It is true that many elderly people record higher rates of depression, such as among nursing home residents. It is also true that, as people age, they are more likely to live alone and experience social isolation. For example, two in five people aged 75 and over in inner-city Melbourne and in the Yarra area live alone.
However, depression is not a natural part of ageing. Rather, it is a person’s overall life circumstances that affect their outlook, not their physical age. It’s one of the reasons why young people account for a very high proportion of diagnoses for mental health conditions.
It is also why a person’s happiness, wellbeing and even their physical health later in life is closely tied to the perceived quality of their relationships, rather than their health, wealth or genetics.
Even so, there are certain things that are more likely to occur later in life which can cause strong feelings of distress. They include deteriorating health, social isolation or loosing contact with people, or the death of peers or loved ones. Many of these can affect a person’s outlook and may result in feelings of sadness or grief. However, they do not automatically lead to depression.
The difference between depression and sadness
Everyone experiences sadness, loss or grief at some point in life. These feelings are often brought about by specific events, such as the loss of a loved one, sudden disappointment about an important occasion, or a heated argument.
It is entirely normal to experience negative feelings in response to a serious and distressing event. However, as unpleasant as it is, those negative feelings tend to last for a limited time.
This means that it is normal to ‘move on’ — the memories of those negative feelings remain, but they are not an overarching presence affecting a person’s day-to-day thoughts, actions and decisions.
Depression may often be confused with sadness (and vice versa). However, where sadness and loss tends to last for a limited time, depression can manifest as intense or prolonged feelings of sadness. These thoughts and feelings may go for weeks, months or even years and may reach the point where they negatively affect daily life.
Depression and age
Depression can be brought about by a range of factors. As mentioned, age by itself does not lead to depression, although many people who are older tend to experience depression for a range of reasons.
Here are some common signs that may indicate someone is experiencing depression.
- Ongoing and intense feelings of sadness that last for more than a couple of weeks. The person experiences more than just ‘down’ days,and has negative feelings that go for a prolonged period.
- Intense or seemingly unnecessary feelings of anxiety. They may seem excessive or even trivial to others.
- Tiredness or a loss of energy. The tiredness or lack of energy may be such that it cannot be explained solely due to the person’s age or physical health (for example, they spend hours or days watching TV).
- Noticeable changes in eating habits, weight gain or weigh loss. For example, they may order far more takeaway than normal, or may no longer enjoy making or enjoying their favourite meal.
- Noticeable increases in the intensity or prevalence of negative thoughts. These could be self-critical (such as constant apologising or blaming oneself for past actions that occurred years ago); or they could be negative views about the surrounding world, such as anger or intense complaining about seemingly trivial things.
- Symptoms that are physical (trouble sleeping, difficulty concentrating, excessive sensitivity to pain) and which cannot be attributed solely to the person’s age.
- A sudden change in self-care or personal habits. This might take the form of no longer washing, cleaning, gardening, disposing of rubbish or taking care of a pet, beyond the limitations imposed by the person’s age.
- Noticeable or sudden avoidance of social interaction, such as no longer responding to phone calls, or avoiding social outings or invites.
The stigma of depression
It is possible that a person’s depression is not talked about or even acknowledged, either by their relatives or by the person themselves. This could be due to a variety of reasons.
It may be that a person’s relatives believe that someone has “always been like that” or that they are just “getting old” and their outlook is a normal part of ageing.
It is also common for many people to deny or hide their signs of depression. Again, there are a wide range of reasons for this — they may believe that acknowledging any kind of mental health condition is somehow a sign of weakness, or they may have lived in an environment where this is regarded as taboo or even shameful.
Some people experiencing depression may even believe that “nobody cares” or that their problems do not warrant discussing (ironically, it may be that the depression itself is influencing them to think this way).
Unfortunately, these attitudes rarely help. People in these situations may focus on the physical symptoms (for example, weight gain or a deterioration in physical health due to inactivity as a result of their mental state) rather than addressing the underlying causes.
Talk it out
It is widely accepted that bottling up or ignoring mental health symptoms is likely to result in a worse outcome. The good news is that depression can be managed and treated. There are many different ways to go about it, from lifestyle changes (such as getting out more often or being more socially active with family and acquaintances) to psychological treatments and even medication.
One of the best things that anyone can do in this situation is talking about it. The act of talking about one’s thoughts and outlook is, for most people, generally beneficial. Having that discussion with a trusted family member or friend is a good way to get that process started. However, if this is not an option, then talking it out with a trained counsellor can help.
CAREinMIND counsellors are qualified professionals who are trained to listen and help people develop ways of coping with things like depression and anxiety. Counsellors are ready to speak to people in central, northern and western Melbourne and are available over the phone or online 24/7.
Concerned? Talk to a professional counsellor on 1300 096 269. It’s free to people in north, western and central Melbourne and is available 24 hours a day, seven days a week.
Want to know where else you can get help? Find out how to access additional community support.
More information about depression
The CAREinMIND blog is delivered by On the Line. The views in each post do not necessarily reflect those of North Western Melbourne Primary Health Network.