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Home for the Holidays? Watch for Signs of Depression in Seniors
Kara Gavin, University of Michigan Health Systems
So you’re heading home to see Mom and Dad this holiday season—or maybe Aunt Sue or Grandpa George. If you’re like many Americans, it may have been weeks, months or even years since you’ve seen them last. And as they—and you—grow older, these holiday reunions grow more special each year.
The special pressures and interrupted routines of the holiday season can create an even greater risk of depression
But what if you notice that one of your older relatives isn’t quite their old self? That they’re more anxious, more irritable, less joyful or quieter than they once were? That they seem focused on talking about people who have died, or have lost interest in things that they used to enjoy—including holiday traditions and festivities?
It’s possible that these changes add up to signs of late-life depression, which may affect as many as one in seven seniors. It’s especially common among those who have suffered a serious physical problem, whether it’s a heart attack, cancer, lung disease, or problems with their hips and joints.
Helen C. Kales, M.D., a member of the University of Michigan Depression Center, hears this tale many times each year, from patients who come to see her after their family members notice a serious change in their behavior at the holidays and encourage them to seek help. As a geriatric psychiatrist who specializes in helping seniors cope with depression and other mental illness, Kales knows that it often takes the prompting of a family member to help an older person recognize their symptoms.
Seniors who have experienced mental health problems in the past, and those who have significant physical health problems that limit their lives, face the highest risk of developing late-life depression. But even otherwise healthy elders can find themselves feeling depressed after a serious blow like the death of a spouse, sibling or close friend, or the loss of their social network when they move to an assisted living facility or to live with relatives.
All of these “triggers,” as they are called, can combine with the special pressures and interrupted routines of the holiday season to create an even greater risk of depression during the holidays. Such feelings may pass as Christmas, Hanukkah and New Year’s Day fade into memory. Or, they can lead the person to develop more serious and prolonged depression lasting weeks or months. That’s when it’s important to get help.
So what can be done for a senior who develops temporary or more lasting depression? The easiest prescription, Kales says, is simply to get out of the house and connect with other people. “That’s actually a hard thing to do, because in depression people feel unmotivated, and feel like being isolated—but it can become a vicious cycle because the more they stay in and don’t connect with others, the worse they feel,” she explains. “They need to try to get over that hump, and get out there. And what I find is that they often feel much better once they’ve done it.”
Another easy way for seniors to confront those blues is to treat themselves to something they haven’t done or had in a while, like a nice dinner or a little present—especially at the holidays. And don’t forget exercise, no matter what form it takes, Kales adds. “We know that exercise causes all kinds of good hormones to be released, and for older people that can make depression lessen.”
Two Approaches Prove Effective
For those whose depression symptoms continue for weeks or months despite these measures, Kales emphasizes two things: counseling, also known as talk therapy, and medication.
Talk therapy, which can be done with the help of a psychologist, mental health social worker or psychiatrist, involves developing new ways of thinking about one’s situation—and confronting negative thoughts and moods. Seniors may conjure up a stereotype of going to a “shrink” as something that will make them recite their childhood feelings while lying on a couch—but that’s not the way it’s done these days at all, Kales says. Counseling, whether alone or in groups, has been proven to help people get better and stave off future bouts of depression.
When other approaches don’t do enough, older people may want to consider some of the modern antidepressants that have been introduced in the last two decades, Kales says. Ultimately, the choice of drug, and of dose, varies from person to person, and it may take patience to find something that works. It’s best if this trial-and-error process is guided by someone experienced in treating depression, or even someone who specializes in treating older people’s depression.
The bottom line is that families need to keep their eyes and ears open for signs of depression in older relatives, especially at the holidays when they have a chance to get together and spend some time. And if someone seems to need help, don’t be afraid to speak up and reach out.
The University of Michigan Depression Center is the first multi-disciplinary center dedicated to research, education, and treatment of depressive and bipolar illnesses. The Center brings together the world-class resources from the U-M Health System and almost all the U-M Schools and Colleges. The result: a unified approach to diagnosing, understanding, treating—and eventually preventing—depression.
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