surrounding depressed people. People who suffer from depression tend to be isolated and constant remarks by people that they are “freaks” are countless. This social stigma that depression receives from the society makes the individual begin to believe that they are indeed “freaks” and that they are not worthy of living in society alongside the rest of the “normal” people. They begin to question themselves, their preferences, their ability, both physical and mental, as well as their role in society. An individual who was once an active member of society and who had total confidence in his or her ability could very well end up being the one who is completely withdrawn and even afraid of speaking to people. Depression also affects the family members of the depressed person. The family members also begin to lose interest in the welfare of the affected. They also fall into mild depression in the event that the affected does not recover as well as they had hoped. This takes a toll on the whole family and even threatens the unity that the family once had. These adverse effects that depression causes to the individual are largely responsible for the desperate measures that depressed persons resort to taking. It is mandatory that as a society, we all understand depression and the effects it poses on the affected in order to fully tackle the problem.

Treatment of depression
　　　　Depression is a disease that can be cured. The ignorance of many individuals on depression, and the effects that it has on a person leads many people into believing that depression is a disease that one can cure by watching lots of comedy and hanging out with friends more often than they do. However, the root cause of depression lies in the mind and a physician with the appropriate knowledge can successfully treat depression. A physician who specializes in treating depression among the aged is called a geriatric psychiatrist.

　　　　There are a variety of methods that can be exploited to treat and cure depression. Of these three methods, all are safe and contrary to popular belief, treating mental ailments does not comprise electrocution. The first method that can be successfully used to treat depression is psychotherapy. This method is commonly referred to as therapy or “talk therapy”. In this form of therapy, the individual is treated by a qualified trained physician who helps the individual deal with their depression by getting them to talk about their frustrations. The physician asks a series of questions that are structured to trigger the individual into revealing the cause of their depression. The patient talks with the therapist about their experiences and in this way, the therapist is able to ascertain the cause of the depression and determine the best approach to adopt in treating the patient. Psychotherapy can be administered in a variety of formats among them individual, group and family therapy. The therapist helps the patient to understand the cause of their depression, the factors that trigger their depression, how to control their depression and how they can regain pleasure in life after recovery from depression. Psychotherapy can be administered to patients suffering from both chronic and mild depression.

　　　　Another method of treatment that can be used to treat depression in late adulthood is the use of antidepressants. An antidepressant is a medication that is used to treat mild depression and is administered through prescription by a physician. Depression is characterized by persistently feeling sad; a feeling that is fully controlled by the brain. The shortage of neurotransmitters in the brain results in feelings of sadness and if this condition persists, depression can kick in, affecting the individual. As a measure of dealing with mild depression, physicians administer antidepressants to patients. These drugs increase the number of neurotransmitters in the brain and in the long run, cure mild depression. The alleviation of depression has been attributed to the constant increase in neurotransmitters in the brain. This method of treatment is highly effective for cases of mild depression, but only when the medication is followed strictly as prescribed. For one to realize the benefits of this medication, it might take a few months of consistent use.

　　　　Another method that is applied in treatment of depression is electroconvulsive therapy (ECT). This sounds like the most dangerous method of the three but it is, in reality, the safest. This is usually administered for up to four weeks with the results being very impressive. In this treatment, the patient is put under anesthesia and electrodes are implanted on the scalp of the patient. The physician then administers a finely controlled current through the brain and this induces a seizure. The seizure can be detected through slight movement of the hands and feet, since the muscles are relaxed. The seizure lasts for a very short period of time and the patient then wakes up. The patient may feel a bit confused but the confusion lasts only a few minutes. Although there is the risk that ECT could be harmful if administered wrongly, it still remains the safest method of treatment for depression.

　　　　Alternative treatments for depression include yoga, acupuncture, massages, hypnosis, herbal remedies, guided imagery as well as chiropractic treatments.
Care for Depressed People in Late Adulthood

　　　　In caring for individuals suffering from depression in late adulthood, plenty of care is mandatory. It is vital that the individual receive special care and treatment to help them in their recovery from depression. The first approach that one should take in caring for depressed persons is having regular check-ups on them. In this way, the individuals can be followed up on their recovery and monitored closely on their improvement. Another benefit of this is that the physician can detect depression in its early stages and treat it before it gets worse.

　　　　One can also care for the depressed by consulting their physicians on their physical limitations. In this way, the individuals will not be allowed to take part in activities that can be physically strenuous on them. This strain leads to the frustration that one’s abilities are impaired and this could result in the aggravation of depression. It is also important to respect the personal preferences of the aged individual. In this way, the change that the individual undergoes is mild and not traumatic. This can go a long way in preventing the onset of depression. Last but not least, people should apply tact when dealing with depressed persons. One should not say things that will dampen the spirits of the depressed as this can lead the individuals into committing suicide.

　　　　Conclusion
　　　　Depression is a treatable ailment like very many others. It is only fair that it is treated like other serious diseases and accorded the attention that it deserves. Among the aged, depression is a more severe problem than it is among the youth. It is a disease that continues to affect many more individuals without their knowledge. It strikes when it is too late and at a point whereby it requires a lot of support and very intensive treatment. The fact that depression in late adulthood can result in suicide, withdrawal and social apathy should be enough to send the message that this is a dangerous disease. It is the duty of physicians the world over, to step up their efforts in the fight against depression particularly in late adulthood. Through campaigns that will highlight the causes of depression, how one can detect depression as well as what measures can be taken to curb the development in depression, it is possible to deal with the menace that is depression in late adulthood.
　　　　
　　　　References
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