– a common affective disorder caused by endogenous and psychogenic factors. The prevalence of depressive disorders in older age groups, according to scientists, exceeds 30% of the total number of older people. However, clinicians argue that this indicator does not correspond to the real picture, since so many people over 60 years of age ignore depressive symptoms.
Women between 60 and 75 years of age are three times more likely than men to exhibit symptoms that meet the criteria for a depressive episode. IN old age(after 75 years) the ratio of female and male patients is approximately the same.
36029009 — portrait of an elderly woman with problem
In most cases, the disease is severe, manifesting itself in a variety of emotional, cognitive, behavioral, and autonomic symptoms. Depression in older people is often aggravated by suicidal tendencies and often ends in a completed act of suicide.
Treatment of depression in old age is a difficult medical task, since people over 60 years of age have chronic somatic diseases and neurological defects, which makes it impossible to use many medications, traditionally used in the treatment of affective disorders. Often the symptoms of depression in older people are interpreted by others as natural aging “shifts”, so the existing problem remains without due attention.
Causes of depression in old age
The manifestation of the disease is most often observed in the first month after a person retires. A radical change in lifestyle, acquiring a new social status is a serious stress for men and women. A previously busy and in-demand professional is deprived of his usual living conditions. A person no longer needs to wake up early and strictly adhere to a daily routine. A pensioner stops living at his usual pace; he does not need to plan his work day, write down tasks step by step, or draw up reports. Lack of workload means extra free time, but the newly minted pensioner does not know how to use it profitably. Often he suffers from idleness and does not find ways to implement his existing knowledge and skills.
Retirement also involves a significant change in social activity. With termination labor activity a person’s social circle is reduced, the number of contacts decreases. Partial social isolation of people in older age groups is often associated with the death of close friends, a spouse, or a relative. Loneliness that hits a previously active person is a direct path to the development of depression in older women and men.
Depression lurks among the elderly parents with many children, who dedicated their lives to caring for the younger generation. When their children and grandchildren become adults and leave the “family nest,” older people experience acute loneliness and become despondent.
Another reason for the formation of symptoms of affective disorders is significant deterioration in a person’s financial situation upon retirement. Unfortunately, in the post-Soviet space the size of pensions cannot always meet the needs of an elderly person. A pensioner often experiences financial difficulties, cannot afford to buy quality food, and is worried about the lack of money to purchase expensive medicines. Thinking about the lack of finances is a direct path to depression and a gloomy mood.
Aspect that negatively affects psycho emotional condition person - deficit physical activity . Some elderly people enroll themselves in the ranks of the “old people” and “disabled” ahead of schedule. They believe that the more time they spend relaxing on the couch, the better they will feel. Many people after 60 years do not exercise, do not spend enough time walking fresh air, refuse to play sports.
Common causes of depression in old age - somatogenic and iatrogenic factors. In people over 60 years of age they become more severe chronic diseases, neurological defects progress, immunity deteriorates, which makes them defenseless against viral and bacterial infections. Many diseases internal organs and nervous system are accompanied by severe depressive symptoms.
Symptoms of depression in older people are determined in the following pathological conditions:
- atherosclerosis;
- acute disorders of cerebral blood flow;
- vascular malformations;
- vascular aneurysm;
- metabolic encephalopathies;
- benign and malignant neoplasms brain;
- diabetes mellitus;
- hyperfunction and hypofunction of the thyroid gland.
Affective disorder can be triggered by taking certain medications taken in the treatment of the underlying disease. The following can provoke the development of symptoms of depression in older women and men:
- beta blockers;
- calcium channel blockers;
- some analgesics;
- drugs with hypnotic effects;
- tranquilizers and certain antipsychotics.
Older men often suffer from chronic alcoholism, and symptoms of depression appear as a result of alcohol abuse.
Symptoms of depression in old age
Manifestations of affective disorders are numerous and varied. Symptoms of depression may occur constantly or occur periodically at “bright intervals.” Depressive symptoms vary in severity, and are often completely “masked” as symptoms of somatic diseases. Depressive disorder in older people is characterized by emotional disturbances, personality changes, deterioration of cognitive abilities, eating and behavioral disorders. Main symptoms of depression in older people:
- sad mood throughout the day;
- perception of the present in black tones, negative assessment of prospects;
- depression, depression;
- narrowing of horizons, loss of interest in current events;
- inability to enjoy pleasant news;
- feeling of one's own uselessness and worthlessness;
- conviction of the meaninglessness of existence;
- increased demands and criticality;
- inadequate sensitivity to the statements and behavior of relatives;
- grumpiness and touchiness;
- causeless anxiety, anticipation of disaster.
A depressed patient is characterized by changes in speech and motor activity. An elderly person may remain inactive for a while and not respond to the calls of others. He thinks for a long time before answering the question. Then he begins a period of active action. He fusses and does meaningless things. The patient is hostile and aggressive towards others.
In old age, with depression, significantly Cognitive abilities deteriorate and memory suffers. A person cannot concentrate on the task at hand. He does all household chores poorly and carelessly. It is difficult for him to assimilate new information. Often a depressed patient cannot understand what is being said in television programs or newspaper articles. It is very difficult for an elderly person to remember specific facts from the past.
Common symptoms of depression are: unpleasant physiological sensations. The patient complains of a “stone in the chest,” abdominal pain, cephalalgia, and dizziness. The sick person changes eating habits. A pensioner may feel the need to take certain foods, for example, sweets. Patients may feel “ravenous hunger” and take huge amounts of food. Some elderly people, overcome by melancholy, lose their appetite and become very thin.
As the disease worsens, the individual is pursued by constant insomnia. A person cannot fall asleep for a long time. Plunging into sleep, he is tormented by nightmares. Presenile mood disorders are characterized by an abnormally early rise in a person in the pre-dawn hours. When the disorder becomes aggravated, the subject develops delusional ideas about imminent punishment for some sins. He anticipates a painful death and contemplates suicide.
A typical feature of presenile depression is the demonstrative nature of symptoms. People around him have the impression that the person is not experiencing pain and suffering, but is simply playing for the audience. His complaints are greatly exaggerated. Gestures and facial expressions are excessively expressive and theatrical.
Treatment of presenile depression
How to help an elderly person get out of depression? The patient’s relatives should remember: the earlier treatment for the disorder is started, the greater the chance that the person will spend old age in good spirits, without tormenting himself and those around him. Close people should be assertive, attentive and tactful.
If you suspect the development of depression, there is no need to categorically demand from an elderly person undergo treatment from a psychiatrist. Relatives must convince the patient to seek medical assistance to the family doctor, suggest being examined by an endocrinologist, neurologist, cardiologist. Experienced, qualified specialists will tell you how to lift an elderly person out of depression and motivate the patient to visit a psychotherapist or psychiatrist. Relatives also need to take into account that it is unacceptable to prescribe treatment on their own, since many pharmacological agents traditionally used in the treatment of affective disorders are prohibited for use by people over 60 years of age.
Drug treatment
The choice of thymoleptics requires a highly qualified doctor, taking into account side effects And existing risk. It should be remembered that some antidepressants increase cognitive deficits, reduce performance, impair memory, and provoke confusion. However, certain medications not only demonstrate an antidepressant effect, but also significantly improve the intellectual capabilities of an elderly person. The negative effect of antidepressants with a sedative effect on patients in the older age group is an excessively high sedative effect, which increases the risk of injury due to carelessness and inattention.
Depressive patients of the older age group can be attributed antidepressant Valdoxan®(Valdoxan®). The drug is active in validated models and in models with desynchronization of circadian rhythms. The drug is effective in establishing acquired helplessness, despair, chronic stress, anxiety reactions.
Many elderly patients taking stimulant antidepressants report increased sleep problems: frequent awakenings at night, nightmares, difficulty falling asleep. To eliminate insomnia, the patient may be prescribed the drug Atarax®. Under the influence of the drug, the total duration of sleep increases, the number of night awakenings decreases, and the tone of skeletal muscles decreases.
Non-drug treatment and prevention
How to get rid of depression in old age? The basis of treatment of presenile affective disorders is p psychotherapy and psychological support. Psychotherapeutic treatment is aimed at restoring mental and social functions and stimulating the patient’s abilities. The psychotherapist helps resolve problematic issues that the subject is unable to overcome on his own. During psychotherapeutic sessions, the patient is in a protected environment, so he can sincerely and openly express his feelings and experiences. In comfortable conditions, a depressed patient finds support and restores the ability to take active action. He gains a sense of independence, interest and satisfaction with life.
Rehabilitation measures and subsequent prevention of depression in old age, as a rule, fall on the shoulders of relatives. Caregivers should be patient and careful in their behavior choices. To quickly restore the emotional status of an elderly person, doctors recommend adhering to the following rules.
Relatives should relieve the depressed patient from social isolation and eliminate the oppressive feeling of loneliness. The best option is to live with an older person for some time. If this is not possible, it is necessary to visit the recovering person daily.
For the health of an elderly person it is necessary strict adherence to a clear daily routine. A pensioner must get up and go to bed at the same time. He should know exactly what time he has exercises, hygiene procedures, meetings with friends, walks in the park. It is necessary to find him an exciting activity: beadwork, assembling airplane models, board games, assembling puzzles.
It is important to maintain cognitive abilities do regular mental exercises. Solving crossword puzzles, learning foreign languages, and mastering a new scientific discipline will help you maintain a clear mind.
For an elderly person to feel well, Persona can be offered cycling, playing table tennis, or swimming in the pool.
The diet of a depressed patient should be varied and contain natural, fresh foods. In old age, you should not overuse spicy, smoked, fried, salty foods.
For a person experiencing depressive episodes, it is extremely important to find “inspiration.” It is necessary to provide him with the opportunity to contact his peers. An elderly person can visit cinemas and theaters, go to events organized for pensioners. Great way maintain mental health - travel. Trips to unknown places, vacations in exotic countries, sightseeing will give optimism and relieve a person from the blues.
Depression is one of the most common diseases of the nervous system in older people. It can occur suddenly at any age during aging. Depression is much more common in women than in men. If left untreated, it can provoke the occurrence of other diseases. Depression in old age manifests itself in different ways. Quite often, its symptoms are confused with other diseases that are common in old age.
The older a person is, the more difficult it is to diagnose depression. Since in most cases patients and their relatives are sure that the symptoms of depression common occurrence for old age. Patients usually have only complaints about diseases of the internal organs. Doctors also primarily pay attention to somatic diseases. Older patients also suffer from the following symptoms of depression: increased anxiety, guilt, neurasthenia.
Depression resulting from exposure to diseases of the internal organs is called secondary depression. Quite often, the cause of secondary depression is vascular diseases of the heart and brain, endocrine disorders, infectious diseases, oncology. Elderly patients are more likely than younger patients to attempt suicide. People who are deprived of support and, in addition to the main disease, suffer from concomitant diseases are more prone to depression becoming chronic.
Causes
Age-related changes in the nervous system. As the nervous system deteriorates with age, older people begin to react more acutely to various stimuli. The slightest stressful situations or overexertion can lead to depression or other disorders.
Diseases
In an elderly person, many diseases begin to manifest themselves, which not only worsen their general well-being, but also the accompanying painful sensations. It is also possible to develop diseases that limit the patient’s capabilities. The result is a depressed emotional state.
Retirement
Very often, depression in old age occurs after retirement. Immediately after a person breaks up with his usual activities, an exacerbation of chronic diseases begins. The patient lacks communication with people, he begins to feel out of place. the right person. Cannot find activities that would fill the appeared free time. All these factors lead to depression in old age.
Feeling lonely
One of the most common reasons why senile depression occurs is loneliness. Reducing your social circle rare meetings with family have a negative impact on the emotional state. A person feels lonely and unwanted, which leads to the development of depression. It is much more difficult for older people to make new acquaintances and even more so to start relationships. The social circle gradually becomes smaller and as a result the person remains completely alone. Elderly people experience the loss of family ties the hardest. Children grow up and leave. And the death of a spouse can even lead to deep depression.
Lost Opportunities
In old age, a person begins to be overcome by thoughts that he could not achieve everything he dreamed of. A person realizes that most of his life has already passed and it was not what he wanted. Time is lost forever and nothing can be fixed.
Effect of drugs
As a result of the constant use of certain medications, secondary depression may develop. Most often, depression is caused by sleeping pills, corticosteroid drugs, and antihypertensive drugs.
Signs
Decreased activity
Depression in older people is accompanied by decreased activity. A person sits at home all the time, and when he needs to go out he becomes nervous. An ordinary walk down the street causes a lot of anxiety, an unreasonable feeling of anxiety. A person’s interests disappear, he stops communicating with friends and family. Leaves home only when absolutely necessary, to go to the store or hospital.
1. The most effective way The treatment for senile depression is a healthy psychological climate in the family. To do this, a person must feel his significance and importance. Feel the support and care of loved ones. And the most important thing is not to be lonely and abandoned.
2. A hobby or hobby is another way to get rid of this illness. A person develops a favorite pastime, a meaning in life, and a desire to lead an active, fulfilling life.
3. Help from a psychologist is another remedy for senile depression. Communication with a psychologist helps older people overcome feelings of loneliness, uselessness, and hopelessness.
4. For prolonged depression, the methods listed above often do not help. Therefore, doctors recommend drug treatment. In such cases, antidepressants are prescribed, as well as various psychotropic drugs.
It is important to appreciate and respect old age. Take care of and love your elderly relatives. Since older people are especially vulnerable, you should not offend them. It is necessary to show more patience and care in dealing with them. And if symptoms of depression occur, take immediate measures to eliminate them.
In more late period Senile depression is characterized by sleep disorders, expressed in difficulties falling asleep or waking up early, which also does not have the best effect on well-being during the day.
Women are more susceptible to involutional depression, and the appearance of its first signs may occur earlier than old age. After all, for psychiatry, the onset of old age is considered to be from 60 years of age.
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In addition, it was found that frequent emotional stress in combination with cardiovascular diseases and endocrine system, as well as with ailments of the musculoskeletal system, aggravate the situation and contribute to the early development of involutional depression.
How can an elderly person get out of depression?
There is no need to attribute your condition to age, and young people should be more attentive to their older relatives. After all, when the first symptoms of depression in old age appear, it is quite possible to cope with this mental illness on your own. It is very important not to deprive an elderly person of attention, to help him acquire some kind of hobby, even better involving communication in a group of his peers. Remember the “Buranovsky Babushki”, do they look like people with senile depression?! You should pay attention to the nutrition of older people. Remove salted and fried meat products from the table! The menu should include dairy products and fish, consisting of easily digestible proteins. These products are needed to provide the body of an elderly person not only with valuable minerals, calcium, magnesium, and, but also D, which ensures normal mineral metabolism. Many older people do not receive this valuable vitamin for a number of reasons, which not only affects the musculoskeletal system, but also develops depression and dementia. During periods of low solar activity or if there are contraindications for an elderly person to be in the sun, you can use it. For example, vitamin complex"Osteo-Vit" contains not only vitamin D, but vitamin B6, which restores the nerve endings of nerve fibers and has an analgesic effect. And drone brood is not only a bioflavonoid and a supplier of many substances valuable for health to the body, but also a means of maintaining the hormonal levels of an elderly person, under whose protection many processes in the body are.
Vegetables and fruits are no less important in the diet of an elderly person. After all, they are rich in antioxidant vitamins that prevent oxidative stress, which accelerates the aging of the body and causes a whole bunch of pathologies, including mental ones. One bad thing is that now it is quite difficult to find natural plant products, and you can only trust those that are grown with your own hands. But that’s not a problem either! Improve overall physical state The vitamin complex "Apitonus P" will help, containing three powerful antioxidants - dihydroquercetin, recognized to this day as a reference, vitamin C and vitamin E, which prevent rapid aging of the body and bioflavonoids - and pollen (bee pollen), which maintains the overall tone of the body and improves mood , helping to increase the adaptive capabilities of the body.
If you begin to notice that your elderly loved one often complains about memory, frequent headaches or high blood pressure. Buy natural “Memo-Vit” for the brain, containing red stem buckwheat, which helps improve cerebral circulation, and rose hips, which no known fruit or vegetable can compete with in terms of vitamin C content. And if the cause of senile depression is Alzheimer's disease, then along with vitamins you can also use natural preparations containing hops. This medicinal culture helps improve cerebral circulation and promotes a healthy night's sleep.
Read also: Why does love pass? How to avoid disappointment in relationships?
Do not feed your elderly relatives synthetic antidepressants and sleeping pills, because it is very difficult for an elderly body to overcome withdrawal symptoms. Therefore, if you have signs of involutional depression, use only time-tested herbal preparations “Valerian P” or “Motherwort P”! But a greater effect can be obtained from the herbal preparation “Nervo-Vit”, produced on the basis of the best collection of sedative herbs, including a natural anxiolytic and antidepressant that reduces anxiety and irritability, and improves sleep. roots and rhizomes have shown that its effect is up to 10 times higher than that of valerian! And vitamin C, which is included in the composition, not only enhances the effect of blue cyanosis, motherwort, valerian and lemon balm, providing a quick and long-lasting sedative effect, but also increases the body's stress resistance to various stress factors. By the way, blue cyanosis is not only an excellent herbal sedative! Previously it was used as a remedy to treat diseases respiratory system, including when bronchial asthma and tuberculosis, and it has now been established that this is also a real help for patients with cancer.
Many have heard about the unique properties of St. John's wort - “a healer for 99 ailments.” But not everyone knows that the flavonoid-rich herb St. John's wort is an excellent antidepressant! Produced on its basis herbal preparation"St. John's wort P", in which the effect of plant flavonoids from St. John's wort is enhanced by vitamin C, a powerful antioxidant.
In the recommended natural remedies, all the healing properties of herbs are preserved in the form in which nature gave them to us! This is thanks innovative technology at ultra-low temperatures, called “Secrets of Longevity”. And the convenient tablet form will help you get a quick effect and save time!
This is how we can help an elderly person get out of depression and live a quality life. And do not forget that only those who live an active life and participate in family affairs and, along with young people, solve common problems can avoid involutional depression! Old age approaches quickly and almost imperceptibly. Take our tips to help protect yourself from senile depression.
Senile depression: symptoms and treatment
Depression observed very often in old age. We can say that this is the most common disease in people over 55 years of age. According to the World Health Organization, depressive symptoms occur in 40% of elderly patients who consulted a doctor due to various diseases. Women suffer from depression twice as often as men, and in women it most often develops at the age of 50 - 60 years, in men at 55 - 65 years.
Home The cause of the development of depressive disorders at this age is the situation of one’s own aging- increasing physical weakness, difficulties in self-care, difficulties in communication due to severe weakening of vision and hearing, loneliness. In addition, old age is rich in various losses, for example, grief over the death of a loved one, the possible illness of a spouse, separation from children, loss of work and loss of social status. Such events occur more often in the second half of life than in the first.
In old age, the adaptive capabilities of the body as a whole decrease, activity decreases, emotional resonance decreases, and stubbornness increases. Older people are beginning to pay more and more attention to their feelings and are overly concerned about their health. It has been established that only about half of older people have an adequate attitude towards their physical condition, one quarter has an overestimation, and the other has an overestimation of a perverted, hypochondriacal nature. Patients are absorbed in the internal workings of their body and are convinced that they have a serious illness. Over the years, the number of experienced illnesses, operations, accidents accumulates, and it is easier to feel sick and in danger. Excessive hypochondriacal preoccupation is often provoked by an exaggerated idea of what activity was previously and what it has become due to physical limitations with age. The unpleasant sensations that appear in the body distract from the outside world and increase turning inward. In general, the older a person is, the less worthwhile things he has to do, nothing distracts him from thinking about himself, and it is easier to notice and talk about minor violations and manifestations.
Elderly people are often oppressed by thoughts about what they missed in the past, remorse, and loneliness. They experience a painful feeling of emptiness and uselessness. Everything that happens before your eyes seems insignificant and uninteresting. Attempts to support and reassure seem to such a person insincere, stupid, empty and often have the opposite effect.
Depression usually develops slowly, although it can also develop acutely, when a decrease in mood is preceded by a sudden mental trauma or acute illness. Depression, unfounded or exaggerated fears for one’s health, the condition of loved ones, and material well-being appear and increase. Attachment to relatives and friends weakens, social connections decrease.
A familiar picture: an old woman sitting alone on a bench in the yard - a mournful pose, her gaze directed into nowhere, the corners of her mouth downcast, her facial folds emphasized - her whole appearance speaks of deep sadness. Talking to such people reinforces the idea that they have a mood disorder.
Essential in the experiences of an elderly person is a painful rejection of one’s own aging, both in its physical and social expression. The loneliness he complains about is of the nature of “loneliness in a crowd.” Impressionability, suspiciousness, vulnerability, pedantry, a tendency to anxious fears, self-accusation and self-abasement increase.
In some cases picture of late depression is defined by a gloomy, grouchy, irritable mood with grumbling and outbursts of discontent over the most insignificant occasion (grumpy depression). As a rule, complaints about a bad mood can only be heard when questioned. Neither the patient nor relatives seek medical help, treatment is rejected. However, the essential thing remains that such experiences are painful for the elderly and turn them into suffering people.
Depression in old age is characterized by a combination of anxiety and sadness. Anxiety is pointless in nature, devoid of specific content or filled with vague gloomy forebodings and the expectation of all sorts of misfortunes. It is especially intensified in the evening and night hours. Patients sob, lament, moan, look around in confusion, wander confusedly or rush around the room. An anxious and melancholy state is combined with slow, inexpressive speech, lethargy, and inactivity. An elderly person is confident in the hopelessness of his situation, it seems to him that depression will last forever, it seems that life has never been and will never be different (nothing pleases or gives pleasure). A typical complaint is the painful feeling of emptiness of today. Everything seems insignificant, uninteresting, the future does not bring anything positive. Patients spend most of the day in bed, are not interested in what is happening around them, and neglect the rules of personal hygiene. Often such patients say: I torture my relatives, they will be better off without me.
In these cases, the risk of suicide is especially high, associated with ideas of self-blame, feelings of hopelessness, hopelessness and loneliness. Awareness of one's own insolvency, the inability to adapt to changing living conditions, and family and household conflicts pushes an elderly person to commit suicide. Suicidal thoughts are especially common in older people when depression is combined with a severe chronic somatic illness. Patients can hide thoughts of suicide for a long time and dissimulate suicidal tendencies. Careful questioning helps to detect the patient’s desire to end his life: does he feel that life has lost its meaning; does he have a desire, when he goes to bed in the evening, not to wake up in the morning, does he dream of death as a result of an accident, how does he feel about the possibility of ending all his suffering at once.
Often, with late depression, complaints of poor memory, disorientation, and difficulty concentrating come to the fore. However, these mnestic-intellectual disorders are not a sign of dementia and are reversible. It is possible to differentiate depression with symptoms of pseudodementia from true dementia on the basis of the signs presented in the table (L. J. Cohen, 1999).
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Options mental state |
Depression |
Dementia |
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Behavior |
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Sleep disorders are always present in the picture of late depression. Symptoms of insomnia include interrupted sleep at night and early awakening with poor health in the morning. Contrary to popular myth, older people need as much sleep as they did when they were younger, if not more. What's more, many older people like to nod off in their chairs while they're awake, a habit that can interfere with what's called a good night's sleep.
To the oldest person, his mood may seem normal and quite natural. Thoughts about psychological help or taking medications are categorically rejected by these people. Patients complain not so much of a bad mood as of feeling sick. Relatives are surprised when they are told that this type of mood can be regarded as a mental disorder. In these cases, they say that depression is hidden under the guise of a somatic (physical) illness. Diagnosis of these conditions is especially difficult, since somatic complaints and various functional disorders make general practitioners suspect the presence of age-related disorders in the functioning of internal organs.
On the other hand, old people often hear from others: “What do you want at your age?” However, the presence of reversible impairments in memory, attention, and intellectual disability in depression emphasizes the importance of early detection and timely treatment of these conditions.
Various psychometric scales for assessing depression help detect depressive disorder. To identify depressive symptoms, the most widely used are: Hospital Anxiety and Depression Scale (HADS) (Zigmond A. S., Snaith R. P., 1983), Beck Depression Scale, Zung Depression Self-Rating Scale. These scales are completed by patients themselves and are subjective. The Hamilton Depression Rating Scale (HDRS) (Hamilton M., 1967) and the Manngomery-Asberg Depression Rating Scale (MADRS) (Montgomery S.A., Asberg M., 1979) are more often used to assess the severity and dynamics of depressive disorder. They are filled out by researchers and then called objective. Despite great value scales in identifying and assessing depression, the decisive role in diagnosis belongs to a medical specialist.
Besides compulsory treatment antidepressants (see antidepressants) patients with late depression need psychotherapeutic help.
Advice like “get busy and it will become easier, pull yourself up, don’t be sad, smile” is not only not effective, but, on the contrary, aggravates the condition of a depressed patient even worse.
Therapeutic activities should direct the patient to receive pleasure. Older people should be encouraged to establish new social relationships and re-establish old ones, and to rekindle or develop new interests in games, home activities, and church. Active participation in mutual assistance and the lives of other people has a beneficial effect. It is important to highlight past achievements and positive interactions, reassure and instill hope, gradually changing motivations from the desire to die to the desire to live.
And it is no coincidence that patients in a hospital or sanatorium feel more comfortable than at home. Here they have their own company, there is no loneliness: they walk, knit, just talk, find understanding, do not feel like a burden to their loved ones, and take a break from problems at home. Gradually the desire to live, to be useful returns, I want to help my children with something. A philosophical attitude comes to life: it doesn’t matter, if your health worsens again, there is hope for help, depression used to go away and now it will pass.
Psychotherapy for older people has its difficulties and advantages associated with age-related mental changes. The use of modern psychopharmacotherapy requires special attention and caution. Together, they make it possible to effectively combat depressive disorders in old age.
Depression affects older people differently than younger people. In older adults, depression often occurs in conjunction with other medical illnesses and disorders and lasts longer.
Depression in older adults is associated with an increased risk of heart disease and an increased risk of death from disease. At the same time, depression reduces the elderly person's ability to rehabilitate. Studies of nursing home patients with physical illnesses have shown that having depression significantly increases the likelihood of dying from these illnesses.
Using a series of standard questions, the primary care physician medical care may provide effective screening for depression, allowing for improved diagnosis and treatment. Doctors are advised to regularly screen for depression. This may occur during a visit for a chronic condition or when visiting health center.
Depression also increases the risk of suicide, especially among older white men. The suicide rate among people aged 80 to 84 is more than twice that of the general population. National Institute Mental Health Services considers depression in people aged 65 years and older to be a major public health problem.
Besides, elderly age often accompanied by loss of social support systems due to the death of a spouse or siblings, retirement, or residential relocation. Because of changes in the older person's circumstances and the fact that older people expect it to slow down, doctors and family members may miss signs of depression. As a result, effective treatment is often delayed, leaving many older adults unnecessarily struggling with depression.
Symptoms of depression in old age
At the everyday level, we hand out “diagnoses” quite easily: “Our grandfather thinks that life is useless and no one needs him. He's depressed! “Grandma, why do you always have a gloomy expression on your face? Well, definitely depression!” “The old lady next door is sad all the time and complains about life. It's definitely depression." It often seems to us that older people are a priori in a bad mood, often sad and dissatisfied with everything.
It is generally accepted that all these are not signs of an incipient disease, but just features of old age. Meanwhile, gerontologists confidently assert that depression during this period can be life-threatening, because the wear and tear of the body’s defense mechanisms in older people practically does not allow them to cope with the disease on their own.
Therefore, it is so important not to miss the first alarm calls about a change in the well-being of a loved one. A disease such as depression, identified in the initial stages, is treated much more effectively, quickly and easily. Remember: being attentive to your loved ones will help prevent the development of a serious illness by starting treatment on time and prevent sad consequences.
One of the main signs by which depression can be recognized in older people is the so-called “depressive triad”:
- persistently depressed mood up to the complete inability to experience positive emotions, when absolutely everything that happens in life is seen only in black terms;
- persistently reduced motor activity, including the inability to exist in a previously familiar rhythm, quickly onset fatigue up to complete absence not only initiatives, but also any incentives to action at all. Old people often have problems with movement, disorientation in space;
- a steady decrease in the intensity of cognitive processes: difficulty concentrating, weakening of memory, depletion of imagination. In older people it may be accompanied by dementia.
Other symptoms of aging depression include:
- feeling of loss of meaning in life;
- feeling of uselessness;
- low self-esteem;
- changing old habits;
- lack of interest in events happening around;
- lack of desire to do what you love (for example, a hobby);
- insomnia or, conversely, increased periods of sleep;
- irritability;
- suspicion;
- aggressiveness;
- tearfulness;
- suicidal intentions;
- disregard for hygiene rules;
- the occurrence of psychosomatic diseases.
To completely get rid of this disease, a combination of drug treatment and serious work with a psychologist or psychotherapist is necessary.
It is noteworthy that in adulthood such conditions are observed much more often than is commonly believed. Many experts prove that this disease is diagnosed most often in people over 55 years of age. Society pays little attention to this issue, they try to turn a blind eye, but the problem does not go away.
Let's start with how the disease manifests itself. Depression can “mature” in a person slowly and gradually, driving him into a corner every day. It may also happen that seemingly healthy and optimistic people suddenly fall into an irritable state. The reason in this case may lie in a sudden shock, psychological trauma, illness.
It’s as if the patient’s eyes open, and he suddenly realizes how old he is, how weak he is. Important symptom depression - reluctance to communicate. A person becomes immersed in himself, attachment to friends and loved ones weakens. At this moment, the patient is almost always in a thoughtful state, speaks little, is reluctant to make contact, and craves solitude and peace. Significant symptoms of senile depression include vulnerability, impressionability, increased anxiety, and self-flagellation.
For some, the disease manifests itself differently. A person withdraws into himself, but the world around him still excites him. Such people become intolerable grumblers and critics. They are constantly unhappy, crave attention and want to teach everyone. The person refuses any help; relatives consider this a sign of harm. But the fact remains that deep down the patient suffers greatly.
continuation
Additionally, depression may express itself through physical complaints rather than traditional symptoms. This delays appropriate treatment. In addition, depressed older adults may not report their depression because they mistakenly believe there is no hope of help.
Older adults may also be reluctant to take their medications due to side effects or cost. In addition, the presence of certain other diseases at the same time as depression may affect the effectiveness of antidepressants. Alcoholism and other substance abuse can cause or worsen depression and interfere with effective treatment.
The main reason
The main reason is that people have a hard time aging. This is the main point that is confusing. We all understand perfectly well that old age is inevitable, but what is it like to see your decline every day? Many people find it very difficult to get used to the idea of “autumn” in their lives. There are many striking examples in the world of celebrities.
These people are used to being visible, being liked, and being admired. They perceive aging, as well as loss of popularity, very painfully. It takes a lot of effort to go into the shadows when the need comes, but it’s even harder to stay in sight and catch disappointed glances and disgust. The same thing happens to ordinary people who are used to enjoying their image, seeing young skin, and feeling a healthy body.
In addition to the main and associated causes which we have described, there are also additional social aspects that are present in the life of every second person and have a strong influence on him. Depression in old age can occur due to the death or illness of a spouse, separation from children, loss of work and social status.
It seems that this is quite normal, but these moments, along with what we listed above, have a pressing effect on a person, which can only be resisted consciously. To do this, you need to analyze and accept the situation, and then direct your thoughts and actions in a certain direction. The situation is aggravated by the fact that all events occur almost simultaneously, not allowing the person to come to his senses and come to his senses.
We have already mentioned the main reason. This is a significant decrease in social connections, falling out of society. Man is a social being, develops and feels comfortable in the presence good relations with others, a sense of personal relevance and involvement in something larger than himself.
When there are no such opportunities or they are sharply reduced after retirement, the feeling of uselessness and detachment from what is happening around causes negative internal states akin to depression. It seems that life is passing you by, and you are no longer busy. But how can this be? After all, only recently everything was completely different. It can be very difficult to cope with such change. Especially if your relatives do not understand your experiences or there are almost no loved ones.
Losing the opportunity to use your abilities and talents at any age reduces your quality of life. We want to feel useful, needed, to use what is inherent in us by nature, enjoying the process, and get results. The formula for dissatisfaction is simple: I want it and I don’t get it. I want to realize myself in society, but I have lost this opportunity.
Some reasons bad conditions depend on the partial or complete loss of what are life values for a particular person.
For example, financial well-being. Nobody wants to survive on a small pension or be completely dependent on children. But if a person has always been ambitious, aimed at success and profit, had business acumen, and strived for material superiority, then a sharp decline income after retirement is especially painful for him. This is perceived as a decrease in social status.
Or a person who has worked faithfully in his profession for many years. Over his long working history, he became a true master of his craft, honed his skills, gained authority and respect from his colleagues. Maybe he was one of the best. And now his experience has become unnecessary? He gave so much effort and effort for the benefit of the common cause, but what next? Very disappointing. It would be good if they at least thanked you for your long, conscientious work.
Lack of communication and emotional connections with other people is one of the main causes of depression in old people, regardless of their psychological characteristics. What do you think motivates older people to start conversations with strangers in transport, a store or a clinic?
Sometimes the experiences of aging differ for men and women.
- A man is usually primarily focused on social fulfillment. He is used to being the breadwinner in the family, providing for his wife and children, having a certain weight in society, and being the master of his own life. Therefore, depression in older men may be associated with the loss of a leading role in the family, in the team, and with an awareness of one’s own dependence.
- For most women, fulfillment in couples and in the family is more important than professional and social fulfillment. They experience failures in the personal sphere much more difficult. The lack of warm family relationships and attention from children and grandchildren can lead a woman to think that somewhere she, as a mother, failed, failed. Or things didn’t work out with the family at all. This is one of the main causes of depression in older women.
Although there is no strict division, both aspects are important in the lives of both men and women.
How is insomnia linked to depression in older adults?
Insomnia is usually a symptom of depression. New research shows that insomnia is also a risk factor for the onset and recurrence of depression, especially in older people.
To treat insomnia, experts sometimes recommend avoiding or minimizing exposure to benzodiazepines (such as Ativan, Klonopin, or Xanax) or newer "sleep aid" drugs (such as Ambien or Lunesta), which, according to the American Geriatrics Society, pose an increased risk for impaired vigilance. respiratory depression and falls.
Geriatric experts often favor treating insomnia in the elderly with the hormone melatonin or the low-dose tricyclic antidepressant drug doxepin (Silenor). Other potentially sedating antidepressants, such as Remeron or trazodone, are also sometimes prescribed for both purposes.
Related Issues
Depression in old age is scary not only because of the awareness that a person is aging. Thinking about it and feeling sad is not the worst thing. A number of problems have a great influence on a person’s emotional state. Firstly, this is physical weakness. It is especially difficult for men and those who are used to feeling cheerful, strong, active person.
For women, physical weakness is easier, but their own shock causes a much stronger shock. appearance. This is understandable, because it is very unpleasant to see signs of old age creeping up so unexpectedly. Women lose their former attractiveness, their eyes fade, their once seductive forms fade, and their health fails.
The second problem is related to the fact that with some diseases and simply with severe weakness, a person cannot do without outside help, that is, he experiences certain difficulties with self-care. As we have already understood, the greatest impact on a person’s condition is the loss of that quality in which he was always confident.
For women it is beauty, for athletes it is strength and agility, etc. The inability to take care of yourself on your own is a great stress for all people, regardless of their character. Some are accustomed to proud loneliness, some are embarrassed for themselves, and some do not want to be pitied. Each individual sees this situation in his own way and finds his own reasons, but the result from persistent negative thoughts is always the same - severe depressive disorder.
The third group of reasons is the loss of the ability to see and hear. For many this is a real disaster. Loss of self-orientation deprives a person of self-confidence. All that remains is dependence on others. It is not surprising that this is difficult for people who are used to leading an independent life.
Treatment of depression in older people is carried out with antidepressants and requires surgical intervention specialists. Often close people think that they understand what is going on, know their loved one well and are able to help him themselves. At the same time, everyone makes the same mistake. For some reason, many people tend to think that depression occurs due to the fact that a person is not busy with anything.
People simply ignore the fact that half the population has hidden depression. This half are healthy young people who go to work every day, communicate with friends, and raise children. Close people begin to motivate the patient to do some activities to distract himself, try to cheer him up and make him smile.
All this is useless, because the person is confused, he does not understand himself or the world around him. All he needs to be happy at this stage is to understand himself, accept himself and find his place. Encouraging only angers the patient because it distracts him from trying to find a new point of support. But you shouldn’t leave your loved one completely alone, giving them time to think, as this may be perceived as an attempt to distance themselves.
Treatment for depression in older people involves working with a psychotherapist. The goal of such therapy is to gain pleasure from life. When working with a specialist, a person learns to accept himself and his new characteristics. As a result, he wants to communicate with people like him. This helps the patient make new social contacts and communicate with those who understand him.
Selfless help has a positive effect in treatment. By helping, a person receives gratitude and appreciation for nothing, and this is exactly what everyone at an advanced age lacks. An important stage of psychotherapeutic treatment is the formation of a good-natured view of the world. A person must learn to see the good not only in his current situation, but also in his entire life. We must understand that everyone has had failures, defeats and mistakes.
Senile depression, the symptoms and treatment of which are interrelated, is especially effectively treated in sanatoriums. Many do not want to visit them and refuse, but in vain. Here patients are surrounded by people like them. Women are starting to go out evening walks, remember their handicraft skills, and hang out with their girlfriends in the evenings. Men master board games, happily share their impressions with friends, brag about their achievements and get into arguments.
There are several treatment options for depression. These include medicine, psychotherapy or counseling, or electroconvulsive therapy, or other new forms of brain stimulation (such as repetitive transcranial magnetic stimulation (rTMS)). Sometimes a combination of these treatments may be used. The choices a doctor may recommend depend on the type and severity of depressive symptoms, previous treatments, and other medical conditions a person may have, among other factors.
The stigma associated with mental illness and psychiatric treatment is even stronger among older people than among younger people. This stigma can prevent older adults from admitting they are depressed, even to themselves. Older adults and their families may also sometimes misidentify symptoms of depression as “normal” reactions to life stresses, losses, or the aging process.
What are the risk factors for depression in older adults?
With timely treatment, senile depression can be successfully cured. Information about the risks of relapse is indicated in the diagram.
Factors that increase the risk of depression in older adults include:
- Be a woman
- Being single, unmarried, divorced or widowed
- Lack of support social network
- Stressful life events
Physical conditions such as stroke, hypertension, atrial fibrillation, diabetes, cancer, dementia and chronic pain further increase the risk of depression. In addition, the following risk factors for depression are often observed in older adults:
- Certain medications or combination of medications
- Damage to body image (from amputation, cancer surgery, or heart attack)
- Family history of major depressive disorder
- Fear of death
- Living alone, social isolation
- Other diseases
- Past suicide attempt
- The presence of chronic or severe pain
- Previous history of depression
- Recent loss of a loved one
- Alcohol or drug abuse
Brain scans of people who develop their first depression in old age often reveal spots in the brain that may not be receiving adequate blood flow, thought to be the result of years of high blood pressure. Chemical changes in these brain cells can increase the likelihood of depression separate from any life stress.
What's going on?
In order to understand how to get rid of depression in old age, you need to understand what is happening. Elderly people adapt worse and more slowly to environmental conditions. In our youth, each of us is full of strength and ready for anything; we quickly get used to even negativity, learn to relieve stress, and find ways out of different situations.
Depression in old age occurs partly due to the fact that a person’s adaptive capabilities are significantly reduced. He rejects and refuses to accept everything new and incomprehensible. He believes only what he knows himself, what is already familiar to him. Emotional resonance with other people decreases. An elderly person is more focused on himself, he refuses to understand and analyze the feelings of other people, it seems to him that the whole world is watching him grow old, smiling furtively. Against this background, stubbornness and a desire to do things your own way grows. A person immerses himself in his emotional state.
It has been noticed that more than half of old people overestimate the complexity of the situation in terms of health, showing unnecessary care. For some it is hypochondriacal in nature. Many people believe that they have a terrible, incurable disease. Over many years of our lives, we witness a number of accidents and illnesses.
In old age, all this is transferred to oneself, the person feels very vulnerable. Obsessive thoughts are accompanied by body pain or physical weakness. All this distracts a person from really necessary things, and he is completely immersed in thoughts, which most often lead to depression in older people. Treatment here requires thoughtful and safe treatment, because it is very important not to aggravate the situation.
Loneliness and analysis of past years
Senile depression is characterized by the fact that a person feels complete loneliness and isolation from the world. At the same time, he sees children and youth whose lives are just beginning, with many new discoveries ahead of them. This aggravates the situation and makes it difficult to survive the crisis. Proper treatment changes a person's perspective and reaction to it. Communication with young people begins to inspire, not depress.
During a crisis, a person begins to analyze his past, remember the bad and the good. I remember everything, but thoughts in the early stages of the disease focus on what was missed and not done. Constantly thinking about it, a person becomes dependent on these thoughts. Later, he already believes that if he had acted differently in some situation, his life would have turned out completely differently.
At this stage, a person may begin to blame his loved ones, children, or spouse for his problems. It comes to absurd thoughts that someone else is to blame for his old age, that she is not natural process. Real life ceases to interest the patient, everything seems too insignificant and unimportant to him in comparison with the internal experiences that he cherishes within himself.
Support in such cases must be provided very carefully, because it is often perceived as pity and rejected.
How do antidepressants relieve depression in older people?
Research has shown that while antidepressants may be helpful in older people, they may not always be as effective as in younger patients. In addition, the risk of side effects or potential reactions with other medications should be carefully considered. For example, some older antidepressants, such as amitriptyline and imipramine, may cause sedation, confusion, or sudden collapse blood pressure when a person gets up. This can lead to falls and fractures.
Antidepressants may take longer to work in older people than in younger people. Because older people are more sensitive to medications, doctors may prescribe lower doses initially. Typically, the duration of treatment for depression in older people is longer than in younger patients.
Most people with depression find support from family and friends, participation in self-help and support groups, and psychotherapy helpful. Psychotherapy is especially helpful for those who have experienced major life stresses (such as loss of friends and family, home relocation, and health problems) or who choose not to take medications and have mild to moderate symptoms.
Psychotherapy in older adults can address a wide range of functional and social consequences depression. Many doctors recommend using psychotherapy in combination with antidepressants.
Psychological assistance to older people is rightly considered a necessary condition their comfortable existence and wellness. In most modern nursing homes, a psychologist regularly works with residents. Trustful atmosphere warm relations between the elderly and medical and service personnel greatly contribute to getting rid of depression.
Few of us know how to communicate with an older person so that he feels supported and cared for, especially if he is depressed. Meanwhile, everything is very simple. The ability to listen, ask the right questions that demonstrate a sincere interest in a person’s life, empathy and sympathy help to recognize the symptoms of depression in time and prevent its development.
Ask your old people about their childhood, parents, grandparents, let them remember funny incidents from their school or student life. Find out if they had a nanny, if they remember the name of the neighbor’s crybaby girl, if they went to the dacha with the kindergarten (usually this was a real adventure for children of that time).
Who was your best friend at school? Let them talk about their first love, about their first teacher, about their performances on stage, about trips to the collective farm, about the team at their first job. Look at the photos together, be interested, find out who is standing next to you, what holiday it is, in what city the photo was taken.
A person suffering from depression needs immediate medical attention.
Depending on the severity of the clinical picture, you should contact:
- psychologist;
- psychotherapist;
- psychiatrist.
In 75% of cases, elderly patients suffering from depression are treated with medications. For major depressive disorder, a combination of psychotherapy and antidepressants is recommended. This approach helps reduce the risk of relapse.
Depressive disorder is very difficult to diagnose. Analyzes show only the physical condition of the patient’s body.
The main methods for identifying depression in older people include:
- Beck scale;
- Hospital Anxiety and Depression Scale;
- Zung scale;
- Hamilton scale;
- Manngomery-Asberg scale.
To the most effective methods diagnostics include taking an anamnesis and talking with the patient. The doctor asks the patient questions regarding the frequency of anxiety and obsessions. The conversation is conducted in a relaxed format.
The method is prescribed against the background of the inability to take medicines. The main task is to disrupt connections formed against the background of a hyperactive exchange of signals from different parts of the brain.
The main indication is depression, during which a person has repeatedly attempted to injure himself or take his own life.
During therapy, an electric current is passed through the patient's brain. Its strength varies from 200 to 1600 milliamps. The current voltage is 70-400 Volts.
Therapeutic effect due to state of shock patient, which occurs during seizures. The recommended number of sessions is 12-20.
Diagnostics
Depression in older people, the treatment of which we will consider below, is defined quite simply. It seems that just observing is enough to understand how things are, but this is an unscientific approach. There are special scales for diagnosing the disease. There are many different variations, but they help determine the stage of the disease.
The advantages of such scales are that you don’t need to “dig” into a person too deeply, force him to answer personal and even intimate issues. Depression in older people (treatment discussed in the article) manifests itself in answers to the most simple and everyday questions. Despite the fact that scales are very important in determining the severity of the disease, the key role is given to a specialist who makes a diagnosis not only after a series of tests, but also after personal communication with the patient. The Beck Depression Scale, the Zung Depression Scale, and the Hospital Depression and Anxiety Scale are widely used.
Features of drug therapy
est can play important role in the treatment of depression in older people. When older patients are unable to take traditional antidepressants because of side effects or interactions with other medications, when the depression is very severe and interferes with basic daily functioning (such as eating, bathing, and grooming), or when the risk of suicide is particularly high, ECT is often an option. safe and effective treatment option.
Elderly people are prescribed antidepressants. They should be taken with great caution and only under the supervision of a doctor. Many drugs in this group contribute to cognitive depression and cause side effects.
| Group of drugs | abbreviation | Description | When does the effect occur? | Side effects |
 | TCA. | Helps increase the concentration of serotonin and norepinephrine in the brain. The effect can be both sedative and stimulating. | 20 days after the start of use. | An overdose can cause death. |
 | MAOI. | Prescribed for atypical depressive disorder, after a course of TCAs. They have a stimulating effect. Helps block monoamine oxidase contained in nerve endings. | 15-20 days after the start of treatment. | - |
 | SSRIs. | Stimulates the supply of serotonin to the brain, which regulates mood. | 10-15 days after the start of treatment. | Drugs in this group are not recommended for people with bipolar depressive disorder. Otherwise they develop manic states. SSRIs can also have a negative effect on erectile function. |
The chart shows the most effective tricyclic antidepressants.
The most effective drugs in this group are presented in the table.
| A drug | Description | Price |
 | Reversible inhibitor of MAO type A. Promotes activation of excitation transmission processes in the central nervous system. Recommended for minor depressive disorder, which is accompanied by hypochondriacal symptoms. | From 176 rubles. |
 | It has a psychostimulating and vegetostabilizing effect. May cause insomnia. | From 184 rubles. |
 | It has a thymoleptic effect and has a balanced effect on the central nervous system. | From 162 rubles. |
Late-life depression often recurs, and the risk of exacerbations increases. Against this background, the patient is prescribed SSRIs.
Table 7. The most effective SSRIs.
| A drug | Description | Price |
 | It is a derivative of propylamine. Improves mood, reduces feelings of fear and tension, helps eliminate dysphoria. | From 194 rubles. |
 | A powerful antidepressant that does not have a sedative effect. | From 371 rubles. |
 | Promotes enhancement of serotonergic transmission and reduces the overall circulation of serotonin. | 770 rubles. |
 | A modern antidepressant, effective in panic and depressive states. Allows you to stay active during the day. | From 219 rubles. |
Drugs in this group have a beneficial effect on brain function. Neurological deficits are reduced and cortico-subcortical connections are improved.
Nootropics also help improve cognitive functions. Recommended nootropics are listed in the chart.
Insomnia affects 89% of older people with depression. Sleeping pills help solve the problem of late falling asleep and frequent night awakenings.
How does senile depression manifest?
The use of medications in some cases is simply necessary. However, treating depression in older people with drugs has its own characteristics. The specialist must not only correctly prescribe a medicine that will reduce stress and anxiety, but also make sure that it does not harm other body systems.
In almost the vast majority of cases, psychotherapy with medication produces effective results. As a rule, patients are prescribed antidepressants. The downside is that they have many side effects. It is better to choose Western manufacturers, since their medicines are more effective and the side effects are very mild.
At the initial stage of treatment, tricyclic antidepressants (TCAs) are prescribed. If these don't help, your doctor may prescribe monoamine oxidase inhibitors. The most expensive drugs are selective inhibitors that act in a completely different way. Unlike antidepressants, they simply stimulate the brain to produce serotonin.
Senile depression, the symptoms of which we have examined, is an illness that can overtake anyone. To prevent this from happening, you should develop a positive outlook on the world in advance, enjoy the little things and understand your importance in the world.
Specific symptoms characterizing senile depression are presented in the table.
Table 3. Features of depression in the elderly.
| Symptom | Description |
 | It occurs against a background of anxiety and reaches a high degree. Sometimes it alternates with a state of lethargy, when a person becomes “stiff” and moves with great difficulty. Behavior becomes demonstrative, there is a “theatrical” touch. Gestures are bright and expressive. |
 | The most striking symptom is a feeling of guilt for mistakes that were made in the past. An obsessive thought arises that an inevitable punishment will follow for a mistake made. In addition to depression, some people develop hypochondriacal obsessions. |
 | The person is in a depressed, depressed state. The mood is almost always gloomy, the emotional resonance is reduced. |
 | Observed in 52% of cases. Memory deteriorates, attention decreases, and it becomes difficult for a person to perceive new information. |
 | Observed at the end of a depressive episode. They can be combined with somatovegetative symptoms such as insomnia and lack of appetite. |
The disorder is characterized by a persistent decrease in mood. Against this background, repeated depressive phases occur. This condition is called "double depression."
Symptoms similar to the initial manifestations of dementia appear:
- memory loss;
- disorientation;
- decreased attention.
There is no specific content, but bad feelings may arise. 80% of patients think that they will certainly die soon. There are usually no other health problems, but any discomfort looks in their eyes as a symptom of a serious disease. Such patients may be tormented by difficult dreams, which they interpret as a warning of imminent death.
In the evening and at night, anxiety intensifies. Gradually the melancholy grows. This condition is accompanied by:
- severe anxiety;
- slow speech;
- inactivity.
A person is confident that his condition is hopeless and often complains of a feeling of emptiness inside. Most of the time the patient is in bed, neglects hygiene, and is not interested in what is happening around him.
One of the main symptoms of depression in older women is headache. It can be either vague or quite severe, migraine-like. Occurrence somatic manifestations indicated in the diagram.
The main differences between depression and dementia are presented in the table.
Table 4. How is it different from dementia?
| Mental state parameters | Depressive disorder | Dementia |
| Affect | Worsening, depressive. Subjective distress is pronounced. | Labile, combined with irritability. There is no concern about the state of their health. |
| First stage | It develops rapidly and is sometimes dated with precision. There is a history of mental disorders. | It begins gradually, there is no time estimate. |
| Leakage | After the debut, symptoms increase quickly. Before asking for help specific signs"live" for a short time. | Symptoms develop slowly as the disease progresses. |
| Features of behavior | The person is indifferent, unable to respond to external stimuli. Social contacts are lost, the patient's behavior does not correspond to severe cognitive dysfunction. | The person becomes anxious and fussy. Some social contacts are retained. Increased dysfunction is observed in the evening and at night. |
| Complaints | There are multiple complaints. | Complaints of cognitive impairment may be absent. |
Against the background of constant anxiety, there is a risk of suicide. The main reasons for this terrible decision are indicated in the diagram.
Old age... When we are young, full of strength and health, it seems to us that this is not about us...
But time is merciless to everyone, we all come from childhood and we all, alas, grow old.
Old age is the autumn of life. It can be calm and warm, or it can be rainy, cold and damp.
Even in our youth, it doesn’t hurt for all of us to think about how we will approach our old age. With accumulated knowledge, wisdom and experience, in a good mood, or burdened with illnesses and problems.
Unfortunately, very often, especially after retirement, older people are left alone with their problems and illnesses. They often feel unclaimed and unwanted. It seems to many that life has already been lived and lived in vain. Plus poor health, lack of energy, lack of desires, feeling superfluous and alien at this celebration of life. If you notice these manifestations in yourself or in your loved ones, we may be talking about the development of depression.
Depression in late life is quite common. According to various authors, from 9 to 30% of retired people suffer from depression to one degree or another.
Women are three times more likely to experience depression than men. This is due, first of all, to the more subtle organization of the female psyche, greater emotional sensitivity compared to the stronger sex, and unstable hormonal levels during menopause.
Depression develops at any age period of aging, but most often those who have just retired are at risk: these are older people 60-75 years old.
Social connections are cut off, there is no need to rush to work, the circle of contacts narrows, more free time appears, and then there are various chronic diseases accumulated over a long life and, as a result, poor health. All this serves as factors that contribute to the development of emotional depression, melancholy and despair.
In old people, and these are age groups from 75 to 90 years, the frequency of development of depressive conditions in men and women is equalized and significantly reduced. This is due to fading physiological functions body and the transition to old age.
In very late old age - after 90 years, depression is extremely rare.Of course, these figures are very average and cannot serve as clear indicators. All people are very different, each of us lives our own individual life experiences, each has a different genetic predisposition and heredity.
In this article we'll talk about various depressive mental disorders during aging, how to avoid it and how to help such people.
Definition of the term and symptoms of depression in old age
Depression in old age is the most common mental illness. But it is often not so easy to diagnose.
Depression is a painful emotional condition in which a person experiences a state of depression, melancholy and despair. The range of interests and needs narrows, up to complete self-isolation and apathy. Bad mood, depression, lack of vitality and energy, insomnia, irritability, detachment and isolation, indifference and lack of interest in what is happening, obsessive thoughts about imminent death, reluctance to get out of bed in the morning - these are far from full list manifestations of this disease. A person becomes unhappy, shows no interest in the world around him, and completely withdraws into himself. This occurs due to feelings of abandonment and abandonment.
It happens the other way around old man shows irritability, dissatisfaction, complaints and even aggression towards others. Of course, it is difficult to be around such a person, but this only indicates that it is very difficult for him, he is sick and needs help and participation.
This is a serious mental disorder and most often an elderly person does not realize that he is sick and needs help. Old people mostly go to the doctor with various complaints on their physical condition, unaware that their physical ailments may be getting worse mental disorders due to various depressive conditions.
Causes of depression in old age
There can be many reasons for depression in the elderly, and everyone has their own, but the main ones include the following:
- Chronic severe illnesses and poor health;
- Reduced social activity and contacts;
- Loneliness, lack of interest from younger relatives and friends;
- Financial difficulties;
- Loss of a loved one.
Types of depression
There are several main types of depression in general, and in older people in particular:- Psychogenic depression is the most common and occurs due to any traumatic events in the psyche: the loss of a loved one, financial difficulties, relationship problems and other unfavorable events in life.
- Somatogenic depression occurs against the background of a severe or incurable disease, long-term pain syndrome and so on.
- Organic depression - occurs as a result of congenital or acquired lesions of the central nervous system, namely trauma, intoxication due to various diseases, vascular changes, etc.
- Endogenous depression occurs due to genetic predisposition.
- Iatrogenic depression is caused by long-term use of medications, and can also occur as a consequence of alcohol and drug addiction.
Consequences of depression
If senile depression is not treated and everything is left to chance, especially in old age, the consequences can be unpredictable and very dire. The disease can break a person mentally and physically, even to the point of suicide. A negative emotional state contributes to the emergence and development of incurable diseases, such as diabetes, myocardial infarction, various cancers, and other serious pathologies. Thoughts about imminent death and the meaninglessness of existence appear. The situation is complicated by an inadequate perception of reality and the fear of being recognized as mentally abnormal and being isolated. This can be a difficult ordeal for family and friends, and if the person is lonely, the situation becomes even more complicated. First of all, it is necessary to show generosity and condescension towards such a patient, because he is sick and needs help and treatment.
Treatment of depressive disorders in older people
First of all, we must remember that elderly and elderly people suffer from a lack of care and attention. They often simply lack communication, they suffer from loneliness, it is important for them to feel the support and interest of young people in the experience and knowledge they have accumulated. Elderly people need support, respect, care and attention from others.For single people, it is very important to be in a group, among like-minded people and friends. Communication about interests among peers is a good distraction from illness and negative thoughts.
In cities there are interest clubs for older people. Everyone can choose an activity to their liking. This could be joint travel, relaxation, sports, dancing, yoga, themed hikes interesting places, excursions, just walks in the park in the fresh air, discussion of social and political news, interesting films and books, board games, Mind games, such as checkers, chess. A very good effect comes from learning something new, for example learning a foreign language, or learning to play some musical instrument, starting to play computer games. It is important to find something you love, a hobby, set goals and make plans for the future, try to find the meaning and joy of life in your declining years. After retirement, there is a great opportunity to engage in self-development and self-improvement, study and practice various esoteric practices, healthy eating, and practice various methods of cleansing and healing the body. All this contributes to a positive attitude, active and creative longevity.
But if a person is deeply depressed, he often does not have the strength and energy to get out of this state. And then qualified assistance from a specialist is indicated, and in more serious cases, hospitalization.
In some cases it is enough drug treatment V outpatient setting. The drugs are selected by the doctor individually in each case and purchased at the pharmacy with a doctor's prescription.
There are a number of drugs that can alleviate the condition of such patients, relieve anxiety, improve sleep and mood, and calm the central nervous system. nervous system. These are sleeping pills, potent sedatives and antidepressants. Such drugs are prescribed with extreme caution, taking into account all contraindications, compatibility with other medications, and possible complications. This remains the sole prerogative of the doctor.
An important principle in the use of drug treatment is the prescription of 2-3 times lower doses of drugs compared to young and mature patients.
Good effect may be from use medicinal herbs and medicines developed by pharmacists based on them. The calming effect of valerian, lemon balm, motherwort, and hop cones has been known since ancient times. These herbs are used in the form of infusions and decoctions, prepared at home immediately before use. They are sold freely in pharmacies, as are alcoholic tinctures of valerian, motherwort, and hawthorn. These tinctures have a sedative effect, improve sleep, calm the heartbeat, and reduce tension in the heart muscle.
St. John's wort is known for its antidepressant properties. It improves mood, reduces anxiety, relieves anxiety. It can be used in the form of infusions and decoctions and purchased at the pharmacy. Preparations based on St. John's wort have also been developed.
Old age is a great opportunity to return to your carefree time, do what you love, find a hobby, and live for yourself. Use this time to enjoy life, love yourself, love life, love people and depression will never touch you!
