It is easy to succumb to the dark clutches of depression at any stage of life. Life is full of surprises and twists, and not all of them have a positive effect on the psyche. However, once a senior is in the grasp of depression, it is often difficult to find release. More than 6.5 million Americans aged 65 and up are affected by depression.

In this issue of The ElderCounselor™, we will explore what depression is, what some causes are of depression in seniors, and some recent scientific research that has given insight on how seniors can take action to deter depression.

What is depression?

Depression is most often characterized by being sad. But depression can be so much more than that. In fact, for many seniors with depression, sadness is not their main symptom. More prominent symptoms may include trouble sleeping, feeling irritable or tired, being confused, or having attention problems. Because of this, depression can sometimes look like Alzheimer’s disease or other health conditions. Some medications can also exacerbate the effects and length of depression.

Depression in seniors is more likely to lead to other health problems, including a heart attack. Likewise, depression can keep a senior from rehabilitating at an optimal pace. Depression can also increase the risk of suicide. The suicide rate for seniors aged 80 to 84 is nearly twice that of the overall population. Fortunately, some preventative measures can be taken to deter or prevent such gloomy depths in our later years.

What Causes Depression in Seniors?

An adverse health event may sometimes be a catalyst for symptoms of depression. Nearly a quarter of seniors who experience a stroke will develop clinical depression. Seniors who have suffered vision loss are at an increased risk of reporting depressive symptoms. When a senior’s body doesn’t let them function like they used to, daily life can be disrupted and the dread of continued health problems can loom in the back of their minds. An elder might be fearful of having to enter a nursing home or otherwise rely on others for care. And of course, reflecting on the end of life can sometimes be tumultuous and frightening.

A widow/widower is also at a higher risk of depression, especially during the first year after the death of their spouse. Bereavement in folks over age 50 more than tripled the probability of depression. Losing a loved one can, understandably, be a devastating event in a senior’s life.

Medical issues, such as brain chemistry and medication side-effects, can also cause depression in seniors. Restricted blood flow may cause blood vessels to harden and cause issues with brain function. Seniors should take their health seriously and have regular visits with medical professionals and care managers. Of course, depression is a medical condition and should be evaluated by qualified medical professionals if an elder is experiencing depressive symptoms. Besides medical intervention, let’s take a look at some other tools that seniors can arm themselves with.

How Seniors Can Take Steps to Deter Depression

Finding a Purpose in Life

Most people want to feel that our existence is worth something – that our presence adds something to the world. As people age, their children grow up and begin their own lives, friends and loved ones pass away, their physical bodies slow down, and many are left seeking out new goals and ways to spend their remaining time.

Depression has been shown to lead to a cognitive decline and may increase the risk for dementia. Establishing a purpose in life has a mitigating effect on depression and cognitive decline. A recent study used many factors – such as age, race, number of living siblings, and whether the participants had a significant other – to compare the rates at which the participants suffered from mental deterioration. The results were encouraging. Finding a purpose in life is shown to prevent, or at least slow, the progression of Alzheimer’s disease and other forms of cognitive degeneration. Since depression is often formed due to an adverse medical diagnosis, like Alzheimer’s disease, having a purpose in life may also curtail the resulting depressive symptoms as well.

These results are not surprising considering the positive effects on mood and drive when one has goals and tasks to accomplish. How can a senior cultivate a purpose in life? Sometimes, this will involve caring for a loved one. Maybe the senior can get more involved with grandchildren, other seniors who need care, or a charity that they are interested in. Helping others can nurture a feeling of purpose in seniors. If the senior knows that someone is counting on them or that others value the senior, this may help deter depression and cognitive decline by igniting a purpose in their life.

Other activities might include regularly scheduled visits to elementary schools to tell stories or read to the children, volunteering at an animal shelter, writing a memoir, mapping out family lineage, or generally finding something new to explore. Finding something or someone in life that brings joy and purpose to a senior is a major step towards their future well-being.

Engaging in Interpersonal-individual Activities

It is no surprise that staying active, enjoying hobbies, and growing friendships have a beneficial effect on mental health. Interestingly, some activities have much more benefit than others. A study on senior health shows that elders that spend time with specific family members or friends enjoy a greater level of protection from late-life depression. Those taking part in solitary or general social group activities did not realize as significant results.

The study, published by The American Journal of Geriatric Psychiatry, explored a small test group of 48 older adults. Those seniors did not have a cognitive impairment but did have major depression. Each person received nine sessions of engage psychotherapy. Engage therapy is one that uses meaningful and rewarding activities at its core.

Seniors engaged in either solitary activities, social group activities (such as church or senior center activities), or interpersonal-individual activities (connecting with a specific friend or family member) experienced an improvement in their depression. Meaning, those that connected with a specific person that they cared about decreased their depressive symptoms.

These results are a reminder for seniors to keep in touch with those that bring them happiness. Encourage seniors to reach out to beloved family members and vice versa. A caregiver for a senior might try and reconnect the senior to loved ones who may have lost touch over the years. Maybe the caregiver can best facilitate the engagement, through aiding with transportation, communication, and scheduling. The study suggests that bonding with others has protective benefits for the minds of seniors. Perhaps the mixer or social event that a senior chooses to attend will not have significant benefits in the long-term, but the potential friendships developed there will.

Staying Physically Active

In a third study, published by the American Journal of Physiology-Cell Physiology, researchers studied the effects of staying physically active on the minds of seniors. There has been a plethora of prior research on the connection of exercise and mental health in young adults, but limited scientific data on the senior population. Specifically, it was unknown whether muscle deterioration, which invariably accompanies aging, would prohibit seniors from achieving analogous results to that of younger study subjects when analyzing the effects of exercise on mental health.

The study analyzed a group of male seniors who followed a specific exercise program for 12 weeks. The patients engaged in high-intensity interval training, in conjunction with strength training sessions. The results were positive. David Allison, the lead author on the study, said “Even individuals who are already metabolically healthy — with good weight, good blood pressure, and blood sugar levels — need to prioritize regular physical activity to maintain or improve upon their mental health. We have shown such benefits are still achievable in old age and further emphasize the importance of maintaining an active lifestyle.”

While not all seniors can engage in high-intensity interval training, many seniors can start somewhere. Encourage a senior to offer dog walking services to a friend who may be ill, or to park at the far end of the parking lot at the grocery store. A senior with more physical abilities might take part in the National Seniors Games. Competitions include bowling, horseshoes, power walking, shuffleboard, softball, and more. While the 2019 games have recently passed, now is the time to start training for next year!

A recent study published by the International Journal of Behavioral Nutrition and Physical Activity found yoga to improve strength, balance, flexibility, and mental well-being. While there are a plethora of yoga variations, many seniors of all abilities have taken up chair yoga. This type of yoga has been modified so that certain yoga poses can be done while seated, making yoga more accessible for those with mobility issues. Yoga has been scientifically associated with decreasing stress hormones, alleviating anxiety, and possibly reducing inflammation. An improvement in heart health is also a benefit. It has been illustrated that test patients over age 40 who had practiced yoga for five years had lower blood pressure and pulse rate than those that didn’t practice yoga.

Resolving Regrets

When a senior looks back on their life, what regrets do they have? How are these thoughts impacting their current emotional well-being? Having past situations where one would have preferred to act differently, or otherwise, have a different outcome to the situation, is completely normal. However, living in these pangs of guilt or remorse can be detrimental to an elder’s health. In a study of 213 lower-income older adults, regrets about career, education, and marriage were common. However, more intense regrets originated from finances, family conflict, and the problems of their children. The study found that having regrets was a significant predictor of depression in seniors.

How can a senior work towards revolving regret? Maybe the senior can obtain closure by writing a letter to someone involved in the remorseful situation. The senior may find peace by explaining that they are sorry and wished things would have worked out differently. If a senior has lost contact with a family member, it might be possible to rekindle that relationship in a healthy way.

A journal may help a senior deal with past regrets by highlighting things that the senior is thriving at in the present and how their life is interesting and full. Contemplating current feelings and events can be a reminder to live in the present. Alternatively, the senior can make a list of things that they learned about from that regretful situation and how they have used the experience to learn and grow. Realizing that everyone makes mistakes, but it is how you respond to those mistakes and alter future decisions, is what is important.

The senior may benefit from therapy with a qualified professional, to see how their regret is impacting their life and work towards resolving those feelings. The therapist may help them answer questions like “How are past regrets effecting your actions and current relationships?”, “Have you changed for the better due to that regretful situation?”, or “Is there anything you can do now that will improve the situation or your feelings about the situation?”

Try the Mediterranean Diet

A recent study that was presented to and discussed by the American Psychiatric Association indicates that adherence to a Mediterranean diet may reduce the risk of late-life depression. The Mediterranean diet plan has been touted in America since the 1960s and has been linked to improved physical health and associated with longer life. Heart health is a big benefit of the Mediterranean diet. However, the research on the mental health benefits of the plan is fairly new.

Researchers in Greece conducted a study on participants in day-care centers for seniors. Of the participants, 64% reported medium adherence to the diet, and 34% displayed a high adherence to the diet. Although cause and effect could not be unequivocally proved, the research team ascertained that a diet low in poultry and alcohol and high in vegetables decreased the probability of developing symptoms of depression in those seniors. The authors of the study concluded, “Adherence to a Mediterranean diet may protect against the development of depressive symptoms in older age.”

What is the Mediterranean diet? It consists of fruits and vegetables, legumes, fish, whole grains, beans, herbs, nuts, and of course, olive oil. Moderate amounts of dairy and eggs are allowed. Red meat, salt, butter, and sweets are a rare allowance. And an occasional glass of red wine can be enjoyed. We’ve all hear the adage, “You are what you eat.” The Mediterranean diet may have not only physical health benefits but mental health benefits as well. If the Mediterranean diet isn’t right for the senior, then make sure whatever diet they follow is a nourishing one, in line with their healthy lifestyle.

In Summary

Everyone wants to be happy. No reasonable person desires to succumb to sadness and depression, especially at a time when one should be celebrating their life and enjoying the years they have left. While seeking professional medical advice would be a recommended first step should a senior start experiencing signs of depression, there are some things that a senior can do to deter depression possibly. This includes finding a purpose in life, connecting with specific friends or family members who bring them joy, staying physically active, and resolving their regrets. The Mediterranean diet might even do the trick! Mental and physical health are intertwined, and helping our beloved seniors stay happy and healthy benefits us all.

Sources

https://www.nia.nih.gov/health/depression-and-older-adults

https://www.ncoa.org/wp-content/uploads/Depression_Older_Persons_FactSheet_2009.pdf

https://www.mentalhealthamerica.net/conditions/depression-older-adults-more-facts

https://www.webmd.com/depression/guide/depression-elderly#1

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4376269/#R1

https://www.sciencedaily.com/releases/2019/02/190207111309.htm

https://www.ajgponline.org/article/S1064-7481(19)30006-5/addons

https://nsga.com/schedule

https://www.ncbi.nlm.nih.gov/pubmed/15255625/

https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2733451?resultClick=1

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2852580/