The Face of Depression in the Elderly
Depression could be called “the illness with many faces.” Consider these examples:
- An 83-year-old gentleman becomes very agitated, pacing back and forth and snapping at anyone who approaches him. He repeatedly talks about the end of the world and the doom of the human race. Although he says he feels tired, sleep seems to elude him, and his pacing continues into the early morning hours. His weight has dropped rapidly.
- Martha, a 78-year-old retired teacher, has slowly started to withdraw from her friends. The clubs and hobbies she once enjoyed no longer hold her attention; rather, she sits in her rocking chair, staring blankly out the window. Although not seeming particularly sad, she does not express pleasure or curiosity. It’s easy to forget her presence, as she seldom verbalizes any needs.
- When Sam’s wife died three years ago, he was very calm. Her caretaker during a long, lingering illness, this 90-year-old minister seemed prepared for her death. However, with no apparent precipitant, Sam has now begun crying many times a day, sometimes sobbing in despair. He has difficulty articulating what is wrong and seems unable to control his tears.
- Clara is 72 and feels she is near death. She describes a vast number of physical problems, all vague and variable. Her bedside table is covered with medications and medical paraphernalia. Because of long hours of bedrest and snacking, her weight has ballooned. Clara’s primary physician, frustrated, avoids her calls. Yet Clara’s obsession with her health only seems to grow.
These cases seem quite different but are all faces of geriatric depression, an illness that affects quality of life and may lead to premature death in older adults. How do we, as caregivers, recognize the signs of depression? Even more importantly, how can we assist in its treatment?
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