Alarming stats for elderly depression and suicide
Teach signs and symptoms of depression
The statistics are alarming. According to the National Institute of Mental Health, in 1997 adults age 65 and older accounted for 19% of all suicide deaths although they only comprise 13% of the U.S. population. The suicide rate for white men ages 85 and older was six times the national average. The main reason for suicide at any age is depression.
There is a myth that depression is not dangerous, yet 20% of the people who suffer from depression die by committing suicide. "It is a dangerous and fairly fatal illness. Most people who commit suicide are depressed," says Elizabeth Harris, RN, APRN, BC, health education coordinator for behavioral health at New York Presbyterian Hospital in New York City.
Although the experts are not sure why the figures are so high for suicides among the elderly, there may be several contributing factors. It is much more difficult for the elderly to survive or recuperate from a suicide attempt, just as it is more difficult for them to recover from a fall or other accident. Also, there are many stresses to which the elderly are more susceptible, says Harris. They have more illnesses, experience more deaths of people they love, and experience loss of independence.
The best way to prevent suicide is to diagnose depression early and treat it, she says. Therefore, the elderly as well as their caregivers should know the signs and symptoms. There must be a cluster of symptoms, at least five, that last for two weeks.
A depressed mood or absolutely no interest or pleasure in anything must be present first of all. "I think that is why depression goes undetected. You don’t have to feel depressed; all you have to feel is that you just don’t care anymore," says Harris.
In addition, a combination of four of seven symptoms must be present. They include:
- problems with appetite, either undereating or overeating;
- problems with sleep, either oversleeping or not being able to sleep;
- physical restlessness or physically slowing down;
- a loss of energy, fatigue, or tiredness;
- feelings of worthlessness or excessive guilt;
- poor concentration or extreme indecisiveness. For example, a person might cry for half an hour because he or she can’t decide what cereal to eat for breakfast;
- thoughts of death and suicide or just wishing to be dead.
The elderly or their caregivers often confuse the signs of depression with aging. Many people believe that you sleep more as you get older, and that is not true. The elderly sleep the same amount of hours, but their sleep is lighter and broken, says Harris. If they are sleeping more it could be depression.
It is not depressing to be old, either. Although more friends die as a person ages and their health has a tendency to deteriorate, depression is not a natural result.
People often confuse depression with Alzheimer’s disease because one of the symptoms is loss of memory. "People who are depressed will say they forget everything, and they don’t remember where they put anything," Harris explains. "They forget appointments, and they forget to call people. For many people, it is a very profound symptom of depression."
Too much concern for physical health could be a sign of depression. The elderly become overly concerned because they feel tired and can’t sleep, or they are sleeping all the time and can’t think right. This often causes them to seek out their physician, which is a good place to start when signs of depression appear, says Harris.
"What we try to do when we diagnose depression is get a clear view of the person’s overall health," says Harris. The signs and symptoms for anemia and an under-active thyroid are similar to depression. In fact, there are a lot of physical conditions that look like depression, she says.
It is important for the elderly to think about their condition before going to see their physician, says Harris. They need to determine if there have been changes in their sleep, in their appetite, or in their spirit. Have they had any suicidal ideas?
They also should be prepared to give a complete personal and family history of depression. A fair amount of detective work is needed to figure if any family members suffered from depression; because years ago, people didn’t seek help and frequently weren’t diagnosed, says Harris.
There is no personality profile for depression. However, a couple of studies revealed that people with particular character traits might be more likely to become depressed.
People who think negatively much of the time, in other words, those who are pessimists, were identified as well as those who have strong dependency needs and those with low self-esteem who in general feel powerless. People more likely to commit suicide are impulsive. "Those who tend to have very powerful feelings and impulsively act on them are more likely to commit suicide," says Harris.
While many believe that only people who suffer from severe depression commit suicide, that is not true. Moderately depressed people who are intoxicated with drugs or alcohol may commit suicide. "It depends on how impulsive the person is feeling and if he or she has taken any substances. You could be only moderately depressed and kill yourself if you have been using drugs and are in a very impulsive way," says Harris.
If an elderly relative seems suicidal, it is wise to ask him or her if he or she has thought of suicide, Harris advises. Simply say: "You seem so sad. I am wondering if you would consider suicide?" Also, if there are signs of depression, help the person seek diagnosis and treatment.
"It is very rare to find someone who doesn’t respond to treatment," she says.
Source
For more information about teaching the signs and symptoms of depression in the elderly, contact:
- Elizabeth Harris, RN, APRN, BC, Health Education Coordinator, Behavioral Health, New York-Presbyterian Hospital, New York City. Telephone: (914) 997-5888.
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