The general criteria for depression are the following: a pervasive feeling of sadness that lasts for at least a fortnight, is of a degree of intensity that it interferes with psychomotor functions such as sleeping, eating and libido, and disrupts normal daily activities such as social or professional functioning. However, according to the South African Depression and Anxiety Group (SADAG), it may manifest slightly differently in elderly people, with possible symptoms including insomnia, memory problems, confusion, irritability, withdrawal from social situations, and somatic ailments such as recurrent aches and pains.
There are a variety of factors that make seniors more vulnerable to depression. Here are a few of the most common causes:
Grief and loneliness
One of the major catalysts for depression in later life is bereavement and the loneliness and social isolation that often accompany the loss of close friends or loved ones. “Loneliness is one of the most dangerous plagues of old age,” says Syd Eckley, chairman of the South African Gerontological Society.
Psychologist Ian Lipman points out that grief is distinct from depression. “Grief is a normal reaction to losing someone close to you, and necessary in order to come out the other side – but the danger for those who lose a partner in old age is that they may not feel motivated to establish new connections,” he says.
To avoid grief sliding into full-blown depression, he urges bereaved elderly people to avoid withdrawing from the outside world completely. “Engaging with the wider world and things that inspire you is key to avoiding feelings of isolation and depression in old age, but people find meaning in different ways – it could be a weekly game of bridge, volunteering at the SPCA, or meeting with your church group.”
Health and medications
Physical decline is an unfortunate inevitability of old age, but lifestyle adjustments can go a long way towards keeping poor health at bay – particularly cutting out cigarettes, keeping alcohol to a minimum and engaging in gentle exercise such as walking or gardening.
Older people experiencing feelings of depression should discuss any medications they are taking with their doctor. Many prescription drugs can elicit depression, with those prescribed for pain, high blood pressure, and arthritis being prime culprits. An antidepressant medication can be helpful in alleviating the symptoms of depression. A GP or psychiatrist will be able to advise you on these, but be sure to fully disclose any other medications you are taking – both prescription and over-the-counter varieties.
Maltreatment of elderly people – in the form of abuse or neglect at home or in an old-age facility – is a widespread problem in South Africa, as well as abroad. If you are experiencing abuse in old age, or if you suspect or know of someone who is, there are organisations you can contact to help you.
• Action on Elder Abuse SA: 021-426-5526.
• SADAG runs a toll-free helpline, open seven days a week from 8am to 8pm. For free telephonic counselling and referrals, call 0800-20-50-26 or 0800-70-80-90, or send an SMS to 31393.
Antidepressants are available at Clicks. Take your prescription to the dispensary at a Clicks near you, and the pharmacist on duty will assist you with the appropriate medication.