Deficiency: What Doctors Often Forget in Elderly Depressive Patients

  • Depression can cover life at any age like a black veil.
  • In the case of older patients, there are also special problems: Something crucial is often overlooked during treatment.

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A gray veil that covers life. The nagging question: “Why continue?”. Emptiness where there may have been joy before. Depression is a mental illness that affects more than five million Germans in a year, according to the German Depression Relief Foundation.

Many older people also suffer from depression. Illnesses, farewells to companions, loneliness: in view of these stressful issues, one might even think that depression occurs more frequently in the elderly than in the youngest. However, that’s not entirely true: “Depression is less a reaction to difficult living conditions than an independent illness,” says Ulrich Hegerl, professor of psychiatry at Goethe University Frankfurt. -Hand. Depression can appear at any age.

Attacks of depression at a young age

Most older people who suffer from mental illness have had depressive episodes earlier in life, says Hegerl, who is also president of the German Depression Relief Foundation.

With age, however, there are peculiarities: “Stress problems are different from those of youth or middle age”, according to the experience of Armin Rösl. The vice-president of the German Depression League runs a self-help group and knows that being alone is a big problem. “The other is the fear of death, which occurs more often in old age than when you’re still in your prime.”

Warning signs: they indicate depression

Although not more common overall, depression is significantly more dangerous in older people, says Ulrich Hegerl. “There is an excessively increasing risk of suicide, especially among men.” And not only that: if an elderly person does not get out of bed for days, moves little and hardly drinks, this can also endanger his life in other ways, for example due to thrombosis.

What should relatives pay attention to so as not to let such a precarious situation happen in the first place?

  • Vigilance is important: Because even if seniors have had to deal with depression in the past, they may not want to accept the current situation, explains Rösl.
  • If a loved one becomes very withdrawn, no longer answers calls and does not reveal much, this can be a red flag.
  • Even if the affected person finds no motivation to take care of themselves, bathe and dress, this indicates depression.
  • A profound lack of joy is also typical. “The tone is more in the minor key”, explains Armin Rösl. People tend to be silent, “what they say is determined by sadness”.

Depression in old age: what loved ones can do

So what can family and loved ones do? Experts advise to definitely talk to this person. Even if it is sometimes difficult to find the right words: “It is better to ask too much than too little”, says Rösl. A phrase that can work as a conversation starter is something like, “I’m very worried about you, you’ve changed so much.”

The first point of contact is the family doctor’s office. There, patients can be referred to a psychiatrist or psychological psychotherapist. Relatives may offer to accompany you to appointments for support.

Above all, if the depressive symptoms appear for the first time in old age, the doctor must first exclude other causes, says Rösl: “For example, there are circulatory disorders or immunological diseases – or it more of a fatigue syndrome in which you are tired all the time?

Careful examination of laboratory values ​​and brain structures is important to find answers to these questions. Alzheimer’s disease and other forms of dementia are sometimes confused with depression.

Deficiency: general practitioners often do not prescribe psychotherapy

Although depression cannot be cured in the classic sense, it is easily treatable – often with a combination of medication and psychotherapy. In the case of antidepressants, however, one must carefully check which preparation is suitable. “Often the elderly already have other illnesses and are already taking other medications, so there can be interactions,” explains Ulrich Hegerl. Nevertheless, antidepressants are important in the treatment of depression.

“One of the most common conversations I have with patients is explaining to them that depression is also the result of impaired brain function and can usually be treated successfully with antidepressants,” says Hegerl. Bad psychotherapists sometimes stoke fears by advising people to stay away from these “psychopills”. Ultimately, however, consistent pharmacotherapy, also in combination with psychotherapy, is effective.

However, Ulrich Hegerl points to a deficit: “Psychotherapy is very rarely offered to the elderly.” Many would like to accept it. Often, family doctors just don’t think about prescribing therapy. “It’s clearly a disadvantage for older people.”

Structure and social contacts help

In addition to therapy and medication, affected individuals can also do some things themselves to relieve symptoms. In fact, they should: “Just taking medicine and waiting for it to pass won’t work,” says Armin Rösl.

It can help older people with depression to consciously make time for a daily walk, for example. “Or I can go to a certain service once or twice a week,” says Rösl. Senior meetings can also be on a fixed date.

The schedule structure is good. Armin Rösl also makes this observation in his self-help group: “For some, this is the highlight of the month that they look forward to and for which they prepare and leave the house.” Even parents who live further away can make such appointments: “For example, I agree with my mother: I will call her every Wednesday at 6 p.m.”, explains Rösl.

No one is to blame

It is very important that relatives correctly classify the disease. The fact that someone can no longer do the simplest things is often difficult to understand at first. Hegerl says, “It’s not ill will and not letting go.”

Because a prolonged bedtime is generally negative for depression, you can try to motivate those affected: “Come on, get up, we’re going outside!” If it doesn’t work, you have to accept it and not get angry.

It is also important that loved ones know that they are not responsible for the illness – nor are they responsible for the recovery. “With love alone, you can no more cure depression than appendicitis,” says Hegerl. (Christina Bachmann, dpa/af)

offers of help for various crisis situations can be found here.

According to a recent study from the Washington School of Medicine, you should neither sleep too much nor too little. Because it should help to stay mentally fit, especially in old age. Even the progression of early Alzheimer’s disease can be slowed down this way.


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