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Elderly Depression Often Unnoticed

Tough to Diagnose

WebMD Feature
Reviewed by Gary D. Vogin, MD

Claire Hamilton was getting worried about her Aunt Julia. Julia always seemed to have some new excuse to stay home. She had already, months ago, stopped volunteering at a local Head Start program because her arthritis was bothering her. Now Claire found herself on the phone pleading with her aunt to join the family for birthdays and other celebrations. Claire finally went to visit Julia. She found that her aunt had lost weight and appeared tired, and Julia's normally tidy apartment was a mess.

When Claire expressed concern, Julia admitted she'd been thinking a lot about death and said it might be better than going on the way she was.

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Or take Al Cannon: His wife, Betty, was worried by a change in his personality. For 15 years, the couple had enjoyed retirement, traveling, and spending time with their eight grandchildren. Al had been a natural leader -- someone his fellow firefighters had looked to for leadership and support. But now he had become withdrawn, forgetful, and irritable. He no longer seemed to enjoy his favorite foods or activities. He also slept poorly and often awakened as early as 4 a.m., when he would go to the kitchen and make a racket until Betty finally got up to see what he was doing.

Both Julia and Al sought help from their doctors, and each was diagnosed with depression, a disorder that's as common in the elderly as it is in younger people. And both, fortunately, were successfully treated. Without treatment, both would they have risked getting worse physically as well as becoming increasingly despondent and even suicidal.

Elderly Harder to Diagnose

People who are clinically depressed experience at least two weeks during which their mood is depressed for most of the day and a decreased interest in almost all activities. Other possible symptoms include:

  • Weight gain or weight loss
  • Insomnia
  • Fatigue
  • Feelings of worthlessness or guilt
  • Difficulty concentrating

In cases of serious depression, thoughts of death or even of death by suicide are common.

The trouble is, depression can be hard to diagnose in older people. That's because they're likely to have other medical conditions that can mimic some of depression's symptoms. Julia's arthritis limited her ability to get around, and this helped hide the fact that she felt less and less energetic because she was depressed. And Al's stomach condition had led him to turn down his favorite foods long before depression took away his appetite.

It is not a normal part of aging to have any of the symptoms of depression. They deserve medical attention -- whether they are caused by depression or by something else. Ignoring the symptoms can lead to an increase in the severity of the depression or other medical illness. And severe untreated depression can even end in suicide.

Suicidal thoughts or actions are a medical emergency that requires immediate evaluation by a healthcare professional.

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