Depression is a mental health disease that can touch any of us at all stages of life. However, it is particularly prevalent in the elderly, and is in fact the most common psychological disorder late in life. Depression affects over 6 million older adults. And yet, in this population, depression is often ignored or overlooked, as its symptoms can be confused with other physical ailments.
In our first post in this series, we discussed WHY we should talk about depression with our aging loved ones. In our second post, we discussed WHEN to talk about depression. In this our final post in the series, we will discuss WHAT we should talk about when discussing depression with seniors.
Once you have decided to talk about depression with an aging loved one, remember that the word “depression” carries a stigma for many of the older generation. When they hear “depression,” they may hear “crazy” or “moral failing.” There may be a feeling that, as good Americans, they ought to be able to pull themselves up by their bootstraps to overcome it. If you have the sense that your loved one attaches this stigma to depression, use the word “depression” sparingly, and instead talk about the symptoms. You may say, “You seem sad, and I’ve noticed that you don’t get together with your friends anymore. Why is that?”
Keep the following tips in mind when you talk about depression (regarding HOW to talk):
- Be compassionate
- Remember to interpret signs of depression (e.g., not returning phone calls, short answers, talking for hours about their own pain or problems) as just that: symptoms of depression, rather than personal affronts. Try to be slow to anger when dealing with these frustrating behaviors.
- Be accepting
- Resist the natural impulse to counter a depressed person’s sadness with pointing out all the good things in his or her life. This tends to trivialize the person’s deep feelings and push that person further away. Instead, listen and accept the person’s emotions and perceptions as real.
- Be empathetic
- Rather than arguing with your loved one over the reality (or lack thereof) of statements made, you might express your understanding of how hopeless and disappointing life can be at times. Help your loved one express feelings of despair without being judgmental.
- Be patient
- Depression is a slow-moving, long-evolving process. Let your loved one know that you support him or her no matter how long it takes and that you will always be there if he or she wants to talk.
- Choose your words carefully
- Use reflective statements, express support, and try to re-direct when appropriate.
As far as WHAT to discuss, you can focus on several areas: (1) the facts, (2) the difference between depression and sadness, (3) the symptoms of depression, (4) signs of substance abuse, (5) thoughts of suicide, and (6) treatment options.
- The Facts: Depression is a physical disease caused by an imbalance of brain chemicals responsible for transmitting messages about mood and behavior. Aging can cause a change in the production of these chemicals, predisposing some elderly folks to depression even when there is no “sad” event to trigger these feelings. This physical disease can be treated.
- The Difference Between Depression and Sadness: Sadness is usually attached to a specific life event. Depression often does not have a clear cause, or even if it does, it persists long after the triggering event has passed. It is normal to sometimes feel sad, but not to be depressed.
- The Symptoms of Depression: Emotional (feelings of emptiness, hopelessness, remorse, guilt); Physical (unexplained pain, headaches, decreased energy, stomach problems, insomnia or hypersomnia, loss or increase in appetite); Cognitive (mental cloudiness or confusion, memory loss, language inhibition, difficulty with concentration, diminished learning capacity, delusions and hallucinations); Behavioral (social withdrawal, irritability).
- Signs of Substance Abuse: People who are vulnerable to depression may use alcohol or medication to alter their mood.
- Thoughts of Suicide: Compared with all other age groups, seniors commit suicide twice as frequently (especially common among elderly men).
- Treatment Options: A thorough medical evaluation is usually necessary. There are usually at least two treatment options, including medication and psychotherapy.
Talking to an aging loved one about his or her struggle with depression is important, but realize your own limitations when you do this. You can’t “cure” your loved one of this disease, nor are you responsible for how he or she chooses to treat it.