In any normal year, the holidays bring about stress, depression, and anxiety due to the number of physical and emotional demands placed upon individuals and families. Planning for get-togethers, shopping, buying that just-right gift, memories, and entertaining tax even the most even-tempered people, but the last couple of years have added yet another layer of stress to the mix - the ongoing coronavirus pandemic. This has left more seniors than ever grappling with the challenges of depression and other mental health issues and is a problem that we cannot ignore.
"The pandemic has affected nearly everyone no matter what the age, but numbers that are starting to emerge regarding mental health indicate that seniors have been disproportionately impacted, " stated certified elder law Attorney Connelly. "Because most seniors could not travel or long-term care facilities were on lockdown, isolation and loneliness appear to have affected their mental health more than any other group. This has led to a serious uptick in mental illness, particularly depression, among our older adults." And depression in seniors is indeed a cause for concern as symptoms are usually overlooked and undertreated in health care settings because it co-occurs with other medical problems that they present with.
Depression in seniors not only affects the mood and general functioning of those with the condition but can also exacerbate other physical health problems. Research shows that older adults with depression have poorer outcomes with chronic medical conditions such as lung and heart disease, high blood pressure, diabetes, and more.
Concerning Pandemic Numbers
A National Poll on Healthy Aging, reports that since March 2020, "...nearly one in five adults age 50–80 (19%) reported worse sleep than compared to before the COVID-19 pandemic. Two in three (64%) said they regularly had trouble falling or staying asleep one or more nights in the past week. Additionally, one in five (19%) reported experiencing worse depression or sadness, and 28% reported worse anxiety or worry, since the start of the pandemic. Worse sleep, depression, and anxiety during the pandemic were also more common among women than men, those aged 50–64 compared to age 65–80, and those who rated their physical health as fair or poor compared to those in excellent, very good, or good health. More than one in four older adults said that for several days or more within the past two weeks they had little pleasure in doing things (29%) or felt depressed or hopeless (28%). One in three (34%) reported feeling nervous, anxious, or on edge, and 44% said they felt stressed. More than one in three older adults (37%) reported feeling a lack of companionship and 46% reported feeling isolated from others in the past year."
Besides the pandemic and its continued variants popping up, there are a plethora of other factors that also play into the psychological well-being of seniors as 2021 draws to a close and 2022 appears to be getting off to a very rocky start. With inflation spiraling out of control, less disposable income, difficulty paying high energy bills, and increased food costs, the upcoming year may offer no relief for seniors struggling with their mental health.
Holiday and Pandemic Struggles
Recently, Attorney Connelly met with Carl and Marie, an older couple who wanted to develop an estate plan. As he discussed the options available to them, he noticed that both became somewhat ill at ease, and then they began to fight back tears. The process was halted for a few minutes to allow them to collect their thoughts.
"Marie voiced her concerns, stating that the discussion actually highlighted the fact that their lives were winding down," said Attorney Connelly. "And for Carl, he shared his sadness of the house being empty for the holiday season with their adult children and grandchildren living in the midwest and west coast, and given the travel difficulties due to the pandemic, they would not be seeing them for the third year in a row."
This couple expressed what so many other elderly couples feel at this time of year -- depression, which has been exacerbated by the ongoing pandemic. In fact, issues like depression are magnified at a time when so many are feeling joyous and happy. It is estimated that over 6 million seniors over the age of 65 are clinically depressed at any given time with the holiday season increasing these numbers even more and as previously stated, the pandemic has added significantly to these totals.
"We haven't seen our grandkids in years and my son is so busy with his job in Arizona that even going there doesn't mean we spend all that much time with them," said Marie. "So we sit in the house, especially if it's cold because of Carl's arthritis, and look at pictures on the mantel. It's really depressing, especially when we realize that our own time is limited."
This discussion occurred in our office but is repeated in households, workplaces, and facilities tens of millions of times during the holiday season and at other times as well -- and it should not be ignored.
Depression in Seniors
First and foremost, depression is not a "normal part of aging" as some like to say. Depression is an extremely serious mood disorder that affects our senior population and we must give it the attention it deserves. According to Mental Health America (MHA), more than 2 million of the 34 million Americans over the age of 65 suffer from some type of depression. Given that, just how knowledgeable are seniors about this disorder? Here's a survey that was done by MHA regarding the question:
68% (7 out of 10) of adults 65 and older know little or nothing about depression.
38% (4 out of 10) of adults over the age of 65 believe that depression is a serious health issue.
If a senior has depression, older adults are more likely to "handle it themselves" than any other age group. Even more concerning, only 42% (4 out of 10) would seek professional help.
Symptoms of depression are more likely to be discussed by those under the age of 64 than by those over the age of 65. The symptoms most discussed are “a change in eating habits” (29% vs. 15%), “a change in sleeping habits” (33% vs. 16%), and “sadness” (28% vs. 15%).
58% (6 out of 10) of adults age 65 and older believe that it is normal for people to become depressed as they age.
And before we continue, there are multiple "types" of depression that can affect seniors. They include:
Major Depressive Disorder - This is diagnosed when the symptoms of depression last for more than two weeks and interfere with the senior's normal functioning.
Persistent Depressive Disorder or Dysthymia - This is when a depressed mood lasts more than two years but the senior is still able to perform their daily tasks, something someone having a major depressive episode cannot do.
Substance/Medication-Induced Depressive Disorder - This is a depression that can be directly related to the use of substances like alcohol and pain medication. But a note of caution, sometimes the use of substances occurs because a major depressive episode was occurring, so it's important to monitor a senior who is abusing a substance and not accept that just stopping access to the drug or substance will cure the depression. Also, don't just take away a senior's access to an abused substance because you could be causing withdrawal, a potentially deadly situation. Always seek medical help.
Depressive Disorder Due to A Medical Condition - Depression can "co-occur" along with a medical condition like heart disease, cancer, or stroke.
There are two concerns to be aware of if the depression is substance induced. First, don't assume that stopping the abuse will halt the depressive episode, and second, taking away the drug or alcohol suddenly may lead to withdrawal, which could be potentially fatal. Consult a professional for advice.
Symptoms of Depression
With older adults, depression may be extremely difficult to identify because their symptoms may present much differently than those of younger people. For instance, feeling sad may not be a complaint of depression with a senior, rather a sense of numbness or lack of interest in engaging in physical activities may be the only sign.
Some of the most common symptoms of depression in older adults are: