The most important thing to do when you suspect depression in the elderly is to fully understand what is going on with them. Depression is triggered by loss. As we grow older the number of losses we experience mount up. After all, life is a series of losses: losing our youth, a love, a job, a marriage, financial health, and physical health…the list is endless. But loss in itself does not have to lead to depression.
Let’s examine this destructive emotion a little more in depth. We cannot avoid loss. Losses happen to us no matter who we are. But more resilient people, those seniors who are mentally more resistant to loss, deal with loss differently. Sadness and depression are two sides of the same coin. Sadness is a healthy but painful and intense emotion. Depression in the elderly is an unhealthy, painful, and intense emotion. The way to tell them apart is by the underlying message, belief, or “Silent Assumption” . When an elderly person is sad, they see the experience of the grief as a temporary event, whereas in depression the pain is seen as permanent and an indication of the loss of life’s value. Depressed people see their life as worthless or meaningless, whereas people who are sad see the loss as very painful but temporary, and does not affect their interpretation of life as a valuable, worthwhile experience for which they are grateful.
The effect of these emotions manifest in the behavior the senior displays as well. A senior who suffers from depression in the elderly becomes lifeless; a sad elderly person cries. Crying is a healthy behavior. It is nature’s way of helping us accept, grieve, and move on through the painful loss. After a good cry we always feel better. The brain produces mood enhancing hormones that help ease the pain, and the very act of accepting the loss helps us see it more realistically.
Never try to “fix” a senior when they are feeling sad or depressed, good caregivers know that. Listening, understanding, and empathetic engagement are the best therapy. Acknowledging their loss with patience and acceptance will help them understand what they are feeling. When they are ready you can point out the realities of their situation. As long as we are alive there are endless lists of things we can be grateful for: life, air, limbs, food, friends, support, family…help the senior build a “gratitude” list, add to it daily, and review it frequently. Other helpful strategies include outings, social activities, planning and preparing healthy meals. Medical intervention and medication may be indicated if the depression is severe, but should always be accompanied by a cognitive plan of treatment, preferably from a cognitive behavioral therapist.