Holiday Blues: Depression in the Elderly

We who are involved in Elder Law have to be vigilant about recognizing the symptoms of depression in our older clients. For one thing, it can affect the care we put in place. This concern becomes even more acute during the holiday season, when the symptoms of depression can become heightened. This is often referred to as the "Holiday Blues".

As we spend time with the older people in our families and communities, we should all be on the look out for signs of depression. It is, it turns out, more common than generally believed. According to the National Institutes of Health, of the 35 million Americans age 65 years or older, about 2 million suffer from full-blown depression, and another 5 million suffer from less severe forms of the illness. This represents about 20% of the senior population.

Exacerbating the problem is that depression in the elderly is frequently misdiagnosed and often goes untreated. The symptoms may be confused with a medical illness, dementia, or malnutrition due to a poor diet. Another factor is that many older people will not accept the idea that they have depression and refuse to seek treatment.

What causes depression in the elderly?

The holidays tend to bring memories of earlier, perhaps happier, times. Additional contributing factors that bring on depression may be the loss of a spouse or close friend, or a move from a home to an assisted living facility, or a change in an older person's routine.

Depression may also be a sign of a medical problem. Chronic pain or complications of an illness or memory loss can also cause depression. In addition, diet can also be a factor when proper nutrition and vitamins are lacking. Often, there are both mental and physical reasons for depression.

Symptoms to look for in depression might include:

• Depressed or irritable mood


• Feelings of worthlessness or sadness


• Expressions of helplessness


• Anxiety


• Loss of interest in daily activities


• Loss of appetite


• Weight loss


• Fatigue


• Lack of attending to personal care and hygiene


• Difficulty concentrating


• Irresponsible behavior


• Obsessive thoughts about death


• Talk about suicide

How do you know if it is depression or dementia?

Depression and dementia share similar symptoms, but here is a guide to some differences that might help to distinguish between the two:

In depression there is a rapid mental decline, but memory of time, date and awareness of the environment remains. Motor skills are slow but normal in depression. Concern with concentration and worry about impaired memory may occur.

On the other hand, dementia symptoms reveal a slow mental decline with confusion and loss of recognizing familiar locations. Writing, speaking and motor skills are impaired, and memory loss is not acknowledged as being a problem by the person suffering dementia.

Whether it is depression or dementia, prompt treatment is recommended. A physical examination will help determine if there is a medical cause for depression. A geriatric medical practitioner is skilled in diagnosing depression and illnesses in the elderly. If you are the caregiver of an elderly person it may be beneficial for you to seek out a geriatric health care specialist.

Treating depression in older people

Once the cause of the depression is identified, a treatment program can be implemented. Treatment may be as simple as relieving loneliness through visitations, outings and involvement in family activities. In more severe cases antidepressant drugs have been known to improve the quality of life in depressed elderly people. Cognitive therapy sessions with a counselor may also be effective.

As a caregiver or family member of a depressed elderly person, it is important to take the initiative. The elderly person will generally deny any problems; they may fear being labelled as mentally ill. Your intervention can make the difference and alleviate the depression and Holiday Blues of a senior in your family or community.
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Disclaimer: The foregoing is not medical advice, and no action or refraining from action should be based on it. Anyone who is dealing with the issues discussed above should immediately consult their physician or other health care provider.