by Susan Hanna 

agh_logoDepression affects people of all ages. But a diagnosis of depression in seniors can be missed altogether because changes are often attributed to “old age” and are not addressed.

Dr. Asif Khan, a geriatric psychiatrist from the Royal Ottawa Hospital who provides psychiatric services to Fairview Manor, answers some questions about depression in seniors.

What causes depression in seniors? – “A history of depression or a family history of depression may predispose a senior to depression,” says Dr. Khan.

“Also, as a person ages, they may have a medical illness, such as heart disease, stroke or severe pain that can predispose them to depression.”

Other factors that can contribute to depression include loss of a life partner, moving from the family home, loss of independence and financial worries.

“There is also a close link between dementia and depression,” explains Dr. Khan. “Sometimes depression is the first sign of dementia.”

What are the symptoms? – “Depression in seniors may present a little differently than in younger people,” says Dr. Khan. “They may not say they feel depressed.

Common symptoms include withdrawing from activities the senior previously enjoyed, complaints about loss of memory or concentration, anxiety and sleep problems.”

Many seniors who are depressed also complain of physical ailments, such as pain or gastrointestinal problems. “Some may feel helpless, feel guilt over events in the past or feel life has no meaning,” Dr. Khan adds. “In severe cases, the person may stop eating or have thoughts that are not based on reality.”

How is it treated? – Treatment of depression in seniors depends on its severity. “A mild case may be treated through talk therapy to help the person be more positive and to help them engage in activities,” explains Dr. Khan. “Providing support to alleviate loneliness or to improve their ability to do things can also help.”

For more severe cases of depression in seniors, antidepressants are the treatment of choice. “We would treat the person for at least two years, or until the symptoms are gone,” says Dr. Khan.

The most severe cases, in which a person may be suicidal or has stopped eating, may be treated with electroshock treatments.

Where can you get help? – If you think you are depressed, or if you think a member of your family is depressed, go to your family doctor.

“The older generation is more likely to be in denial about depression or to think there is a stigma around mental illness,” says Dr. Khan. “If you are concerned, talk to your family doctor or request a psychiatric assessment.”