The blues may be a natural part of life, but when sadness persists and interferes with everyday life, it may be more serious. Depression is not a normal part of growing older. It is a treatable medical illness, much like heart disease or diabetes.
THE STORY
When Mr. S., Abdullah reached hospital, he refused to get out of bed and consciously wet and soiled himself. As soon as the nurses tried to clean him, he punched them saying, “I just want to be left alone… Cut my head and throw it in the rubbish bin.” That is what this 65-year-old Emirati patient kept saying. Feeling lonely since his family abandoned him, is his an issue of dementia or does he suffer from something else? His physician Dr. Ahmed Foul explained that his patient was severely depressed and needs urgent medication in order to avoid the risk of suicide. “He required antidepressants instantly to prevent major developments as depression could be a fatal illness.”
There is a biological disposition that comes together with the illness of depression. For example, the cortisone levels decrease. What does this mean? “Cortisone is responsible for the production of serotonin, which is a hormone released in the brain to stabilise the mood. If this hormone is present in lower than normal quantity, depression strikes.”
What are the effects of depression on the ageing process?
Dr Foul explains, “Depression is proved to catalyse the ageing process and makes a person feel 10 years older and sometimes even look 10 years older. The chromosomal regeneration slows down as depression becomes more severe. “Depression isn’t only a feeling of sadness that should be accompanied by loss. This feeling of melancholy should continue for at least two weeks to enable us to declare officially that the patient is depressed.”
MISERY IS NOT A PASSING MOOD
Sadness isn’t the only symptom of depression; it can be the main symptom that gets patients to seek help. There are more significant symptoms associated with sadness. For instance, insomnia is one of the common symptoms that depressed people suffer from. Another indication is ‘psychomotor retardation’, which means slowness of the thinking process. This causes the patient to talk slowly and sometimes he or she doesn’t respond to questions, failing to communicate properly. Highly frustrating, psychomotor agitation could be the presenting symptom in which the patient accelerates his or her aggressive response to mild triggers even during conversation, sometimes leading to physical and verbal aggression.
Can a patient suffer from psychomotor retardation and psychomotor agitation simultaneously?
Dr. Foul says “The 65-year-old patient I was helping, suffered from both symptoms. Whenever we asked him questions, he didn’t answer, not even with a nod and he walked slowly as well. On the other hand, he also suffered from psychomotor agitation since he pinched and pushed away any doctor or nurse that came in contact with him.”
Loss of appetite and loss of weight is another indication of depression. Patients who suffer from depression stop eating or dramatically reduce the amount of food that they eat. They can reach easily reach a severe level of malnutrition and dehydration in a short space of time between their regular visits to hospital, and without the doctors recognising this has been brought on by depression.
Feelings of guilt are another key clue. When patients start blaming themselves for everything, then it’s a sign that their attitude is out of whack. Even though Mr Abdullah never said that he felt down, certain symptoms like loss of appetite, dehydration, psychomotor retardation and psychomotor agitation indicated that he was. So the question here might be, “How can we treat depression?”
Dr. Foul explains, “Medication is the fastest and most efficient way to treat depression.” Despite the fact that many people and especially the elderly might not prefer medication to tackle this malaise, sometimes it is the only way out.
Why not adopt psychological therapies with the older patients if they are not comfortable with medications? Dr. Foul adds, “especially when older, severe depression can’t be cured efficiently by therapies alone as it may take ages for patients to be cured. Sometimes, medications and therapies could be used together or simultaneously but medications are a must. With aggressive treatment of three different antidepressants, the patient starts to improve after two weeks and becomes completely normal in one month. In the case of Mr Abdullah, when this regime was adopted, he started to take care of himself again such as ensuring he was well groomed. Were the underlying causes of his sadness ever addressed via psychotherapy? No, but the symptoms were fixed.
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IS CONVENTIONAL MEDICATION THE ONLY REMEDY?
Alternative medicine for depression in the elderly
Herbal remedies and natural supplements can also be effective in treating depression, and in most cases, are much safer for older adults than antidepressants. However, some herbal supplements may cause interactions with certain medications or occasionally carry side effects, so always check with your doctor before taking them.
- Omega-3 fatty acids may boost the effectiveness of antidepressants or work as a standalone treatment for depression.
- St. John’s wort can help with mild or moderate symptoms of depression but should not be taken with antidepressants.
- Folic acid can help relieve symptoms of depression when combined with other treatments.
Counselling and therapy
Therapy can help people come out of depression because it addresses the underlying causes of the depression, rather than just the symptoms.
- Supportive counselling includes religious and peer counselling. It can ease loneliness and the hopelessness of depression, and help you find new meaning and purpose.
- Therapy helps you work through stressful life changes, heal from losses, and process difficult emotions. It can also help you change negative thinking patterns and develop better coping skills.
- Support groups for depression, illness, or bereavement connect you with others who are going through the same challenges. They are a safe place to share experiences, advice, and encouragement.
THE END
Soon after, the old man died of a chest infection contracted during the time when he was feeling down and had failed to take his medicines regularly. Or could it have been, at a subliminal level that he had simply lost the will to live? Mr. Abdullah’s son visited the hospital on the day that his father died and he said, “I wish he would forgive me for not being there for him.” Dr. Foul concludes, “If someone feels that they are down or that they have lost interest in life, they should immediately consult an expert because depression could be fatal. He claims that older people need to take medication for the rest of their lives because they can easily relapse and become depressed all over again. However, who knows if there would be a different light at the end of the depression tunnel?
Medications that can cause or worsen depression
- Blood pressure medication (clonidine)
- Beta-blockers (e.g. Lopressor, Inderal)
- Sleeping pills
- Tranquilizers (e.g. Valium, Xanax, Halcion)
- Calcium-channel blockers
- Medication for Parkinson’s disease (L-Dopa)
- Heart drugs containing reserpine
- Steroids (e.g. cortisone and prednisone)
- High-cholesterol drugs (e.g. Lipitor, Mevacor, Zocor)
- Painkillers and arthritis drugs
- Oestrogens (e.g. Premarin, Prempro)
WHAT IF IT’S NOT DEPRESSION
“The idea that Alzheimer’s is completely genetic and unpreventable is probably the greatest misunderstanding regarding the disease,” says Gary Small, M.D., director of the UCLA Center on Aging. Researchers now understand that Alzheimer’s, similar to heart disease and cancer, evolves over decades and can be affected by lifestyle factors including cholesterol, blood pressure, being overweight, depressive disorder, education, diet, sleep and mental, physical and societal activity. Mountains of research explain the basic things to do to minimize your odds of losing your mind to Alzheimer’s.
- Have coffee. In an amazing flip-flop, coffee is the new brain tonic. A large European study demonstrated that drinking 3 to five servings of coffee a day in midlife cut Alzheimer’s chance 65 percent in later life. Coffee decreases dementia-causing amyloid in animal brains.
- Floss. Strangely, the wellbeing of your teeth and gums can help predict dementia. University of Southern California analysis found that having gum disease before age 35 quadrupled the possibility of dementia years later. Elderly individuals with tooth and gum disease score lower on memory and cognition tests. Experts speculate that inflammation in diseased mouths migrates to the brain.
- Google. Doing an online search can stimulate your aging brain even more than reading through a book, affirms UCLA’s Gary Small, who used brain MRIs to demonstrate it. The biggest surprise: Novice Internet users, ages 55 to 78, triggered essential memory and learning facilities in the brain after just a week of Web surfing for an hour a day.
- Develop new brain cells. Impossible, scientists used to declare. Now it’s believed that thousands of brain cells are born every day. The key is to keep the newborns alive. What is effective: cardiovascular exercise (such as a brisk 30-minute walk every day), intense psychological activity, consuming salmon and various other fatty seafood, and averting morbid obesity, chronic stress, sleep deprivation, heavy drinking and vitamin B deficiency.
- Drink apple juice. Apple juice can motivate generation of the “memory chemical” acetylcholine; that’s the way the well-known Alzheimer’s drug Aricept functions. Thomas Shea, Ph. D., of the University of Massachusetts was surprised that old rodents given apple juice did better on learning and memory assessments than rodents that received drinking water. A dosage for humans: 16 oz., or two to three apples a day.
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