What Everyone Needs to Know about Geriatric Depression

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It’s important to know that depression can occur at any age, but the geriatric population - individuals 65 years of age and older, face particularly concerning issues.

Sometimes referred to as depression in later life, geriatric depression is vastly different than depression in younger adults. Depression in seniors is linked to greater vascular and environmental origins, whereas early onset depression typically involves genetics and social learned behaviors. Research reports that seniors don’t experience depression in the same ways as children and adults – often reporting more physical (headaches, backaches, fatigue) and cognitive difficulties (forgetfulness, poor reasoning, slowed thinking) than kinds of sadness or despair younger people report. As a result, older adults think their memories may be failing or the reason they have aches, pains and irritability is due to “old age.” The bottom line here is that many seniors don’t even know they’re struggling with a treatable mental illness.

While gerontology, the study of the aging process in human beings, has brought insights about the physical, emotional and social needs of this population, little has been done to train geriatric health professionals. In fact, 97% of medical school students have no training in geriatrics, and the rate of doctors graduating with a geriatrician degree are lower now than ten years ago. Even geriatric psychology, or geropsychology, the specialty that focuses on the mental health of the elderly, isn’t gaining the kind of traction needed to help those living in their golden years. This makes identifying and treating depression in later life difficult because many health professionals mistake this mood disorder for other conditions associated with getting older like memory loss, muscle/joint weakness or side effects from medications.

Depression is NOT a Normal Part of Aging

Depression affects an estimated 15% of Americans ages 65 and older. The World Health Organization reports that late life depression effects 7% of older people worldwide. While these statistics on face value don’t ring the alarm, it’s estimated that upwards of 90% of seniors don’t receive adequate care for depression, with 78% not receiving any kind of treatment at all. The financial cost of misdiagnosis or mismanagement of geriatric depression is enormous with research saying it worsens co-existing physical illnesses, hastens mortality and increases the rates of suicide by death for seniors.

Statistics for those 65 years or older who have subclinical depression – having many symptoms but falling short of making a clinical diagnosis - approximates 25% of the geriatric population. This is a particularly startling number that carries with it an equally startling fallout because there are more seniors with subclinical depression than those with a diagnosed depressive disorder. And what’s even more alarming is that seniors who have subclinical symptoms are not identified early, and therefore, not treated appropriately. Studies show that a long untreated subclinical depression of up to 3 years will lead to a major depressive episode. The single cause for this oversight is that many people, health professionals included, believe that depression is a normal part of aging.

It is not.

In fact, this is one of the greatest myths about aging found the world over.

How to Identify Geriatric Depression

Greater understanding of geriatric depression comes with identifying three specific areas: 1) Behavioral symptoms, 2) Physical symptoms and 3) Cognitive symptoms. Take a look at the list below and learn how you can help diagnose depression in later life for yourself or a loved one.

Behavioral symptoms

• Anhedonia – loss of happiness of things that were once pleasurable
• Agitation
• Anger
• Apathy
• Decreased ability to care for self
• Feeling like a burden to others
• Feeling hopeless
• Inappropriate feelings of guilt
• Increased anxiety
• Irritability
• Isolating oneself from others or activities
• Loss of self-confidence
• Pacing or fidgeting
• Preferring to be left alone
• Tearfulness, but necessarily reporting feeling sad

Physical symptoms

• Excessive aches and pains
• Fatigue or reduction in energy
• Increase or decrease in appetite or weight
• Increase or decrease in sleeping
• Slowness in movements or gait
• Vascular changes in brain or body

Cognitive symptoms

• Distractibility
• Foggy thinking
• Indecisiveness
• Memory loss
• Negative thinking
• Persistent thoughts of hopelessness
• Poor concentration
• Rapid mental decline
• Slowed decision making
• Thoughts of death or suicide

What to Do Next

If you or a loved one are experiencing any of these symptoms, there are 4 vital things to do.

1. Immediately contact your medical health professional for further evaluation to make sure geriatric depressive symptoms are not the result of an untreated medical condition.
2. Consider using a genetic Cytochrome p450 Testing Panel to address possible side effects from medication or adverse side effects causing depressive symptoms. This is a simple cheek swab test that can be ordered by your physician to evaluate your specific metabolism.
3. A comprehensive geriatric mental health needs to be conducted to address cognitive, adaptive and mental well-being.
4. Finally, I recommend beginning treatment to address geriatric depression whether you have a true clinical disorder OR if you’re struggling with subclinical issues. Doing so ensures that you can achieve and maintain well-being.

Geriatric depression can be difficult to diagnose, but knowing the symptoms leads to early identification. With proper treatment, the golden years can remain a meaningful chapter in your life.