There are plenty of reasons why people get depressed as they get older – being widowed, isolated and lonely, unwell, or worrying about money, the future, or their health. Thankfully there is much less stigma to depression these days, and there are many ways of dealing with it. Sometimes it’s easier for you to see it than for them to identify it in themselves – particularly if they are of “that generation” where emotions are not really for public display. This is our guide to dealing with depression in the elderly which we hope you find useful.
Treatment for depression
Anti-depressants have been standard treatment for depression for many years now, but while they help some people they are not always the answer for everyone. This could be because they suppress the problem and numb the pain. When someone has experienced serious trauma or is unable to function normally antidepressants can be essential to help them get through a bad period.
Recognising depression in the elderly
Most people feel low and miserable some of the time, but depression is when these feelings continue for months on end and do not lift. Symptoms to look out for may include:
- Crying all the time
- Feeling negative – unable to enjoy anything
- Loss of confidence and a sense of worthlessness
- Feelings of hopelessness and helplessness
- Tired and low in energy
- Feeling indecisive
- Inability to concentrate
- Not wanting to see people
- Strong feelings of guilt and blaming themselves
Carrying negative feelings inside can impact on both emotional and physical health and in this instance a problem shared is a problem halved.
Someone who is feeling depressed may not feel inclined to talk to anyone who is close to them. They may not want to reveal their feelings or they may feel protective towards you, not wanting to upset or worry you. It may therefore be more effective to speak to someone who is not emotionally involved.
CBT: The first person to ask about talking therapies is the doctor. The NHS can provide cognitive behaviour therapy (CBT) which helps people to look at their negative thoughts and beliefs and find ways of changing reactions and behaviour. Although it is free there can be a long waiting list, or there may be access to online CBT for those who are familiar with using a computer.
Find out more at The British Association of Behavioural and Cognitive Psychotherapists, 0161 797 4484, www.babcp.com.
Counselling: Some people prefer counselling where they can discuss their feelings and get a chance to examine what has happened to them and work through it. It helps people to understand themselves and cope better. There are several ways to access a counsellor:
For a private counsellor who is accredited go to The British Association of Counselling and Psychotherapy website www.bacp.co.uk.
Cruse Bereavement Care provides bereavement counselling, https://www.cruse.org.uk/bereavement-services/get-help or call Freephone 0808 808 1677.
The Counselling Pastoral Trust provides a range of therapies: http://www.counsellingpastoraltrust.org
Natural alternatives to anti-depressants
Some people prefer to take something natural and there are plenty of herbal remedies and flower essences that can help someone to get through a difficult patch in their lives. Herbal remedies for stress should not be taken with certain medication such as Warfarin, but advice can be sought from the GP or a medical herbalist. Flower essences include Rescue Remedy which can help with calming and relaxing.
The National Institute of Medical Herbalists, http://www.nimh.org.uk/
Mindfulness is being aware of everything around you, including yourself – how you are feeling both physically and mentally. The more aware we are of our feelings, thoughts and behaviour the more we are able to control it.
A component of mindfulness is meditation which encourages relaxation and focus and can be a helpful tool for anyone who is feeling depressed. For those elderly people who have never experienced meditation before there could be some resistance, but it really isn’t that difficult or weird and can be provide a self-help technique that they can use when feeling down. It doesn’t have any religious connotations so if someone is worried about it conflicting with their beliefs it doesn’t.
To help them get used to the idea, you could ask them to sit comfortably in a chair with feet flat on the floor and to close their eyes, breathe deeply and slowly and concentrate on their breathing. They may like to focus on repeating 1-2, which helps to keep the mind on the breathing rather than on thoughts and worries.
Just taking time out every day to focus on breathing and having quiet time away from negative thoughts helps people to believe that they have a solution in their own hands, which is very empowering.
Mindfulness courses are now available all over the country and free online courses can be found at www.futurelearn.org.uk
Meditation is recommended by https://www.mentalhealth.org.uk/
Nutrition and the mind
It’s a new way of looking at depression and the mind to relate it to the food you eat and your stomach, but we tend to feel stress and anxiety in the gut, so it’s logical that they are linked. Researchers have found that many people who are depressed do not have enough ‘friendly bacteria’ in the gut. With elderly people this can be due to a number of factors:
- Medication adversely affects the micobiome (microflora or bacteria in the alimentary canal), especially antibiotics.
- Stress and worry can destroy ‘friendly flora or bacteria’.
- Illness, particularly diarrhoea, also upsets the balance of the microbiome.
- Diet – not enough fluids, too many processed foods, too few fruit and vegetables.
- Probiotics are available in yoghurts but capsules that are packed with the most needed friendly bacteria are more effective.
Exercise and activity
Any amount of exercise can help to relax the mind – whether it’s a short walk, an exercise class (at the right level), or getting on an exercise bike. Exercise releases endorphins in the body which are known as ‘happy hormones’. When someone is depressed it can be the last thing they want to do, but if you can encourage them to make a small start, walking the dog perhaps or going to the corner shop every day, the benefits may make them want to carry on.
Loneliness is debilitating and depressing and because you or other relatives cannot always be with your loved one, there are practical things that can be taken up. Someone who is depressed may not feel that inclined to take up a new hobby, but it would help them to meet people. Alternatively there are organised groups to help people to meet people and make friends.
Age UK runs groups to help elderly people meet others like them: https://www.ageuk.org.uk/get-involved/social-groups/friendship-centres/
Contact the Elderly runs monthly Sunday tea parties for the elderly: http://www.contact-the-elderly.org.uk/ Freephone 0800 716543.
For those who want to learn new things the University of the 3rd Age provides talks and outings: https://www.u3a.org.uk/
Frances Ive is a journalist and a member of the Guild of Health Writers.
A discussion on depression in old age with expert Dr Alex Bailey
Do you want to be able to spot, treat and prevent depression in old age? In a recent episode of the Age Space Podcast, we talk to Dr Alex Bailey, a Westminster-based psychiatrist specialising in old age.