Depression – what you need to know and how to deal with it

With an estimated 10 and 15 per cent of older people experiencing depression1, chances are that it will eventually affect you or someone you know or care about. With that in mind, it makes sense for all of us to be more aware of the signs, be better able to respond to it and to know where to go for help.

Dr George Miller, who works on the NSW Central Coast, has a special interest in the care of older people and is heavily involved in the Palliative Care & Hospice Foundation, as well as Advance Care Planning. Here he shares some wisdom from his experience of depression in older Australians.

Are older people more susceptible to depression?
“It’s difficult to generalise about one group of the population being more susceptible, but older people do have to deal with issues that are happening around them and to them, such as bereavement or loss of cognitive skills and potential onset of dementia. Their response to such events can sometimes present as depression,” he said.

A reluctance to seek help
Having grown up in an age where depression was swept under the carpet or seen as a sign of weakness, there is perhaps a greater reluctance among older Australians to admit that they may be suffering.

Older Australians sometimes worry about becoming a burden to their families, which can also lead to a lack of willingness to admit that they are struggling mentally, says Dr Miller. “There is perhaps a greater sense of stoicism among older generations. They also tend to place a high value on privacy and men in particular are reticent about entertaining the idea that they may be depressed,” he says.

Recognising the warning signs
Awareness of the warning signs for depression, both in yourself or those dear to you, is an important first step we can all take. These can present as emotional, physical or behavioural symptoms.

“Loss of energy and sleep disturbance are two common symptoms that warrant further investigation,” Dr Miller remarked. Other indicators may include restlessness, social withdrawal, irritability, digestive upset and a sense of hopelessness.

While these symptoms are not definitive in themselves, they should prompt attention and warrant further investigation to determine if depression is the cause.

Mature -friends -playing -croquet -wyza -700x 400
Connections matter: strong ties with family, friends and the community provide a sense of purpose and helps strengthen a person's mental and physical wellbeing

Don’t jump to conclusions
Dr Miller cautioned about the need to not label all forms of sadness as depression. “Someone who is grieving the loss of a loved one, for example, can have feelings of deep sadness, but they may also have periods where they feel happiness and enjoyment. Bereavement does not automatically equate to depression.

“If, however, they tend to feel a sense of hopelessness and sadness more profoundly and seem unable to feel happy in any situation, then that is when depression may come into calculations.”

What can be done?
If you have concerns about someone near to you, it may be possible to sensitively express your concern. Of course the person may initially be reluctant, ashamed or uncomfortable to talk about it, so it helps to have the conversation at a time when they will be more relaxed, receptive and not distracted by other activities.

Express your concern about changes you have noticed and your desire to better understand their situation in a supportive and empathetic manner. Listening attentively is critical, but don’t feel compelled to offer instant solutions. The important thing is simply to allow the person to open up and express how they feel. This in itself will help them more than you might think.

Dr Miller points out that sometimes the choice of words in such discussions can make a big difference. “Sometimes the terminology we use can get in the way,” he says.

“Words such as depression, panic, or anxiety are not things that older people will readily admit to feeling. But if you ask them whether they are feeling a greater sense of sadness or upset then they may be more willing to identify with those expressions. Another useful pointer is if the person is asked about how they feel about the future. If they express that they don’t have any sense of hope or expectation about things improving, then that could be a flag that further investigation is needed.”


A small conversation can make a big difference

Finding solutions
There are many different types of help available for people with depression and anxiety. A valuable goal to work toward is to encourage them to talk with their doctor about how they feel and the options for treatment. If this seems confronting for them, they may appreciate you accompanying them for moral support.

Conversely, the person may be happier to talk to a professional rather than their own family or friends. If this is the case then you should be supportive of them doing that and not insist that they confide in you.

Ultimately, the treatment can differ greatly from person to person and can be multifaceted. This might include:

  • lifestyle changes and social support 
  • professional counselling from a psychologist, psychiatrist, social worker, counsellor or other health professional
  • medical therapies.

If you have acute concerns about a person’s safety then suggest they contact the beyondblue Support Service on 1300 22 46 36 or Lifeline on 13 11 14.

Getting better equipped to offer support
To gain greater awareness of how depression can manifest in older people, how to detect the symptoms and how to prepare yourself to engage with the person, you can find some excellent resources at www.beyondblue.org.au.

Reference:
1National Ageing Research Institute. (2009). Depression in older age: a scoping study.

Do you have experience of supporting someone with depression? Share what you have found to be helpful below.

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