Signs and symptoms

Just a bad day or is it depression?

People use the word ‘depression’ in many different ways. Everyone can have a day when they feel out of sorts or sad, and they say “I’m really depressed today.” But most often these moods are normal reactions to stressful life situations and pass with time.

Depression, the illness, is significantly different. It is a mood state that persists for weeks at a time. Symptoms will affect mood, include very persistent negative thoughts, and impact a person's physical state and ability to function socially and at work.

Not all people with major depression will have identical symptoms, but it's common to experience any of the following physical, emotional, or cognitive (relating to thinking, memory and concentration) symptoms:

• Physical Symptoms
  Sleep:

  •     Sleeping too much
  •     Not sleeping enough
  •     Insomnia – being unable to sleep or waking up very early in the morning and not being able to fall back to sleep

  
  Appetite:

  •     Changes in appetite – eating too much or not enough
  •     Changes in appetite can be a concern in the elderly because they are more vulnerable to nutritional deficiencies
  •     Weight loss or weight gain. Weight loss can be a concern for frail older adults

  
  Energy:

  •     Loss of energy, listlessness, tired all the time
  •     Restlessness

  
  
   
• Emotional Symptoms
  
  Mood

  •     Feeling sad, low, empty
  •     Loss of interest or the ability to experience pleasure or joy in hobbies, with family etc.
  •     Withdrawing from social activities
  •     Feeling anxious, frantic
  •     Feeling isolated
  •     Feeling overwhelmed
  •     Feeling of things slowing down around you

  
  
   
• Cognitive Symptoms
  
  Thoughts:
  
      Negative thoughts blur and distort thinking. Common thoughts include:

  •         I’m no good.
  •         I’m worthless.
  •         I should be able to get over this on my own.
  •         There’s something wrong with me.

   

  •     Unable to make decisions
  •     Exaggerated sense of responsibility or guilt
  •     Unfairly critical of themselves seeing only personal faults, failings
  •     Future appears bleak
  •     Unable to participate in day-to-day living
  •     Thoughts of worthlessness
  •     Thoughts of death and suicide (Click to read more about thoughts of suicide and self harm in older adults with depression)

  
  Memory:

  •     Difficulty with memory
  •     Trouble concentrating

  
  
   

Recognizing depression in older adults

Depressive disorders are common in adults over the age of 65. Depressive disorders can span from mild to severe. Regardless of the severity, any combination of symptoms can be upsetting to the person suffering with them.

Some older adults may not even be aware of changes taking place within them, or they may misunderstand the cause of the changes. Others can appear to be carrying on normally, when they may be clinically depressed. Not all older people who are depressed will have the same symptoms, but there are common experiences:

In general, research shows that depressed older adults:

• Are more concerned about problems related to concentration and memory.
• Complain of being in a depressed mood – feeling sad, down, low, empty.
• Report less in the way of feeling guilty or worthlessness than younger people with depression.
• May give up activities and hobbies that were once pleasurable.
• Lack interest or do not experience pleasure or joy.

Fight the thoughts – ask for help.

Depression is unpredictable. It can happen for the first time in late life, even if you have never had it before.

Many people have an optimistic streak within them, but when they are depressed it’s very hard to be positive.The combination of symptoms can conspire to stop you from asking for help. People who have depression will notice that their thoughts tend to be more pessimistic and negative.

A depressed person feels negative about:

• Themselves
• Other people
• The world around them
• The future

These types of thoughts are typical of depression.

Would you tell someone who has had a heart attack or stroke to ‘get over it’? No. It is the same with depression - it is a medical illness - medical intervention is needed.

For this reason it is very important that family, friends and the community are educated in order to recognize symptoms and understand how to help someone who may be struggling with depression.

Having a positive attitude is critically important. People with depression need to recognize that negativity is part of the illness – and they need to fight to be positive and find balance. Scientific studies show that people who have a positive attitude towards aging itself tend to live significantly longer than those who don’t.

The importance of asking for help cannot be stressed enough.

When depression is identified and treated early, the majority of older adults respond well to treatment and are able to get back to living healthy, independent and fulfilling lives.