Click on topic:       Depression      Depression Signs & Symptoms     Death, Bereavement & Grieving      Alzheimer's       Caregivers

In 1900, the number of older adults (65+)in the US population was about 12 %, but by 2050 is projected to be 20% of the US population. Our population is rapidly becoming proportionately older. Most people are aware that better nutrition and advances in medicine, including newer medications, are helping us live longer. This is good news! Still this good news about a potentially longer life needs to be viewed in relation to many of the realities that also do come with getting older. With age can come loss and degenerative changes, though there will be degrees of this and responses to these changes will differ according many factors: our personal styles, religious or spiritual beliefs, our attitudes, genetic make-up, family and community supports, and so forth. At any rate, each and every day we are all aging, and one day, each of us will fall into the " older adult category." Our choice can only be, no matter what our age or stage of life, how do we choose to live each and every day of our life, as we have only limited choice, if any, in the amount of time lived on this earth.

Have You Heard This Before?

Depression -- because of age -- is not a given and it is not normal, nor should it be accepted as a normal part of aging. No one should have to suffer from depression because of the myth that " depression comes with age." Depression is not a number (65 or 85), but is our brain’s response to either some powerful event (s) in our life or even a physiological response to changes that may be taking place within us. Depression can also be the result of a medical condition (e.g., hypothyroidism) or even medication. So if you are feeling somehow empty or sad or have lost interest in your usual activities daily for more than two weeks, then you need to have this evaluated by a mental health professional or your physician. I would recommend both a medical check-up (first) and seeing a mental health practitioner to screen you for depression and any other possible conditions. There is no need to live a life that is sad and without joy or happiness.

It is very difficult to overcome this kind of deep-seated belief because we hear our parents (even if no longer here) saying this to us (loyalty to our family) and because we often don’t want to be a burden to others (our children, a spouse). However, keeping your fears and feelings to yourself is a sad price to pay for the relief and joy you may experience with help from a professional, who can and will support you in feeling better. Also, because depression and anxiety was once misunderstood, and not realized to be caused by an imbalance in our brain chemistry – many people once saw psychological problems as something to hide or be ashamed of (a stigma). We know so much more today and can help people to suffer less or not at all through various therapies and newer medications.

Depression in the elderly has been accepted as normal, when in fact depression is not a normal part of aging. If someone is depressed, no matter what the age, then that person deserves evaluation and treatment.

Sometimes it is hard to detect depression in the elderly because many of the signs of depression can be masked by somatic complaints (stomach aches, backaches, diarrhea, and constipation.) An older person may focus and complain a lot about physical symptoms, not realizing that these are signs that the person is depressed.

If you are very sad or have no interest in anything (once enjoyed) or have no more pleasure for at least two weeks, you may be seriously depressed.

Signs & Symptoms of Depression

1) trouble falling asleep or staying asleep,

2) loss of appetite (lost weight) or your appetite has increased,

3) are agitated or slowed down,

4) feel worthless or excessively guilty,

5) are fatigued or tired all the time,

6) cannot think or concentrate or make a decision

If you cannot envision a future and feel hopeless about the future, then you need immediate help. If you are seriously thinking about suicide, and have the means and intention to carry it out, you must get help now. Call a friend or relative to take you to the emergency room now, or call a crisis center or 911 for help. Do not delay as you seriously need assessment and treatment now.  (See  If You're Suicidal.)                                                                                                                          [Top]

   The death of a loved one, a spouse and lifelong partner is a major loss for the one left behind. Bereavement is normal and in our culture we mourn the loss of the one we have loved and lived with for so long. There are many ways we mourn and cultural differences, as well as religious differences, but we have a period of mourning that involves friends and family and likely many comforting rituals. But once the other mourners and family and friends are gone, we are often left alone with our grief. We also often wonder how long is it normal to mourn – to grieve for the one we have shared so much of ourselves with for so many years of our life? Also, what will be there, and who will be there, in its place, when the grieving is done? Who or what can replace the loss and pain now felt for the deceased lifelong partner or spouse?

Each individual responds differently to the loss of a loved one based on so may factors, which include how important that person was to the one left behind, dependency needs, financial status, depth of the relationship (soulmate versus a companion), predisposition to depression, family closeness or supports, community and religious supports, beliefs about life after death, and so forth. So there is no magical number of months or years for grieving the loss or way to grieve. However, if after three months, a person is nonfunctional, preoccupied with feeling worthless, very slowed, unable to begin resuming some normal routines, or suicidal, then professional advice should be sought. This person may also be suffering from a major depression. This differs from periods of sadness over the memory of the dead person. It is reasonable to expect some difficult periods for a year or more when a spouse is lost late in life. Holidays and anniversaries will rekindle the sadness and the memories, as will some unexpected reminders. But these sad moments have sandwiched between them other moments of relatively normal feelings and functioning. In time, whatever that may be, the " pangs of sadness" come less often, although the memories never disappear. (Also see Loss and Grieving and Geropsychiatry in Bibliotherapy .)

No one can tell anyone how long they should or should not grieve – we are too individualistic and all relationships are different. But no one should have to suffer the pain of a serious depression that might be triggered from loss. Isolation, sleeping all the time, excessive alcohol intake, and withdrawal for more than 3 months suggests the need for professional help. As always, suicidal thoughts with intent and a plan require immediate help and a call to 911 (See If You’re Suicidal).

No one discussion about aging, various disorders, or death and dying, can include everything available. This discussion is meant to provide some information as a springboard to further reading or the seeking of professional help (medical/psychiatric) or reaching out to family, friends, or a support group, if needed.

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Alzheimer’s and dementia are very important topics for older adults ( and even younger adults) and their families and caregivers. There are many excellent resources available in the geropsychiatry/ gerontology section of the Bibliotherapy section – for those experiencing memory problems, Alzheimer’s/ Other Dementias, and for Caregivers who often suffer from burnout and Caregiver Burden.

Caregivers

A caregiver is usually the primary person responsible for the day-to-day physical and/or emotional care of an older parent -- and more often than not, this person is a female child of a parent. The caregiver is unable to realistically relinquish the other responsibilities within her own family, which may be wife, mother of own children -- and in this day and age, employee. So in some sense a " stacking" takes place, whereby, more and more responsibilities are placed upon this one person -- to the point of breaking. Caregivers need help and support in dealing with old, sick, and/or frail parents. And with older adults living even longer, we need to address " caregiver burden" and the needs of the caretakers as well as older members of our families.

If you are a distressed family member (a caregiver) who would like to talk with PsychOptions™  about someone under your care, please go to our Registration site or view our Rates/Types of Services.  Also see several helpful references in the bibliography section, Geropsychiatry/Caregivers  (see Bibliotherapy).

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If for some reason, you would still like to arrange for some on-going sessions ( go to Registration site) , I would be willing to work out some sessions at a reduced rate        (contact PsychOptions™  at: psychoptions@psychoptions.com to request an adjustment to your fee [ place Adjustment Request in the Subject line]), if in fact you are living on a fixed income. The first session or consultation, however, requires the fee for consultation (see Types of Services & Rates). Again, if in my judgement (based on information provided) I think you would be better served by a mental health provider, who provides services face to face and can directly assess you, I will advise you of this and discontinue our work together for your benefit. Please understand the limitations of the internet (sight/sound) and that more traditional services may be needed at some point and may be in your best interest.

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