Is Melancholy an Inevitable Outcome of Getting Old?

Elderly Depression: Is Melancholy an Inevitable Outcome of Getting Old?

BLOGGERS: Michael B. Friedman, LMSW and Lisa Furst, LMSW

Depression is dangerous and one of the most significant impediments to aging well.

People with depression[i] usually experience a profound sadness and sense of hopelessness that goes far beyond ordinary unhappiness.  They often experience terrible psychic pain, which some people report is harder to bear than severe physical pain.

People with depression often experience a profound disinterest in life.  What has made them happy and kept them vibrant no longer does.  Life may have no meaning for them.

People with depression often find it difficult to carry on ordinary life functions.  They may have trouble sleeping or sleep too much.  They may have no interest in food or may stuff themselves in futile efforts to counter their bad mood.  They may find it difficult to concentrate on work, day-to-day tasks, or social interaction.  They may ruminate about relatively minor matters and be unable to make a decision or forgive themselves for errors or discourtesies.  They may feel that doing anything takes too great an effort.  They may always expect the worst and give up without trying.  They may be angry much of the time, easily irritated by small aggravations.  They may often think about death, even about taking their own lives.

People with depression have lower life expectancy than those without.  The combination of depression and a serious, chronic physical illness, such as diabetes and heart disease, results in greater risks for disability and premature death than for people with the same physical conditions without depression.[ii]

People with depression are also more likely to be socially isolated and caught in a vicious cycle in which depression feeds isolation and isolation feeds depression[iii].

Most people who complete suicide are depressed.[iv] And the sense of hopelessness inherent in depression makes many people reluctant to seek or accept help.

Obviously, depression makes it hard to live well at any age, including old age.

The good news for older adults is that, contrary to common belief, depression is not a normal or inevitable outcome of aging.  But the ageist expectation that it is frequently results in failure to take steps to overcome it.  ”There’s nothing to be done.  They’re just old.”  This attitude too often robs older people of opportunities to enjoy life.

In fact, each year major depressive disorder affects fewer than 5 percent of adults 65 or older who live in the community.[v] The rate is higher among older adults with serious chronic health conditions, those who need home health care and those who are institutionalized.

A much higher proportion of older adults who live in the community — perhaps 20 percent — experience symptoms and forms of mood disorders, such as dysthymia or sub-syndromal depression[vi], that are not as severe as major depressive disorder but may have nearly as much negative impact[vii].

So, a significant proportion of older adults suffers from depression.  But, it is important to note, 75 to 80 percent of older adults do not experience depression in any given year.  Depression — to say it again — is not normal in old age, an encouraging fact for those who may feel hopeless about their lives.

Depression often can be treated effectively or overcome through other means such as meaningful relationships, activities, or spiritual experience.  Unfortunately, it often goes unrecognized.

One reason for this is that it may not look like “depression”.  Frequently, it is expressed through physical symptoms such as headaches, “stomach” problems, aches and pains, fatigue or insomnia.

Depression also can be hard to recognize because it does not necessarily involve having a depressed mood.  There are two “cardinal” symptoms of major depressive disorder — profound sadness for two weeks or more and loss of interest and pleasure in activities that have had the greatest personal meaning.  It is necessary to have one, but not both, of these symptoms to be diagnosed with major depression.  It may seem strange, but there is depression without sadness[viii].

In older adults, depression may be missed because it involves cognitive difficulties that get diagnosed as dementia.  This common misdiagnosis is terribly unfortunate because successful treatment of depression can restore cognitive capacities that have been lost due to depression — even in people with dementia.[ix]

Finally, depression can be hard to spot because many people with depression are able to hide it.  From the outside they may seem unchanged, even though they may be suffering terribly on the inside.

So depression is dangerous, and it often goes unrecognized and untreated, depriving older adults of opportunities to get the most out of life.  What can be done about this?  We will address this question in our next post.

In the meantime, if you or someone you care about needs help, call 1-800-273-TALK.

And to find a geriatric psychiatrist in your area, refer to the website of the Geriatric Mental Health Foundation, http://www.gmhfonline.org/gmhf/find.asp.

This article was co-authored with Lisa Furst, L.M.S.W., Director of the Training and Technical Assistance Center of The Geriatric Mental Health Alliance of New York and co-author of  Depressed Older Adults: Education and Screening

75 Year-Old Woman Gets Breast Implants

Visit msnbc.com for breaking news, world news, and news about the economy

Staying Mobile Helps with Aging

IF YOU WOULD LIKE TO SUBSCRIBE TO RECEIVE UPDATES ON BLOG POSTS, PLEASE ENTER YOUR EMAIL ADDRESS ON THE LEFT SIDE OF THE SCREEN WHERE IT SAYS ”SUBSCRIBE”.

To become a Fan of ImagineAge on Facebook, click here!

To join the ImagineAge Group on Facebook, click here!

If you enjoyed this, click the button below to share it!

CNN: Granny, 76, Gets Guinness World Record

Classmates from 1958 Jump off a Plane

CNN – successful aging!

To receive updates from ImagineAge, enter your email in the “subscribe”

box on the left side of the screen.  Your email will NOT be sold!

To become a Fan of ImagineAge on Facebook, click here!

To join the ImagineAge Group on Facebook, click here!

If you enjoyed this, click the button below to share it with others!

Buffett’s Vow: ‘Work Past 100′

What Does it Feel Like to be 75?

NPR

What Does It Feel Like To Be 75? Say Goodbye To Spry

Warren Buffett at 80

WHY I LIKE WORKING WITH OLDER PEOPLE

Why I like Working with Older People

BLOGGER: LAURA TRAYOR

My boss is a 74-year old woman who is by far, the best manager I’ve had in my 20+ year career.  She’s curious, energetic, charismatic and above all, connected.  She’s the antithesis to prevailing aging stereotypes that depict older workers as those who tire too easily, get sick often, or are just too rigid or slow for a fast paced workplace.

Not only is my boss an older person, but so too are most of the people I routinely work with.  They’re all 50+ and many are in their 60s and 70s.  I consider myself fortunate to work with such an interesting and inspiring group of people, which is why I’m always perplexed when I read about the difficulties older people face when looking for a new job or re-entering the workforce.  I recently came across a press release from the US Equal Employment Opportunity Commission (EEOC) that featured findings from a public hearing on developments (widespread layoffs, threats to benefits) under the Age Discrimination in Employment Act.  Expert panelists testified about “conscious and unconscious aging stereotypes” that cause employers to undervalue the contributions older workers make to their organization.  Moreover, because of these stereotypes, older workers are targeted disproportionately during workforce reductions. (http://www.eeoc.gov/press/7-15-09.html.).

I think hiring and HR managers have it all wrong.  There’s a lot to be said for the experience that comes from lives lived.  Like the following:

• High powered connections – my boss can pick up the phone and reach government officials or executives at leading health care organizations;
• Appreciation that time is an important commodity that should not be wasted in meaningless meetings;
• Willingness to take risks because they can handle rejection and are past caring about what other people think (did you know over the past decade or so, the highest rate of entrepreneurial activity is among those 50+?  Check out this report: http://www.globalaging.org/health/us/2009/entrepreneurship.pdf);
• Ability to follow through on their word – older workers are incredibly dependable;
• Perspective – will the world really come to an end if you miss a deadline?

So my advice to any hiring managers reading this blog is to think twice the next time a “seasoned” resume or older job applicant comes your way.  Cast aside those ageist stereotypes and focus instead on the valuable skills and experience this person can bring to both your organization – and your life.

Laura Traynor is a project manager with The Transition Network, a growing non-profit organization for women 50+.  Together with her boss, Charlotte Frank, she manages the Caring Collaborative, an innovative program of strategic assistance offered by friends and neighbors to help women effectively handle emerging health issues ( www.ttncaringcollaborative.org ).

To find out more about Laura and the ImagineAge bloggers, click her photo.

To receive updates when new blogs are posted, enter your email in the “subscribe” box on the upper left side of the screen.  Your email will NOT be sold!