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Maureen Duffy’s memories of her grandmother are cloudy. Not because of time, but by a condition that cast a shadow over the woman Duffy had visited as a child.
“She was blue. Even as a child I could see it. She was very negative and just could never really find any joy in life…not even from her children or grandchildren,” Duffy recalls. “A physician diagnosed her with depression, but she was only given tranquilizers. She was not a happy person. By the time she went to a nursing home, no one wanted to visit her. It hurt my heart.”
Duffy’s story is not uncommon. According to the National Institutes of Health, of the 35 million Americans age 65 and over, about 2 million suffer from full-blown (major depressive disorder) depression and another 5 million suffer from less severe forms. In 2004, adults 65 and older accounted for 16 percent of suicides in the United States; non-Hispanic white men 85 and older have the highest suicide rate in the country.
“It is very much a serious condition that can be life-threatening. There are several risk factors that can make you more susceptible to it,” says Jair Soares, MD, chairman of the Department of Psychiatry and Behavioral Sciences at The University of Texas Medical School, part of The University of Texas Health Science Center at Houston (UTHealth) and co-director of the UT Center of Excellence on Mood Disorders. “Today, imaging also shows us that changes in the brain as we age can make a person predisposed for a type of depression called vascular depression.”
Vascular depression occurs when blood vessels leading to the brain become clogged, even to the point of stroke. The reduced blood flow impacts the cerebral nerve pathways that are involved in mood.
Risk factors for vascular depression include diabetes, high blood pressure, high cholesterol and high lipid levels. “It is just one of many physical and life changes that can increase an elderly person’s risk of depression,” Soares says.
Other risk factors include
The encouraging news is that all forms of depression are highly treatable using medication and psychotherapy, Soares reassures.
“Depression in the elderly has to be treated very carefully. The depressed elderly need to be closely monitored for side effects and compliance with medication,” says Vineeth John, MD, associate professor of psychiatry also at UTHealth Medical School. “As we age, our bodies do not metabolize medications the same way they did when we were younger. A treatment plan must be highly individualized and approached with the utmost care.”
John is a geriatric psychiatrist, the specialized field of psychiatry that addresses the needs of elderly patients. “The need for mental health intervention in the elderly will be great as a high number of the US population enters their senior years,” explains John, who practices at UTHealth’s Behavioral and Biomedical Sciences outpatient clinic and at the UT Physicians Bellaire clinic.
“Depression that isn’t treated in the elderly could lead to worsening health complications including dementia,” John says. “Family members, friends and neighbors should be watchful of any symptoms of depression in their older loved ones. It is important to ask them questions if you suspect depression.”
John says to pay close attention to the answers provided. If you suspect aging members of your life might be depressed, speak with them or encourage them to make an appointment with their family physician. “An elderly person may not even realize he or she is depressed,” John says. “By intervening early, you can actually save someone’s life. Untreated depression is the leading cause for suicide. The suicide rate for the elderly is very high.”
Warning signs of depression include irritability, difficulty sleeping or sleeping too much, change in weight, lack of interest in personal care, frequent crying, memory problems, expressions of hopelessness, helplessness or loss of happiness.
Duffy says her experience with her grandmother helped her recognize the warning signs in her mother-in-law. Despite her best efforts, however, she wasn’t able to persuade her mother-in-law to get help. “My advice is to just keep pushing and asking questions. I kept at it,” Duffy remembers. “I even spoke to her physician about her symptoms, but she didn’t want to seek help. She was in denial. She could have enjoyed life so much more had she gotten the help she needed. Instead, she spent many of her days locked in her bedroom. She eventually died alone in her room.”
The strongest possible prevention for depression is to live a healthy lifestyle, experts say.
“Take care of yourself. Eat well, exercise and if you have an illness be proactive,” Soares says. “We still don’t have a full understanding of depression. We aren’t there yet, but we hope to be soon.”
Send us your questions for the experts, comments or suggestions.
Last Updated:8-04-2010
The University of Texas Health Science Center at Houston (UTHealth), the most comprehensive academic health center in The UT System and the U.S. Gulf Coast region, is home to schools of biomedical informatics, biomedical sciences, dentistry, medicine, nursing and public health. UTHealth educates more healthcare professionals than any health-related institution in the State of Texas and features the nation’s seventh-largest medical school. It also includes a psychiatric hospital and a growing network of clinics throughout the region. The university’s primary teaching hospitals include Memorial Hermann-Texas Medical Center, Children’s Memorial Hermann Hospital and Lyndon B. Johnson General Hospital. Founded in 1972, UTHealth’s 10,000-plus faculty, staff, students and residents are committed to delivering innovative solutions that create the best hope for a healthier future.
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Dr. Jair Soares is chair of the Department of Psychiatry and Behavioral Sciences at UTHealth Medical School and Executive Director of UT Harris County Psychiatric Center.
Dr.Vineeth John is an associate professor of psychiatry at the UTHealth Medical School.
Simple Ways to Help
Young and Old Eyes
May is Healthy Vision Month and it is imperative to take care of eyes whether they’re young or old.
Children should have their vision checked by age 6, even if there aren’t any signs of eye problems. Healthy eyes and vision are very important to a child’s development. Finding and treating eye problems early on can save a child’s sight. Two common eye problems in children are:
Both of these eye problems can be treated if they are found early.
Here are ways to help your child develop vision skills:
Don’t let poor vision put elders at risk. Leave a three-foot, clear path through each room of their house. Outline edges of steps, coffee tables, doorways and bathtubs with colored tape to contrast with surrounding areas. Install lights along outdoor pathways and keep foyers well lit to avoid having to enter dark areas. Replace switch plates with colors that contrast with walls, or outline them with tape of contrasting colors. It is also always smart to use nightlights during the night.
