The first time I held one, it immediately slipped out of my hand. A tube filled with liquid, it slid down the middle of itself and gravity sent it flying to the ground. Afraid I’d broken the thing, I picked it up, only to have it slip out again. Long before fidget toys were invented, this slide thing could keep people like me amused for hours.
Trying to diagnose depression, especially in the elderly, reminds me of that toy. Every time you think you’ve got it, it slips away.
This list of symptoms of depression is typical.
- Sadness or feeling of despair (Maybe, but grief or a difficult medical diagnosis could also brings these feelings.)
- Unexplained or aggravated aches and pains (Do you know any elders without these?)
- Loss of interest in socializing or hobbies (Possibly, or maybe they are an introvert who needs alone time.)
- Weight loss or loss of appetite (Poor appetite among elders, especially when less active, is common.)
- Feelings of hopelessness or helplessness (Again, maybe. But has there been a huge lifestyle change lately, and has the need for purpose been addressed?)
Lack of motivation or energy (A physical reason may be the cause.)- Sleep disturbances (Again, not unusual among the elderly.)
- Low self-worth. Worries about being a burden, feelings of worthlessness or self-loathing
- Slowed movement or speech (Can often have a physical basis.)
- Increased use of alcohol or other drugs. (This can be a good indicator, but may also be a symptom of dementia, where memory or judgement is an issue.)
- Fixation on death, thoughts of suicide (When you work with frail elderly, you realize they talk/think about death all the time. But any talk of suicide should be taken seriously and be a reason to get immediate help.)
- Neglecting personal care–skipping meals, forgetting meds, neglecting personal hygiene. (A good indicator, but can also be sign of dementia.) 1.
Add to all this confusion the many medications some elders need to take and their complicated medical histories, and it’s no wonder even the most experienced doctors have difficulty finding the right antidepressant at the right dose. It’s like trying to hold one of those fidget toys.
They don’t know your elder. You do. Your input is invaluable in the ultimate diagnosis.
Ask yourself:
- Are the symptoms new? Is what you are seeing something you’ve noticed in just the last few months?
- Is this behaviour constant? Everyone can have a bad day.
- Do any efforts you make to improve the situation help? If your elder is a different person after a day with the grandchildren or a drive in the country, maybe the problem is something else.
- Does talking about it help? Sometimes simply mentioning what you’ve observed will lead to insights that can help. A listening ear can sometimes make a difference.
- Is there a medical basis for what you are seeing? Even if you believe you know your elder’s medical issues, they can change in a minute. Start with a physical and review of medications.
As care partner, you have the opportunity to give the most valuable input about your elder to those who care for them.
1. https://www.helpguide.org/articles/depression/depression-in-older-adults.htm (all bracketed comments are my own)
Itís difficult to find well-informed people about this topic, however, you sound like you know what youíre talking about! Thanks