Caregiver Guide: Depression

Understanding the Problem

We all experience life changes that can lead to feeling depressed. Some people go through physical changes affecting their eyesight, hearing, or how well they can move. Others have changes in their health that are treated with many medicines. Still others have changes in their ability to think and remember.

Lifestyle changes are also common. Some older adults retire from their work and need to find new ways to fill their time or make themselves feel useful. Others move into a smaller house or apartment, or move in with family members who can help take care of their needs. Some people move into assisted living facilities or nursing homes. Finally, older persons lose friends or family members close to their own age who pass away. Studies show that as many as 25% of people who lose a family member or close friend are seriously depressed for months after the death.

It can be hard to cope with these changes, which become more common the longer we live. This is especially true when several changes occur at the same time. The emotional stress of dealing with these changes can cause many uncomfortable feelings, including depression.

Symptoms of depression

Sometimes older people are able to get over "the blues" after a short time. However, sometimes these feelings last a long time and can severely hurt their quality of life. When a person is sad, discouraged, gloomy, or feeling hopeless for several weeks or months, and when these feelings interfere with being able to manage day-to-day affairs, we say that he or she is suffering from depression. Depression can last a long time if the person does not do something to stop it.

Not everyone notices feeling sad.  Symptoms of depression may sometimes only show up as problems with appetite, sleeping, lack of energy, ability to pay attention to things, and loss of enjoyment of favorite activities. Other symptoms can be vague physical complaints such as headaches, constipation, or aches and pains in several parts of the body for which there is no medical explanation. Excess use of alcohol, especially if it is new or worse since the person has been through a significant life event, may also be a sign of depression. Sometimes a depressed person thinks about suicide as a way out of his or her problems.

Depression works like a downward spiral

The person feels down, so he or she does not put energy into solving problems. When the problems get worse, they can make the person feel worse. And so it continues. This spiral pattern must be interrupted. Some kind of change has to happen, or these feelings will become severe and will last for a long time.

Depression can also be a side effect of some medicines, or it can be caused by chemical imbalances in the body due to medical illnesses. It can also be caused by the combination of several medicines taken at the same time. When this happens, changes in medical treatments may help the depression.

It is important to remember that, although depression happens often to older adults, it should not simply be accepted. There are several treatments available to help relieve depression and most people can find relief with at least one of them, regardless of their age or situation. People may also experience depression along with medical conditions. Even when everything is being done to treat the medical conditions, additional efforts often can be made to relieve the depression as well.

Your help is valuable to a person who is feeling depressed

However, it is also important that he or she help themselves. You and the person you are caring for can work together as a team to deal with depression.

Some symptoms are a normal response to the stresses and uncertainties people have in everyday life

Don't expect to all these feelings to go away. However, as a caregiver, you can help prevent feelings of sadness or discouragement from becoming severe or continuing for long periods of time. By working with the person, you may help keep depressed feelings under control. If the symptoms become severe, you can encourage the older person to seek professional help.

If the older person is seen by a doctor, he or she may prescribe antidepressant medicine

You may need to help the older person take the medicine as directed and watch for side effects. It may take several weeks or even months before the medicine takes effect, and it may also be continued on a low dose after the depression gets better. You may have to keep watch on how the antidepressant medicine is taken for a long period of time.

The healthcare provider who is prescribing the medicine will need feedback on how the older person is responding and you might need to help here as well. It is also extremely important that they are fully aware of all the medicines that the person you care for is currently taking, regardless of the reasons why they were originally prescribed.

Preventing negative drug interactions is very important

Be sure to give all healthcare providers a list of all prescription medicines, over-the-counter medicines bought at the pharmacy, and any herbal or other alternative therapies, as well as the dosage levels and the times they should be taken.

Pay attention to your own emotional health

Living with or spending large amounts of time with a person who is depressed can be stressful and can even lead to you feeling  depressed. It is important to pay attention to your own emotional health so that you can do your best as a caregiver.

Your goals are to:

  • Work together with the older person to manage depressed feelings and thoughts
  • Keep an eye out for early symptoms of depression and help the older person manage depression before the symptoms become severe
  • Be alert to when professional help is needed and assist the older person in getting this help
  • Take care of your own emotional needs when caring for someone who is depressed

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