Lately I’ve been spending a lot of time with the super seniors—those who are 75 years old and above. Some seem to have defied time and lead very active lives, engaged in their communities and with their families.
Then there are those who seem to have had the wind knocked out of them. They stay home for the most part and hardly ever socialize.
Depression is a reality in the super senior population, just as it is among the youth. The numbers are just about the same. In a World Health Organization (WHO) report on global rates for depression, Southeast Asia leads the pack at 27 percent, while Americas are only at 15 percent, Africa, 9 percent.
It is estimated that there are 322 million people worldwide who live with depression, and there has been an 18-percent increase in the number diagnosed between 2005 and 2015. The numbers continue to rise.
Depressive disorders involve sadness, loss of interest or pleasure, feelings of tiredness, disturbed sleep or appetite, feelings of guilt or low self-worth and poor concentration. Depression impairs the ability of an individual to function at work or in school and cope with daily life.
According to WHO, in 2015, 4.4 percent of the global population was estimated to live with depression. Depression is more common among females (5.1 percent) than males (3.6 percent). In terms of age groups, prevalence peaks in older adulthood (above 7.5 percent among females aged 55-74 years, and above 5.5 percent among males of the same age group).
There are many factors that contribute to depression in the senior and super senior population. The most common is dealing with loss on a frequent basis—loss of physical and mental agility, but also of family members who have either passed away or moved away due to work or migration.
They also lose dear friends and colleagues, people they have shared many memories with. Too many losses can be overwhelming and take an emotional toll.
3 important signs
There are three important signs of depression among the elderly that must not be taken for granted.
One, there is a loss of interest in activities they normally enjoy, and/or an inability to carry out daily activities for at least two weeks.
Second, there is an observed loss of energy, clear changes in appetite, difficulty sleeping or a marked change in sleeping patterns, anxiety, reduced concentration, restlessness, constant feelings of worthlessness (as opposed to the usual tampo or touchiness that we sometimes observe in the elderly), guilt or hopelessness and, most important, thoughts of self-harm or suicide.
Depression among seniors and super seniors is more often also associated with physical conditions such as heart disease, high blood pressure, diabetes, or any other disease that diminishes their agility or physical mobility.
Life-changing events, such as losing a partner and a reduced ability to do things, may also contribute to depression.
Depression, whether in the young or the old, can be treated.
First, it is very important to offer unconditional support to and listen closely to what the person says. Little changes in their life can be warning signs. Early dementia often has very subtle signs, so it’s important to pay attention. When caught early, it’s possible to “stabilize” or slow down decline.
Next, we need to take an active role in their care. Go to appointments together as much as possible, and if any medication is prescribed, help your senior or super senior stay compliant. Encourage them to keep regular eating and sleeping schedules, to continue with their activities, and have some form of exercise every day.
Isolation is the super seniors’ worst enemy. It’s very important to hear them out and to honor their emotions. The elderly are often challenged by the strong emotions that come with loss and difficult life events. Talking about memories and walking with them at this point on the journey is very affirming and life-giving.
Ensure that your super senior continues to have regular socialization. In a recent study on aging among people in their 90s, it was shown that the leading indicator of healthy aging is having some form or other of social integration.
Feeling of purpose
Never diagnose on your own. Psychiatrists or geriatricians (doctors who specialize in caring for seniors and super seniors) are the most equipped to spot and diagnose depression.
Let the person feel you’re available for them. Allow him /her leeway and don’t take over their life and do things they can still do for themselves. Doing so will only reinforce their perception that they are worthless.
What is important is that our seniors continue to have a “why”—a feeling of purpose for waking up each morning. If we succeed in helping them find that why, and ways to accomplish it, we can help keep their lives meaningful.