How Common is Depression?
Depression is not a normal part of ageing – most older adults will not experience depression. About 5-10% of older Canadians living in the community have some type of depressive disorder. However, it is more common among older adults in institutional care settings, with upwards of 30-40% experiencing depressive symptoms.
WHo is Likely to be Diagnosed with Depression?
You are at increased risk of developing depression if you:
- Lack social supports
- Have a personal or family history of depression
- Have a chronic health condition that affects your functional ability and independence
- Live with chronic pain
- Have a fear of death or have recently lost a loved one
- Have heart problems, low blood pressure, cancer or diabetes
- Live in a long-term care setting (nursing home)
WHAT CAN DEPRESSION LOOK LIKE?
A person with depression may show some of the following symptoms:
PHYSICAL CHANGES
- Changes in appetite, resulting in weight loss or gain
- Changes in sleep, such as sleeping too little or too much, or lack of restful sleep
- Decreased energy, resulting in feelings of fatigue
- Pain with no identifiable physical cause and which does not improve with treatment
CHANGES IN THINKING
- Obsessing over negative thoughts
- Becoming preoccupied with perceived failures or personal inadequacies, leading to reduced self confidence
- Being harshly self-critical and judgmental
- Having difficulty concentrating, remembering details or making decisions
- Having suicidal thoughts
CHANGES IN FEELINGS
- Experiencing a loss of interest in one’s favourite activities
- Experiencing feelings of hopelessness or pessimism
- Experiencing feelings of guilt, worthlessness or helplessness
- Experiencing feeling irritable or restless
CHANGES IN BEHAVIOUR
- Neglecting duties such as housework and paying bills
- Decrease physical activity and exercise
- Reduced self-care activities such as hygiene and grooming
- Increasing the use of alcohol and mood-altering prescription or non- prescription medication
WHY IS IT IMPORTANT TO DIAGNOSE AND MANAGE DEPRESSION?
Older adults are often under-diagnosed and undertreated for depression because some see depression as a normal response to ageing and its challenges. It isn’t. As well, older adults may not experience the same mood changes as younger adults; they may not identify as feeling “depressed” but rather simply have lost interest, or their “zest for life.”
It is important to diagnose and manage this medical disorder because untreated depression can lead older adults to become socially isolated. Depression can also have a negative impact on family relationships and friendships, which in turn, can worsen depression. As well depression can negatively impact management of one’s other chronic health conditions.
Finally, untreated depression can lead to suicide. Older adults, especially older men, have the highest suicide rate of any group. Recognizing the signs of suicide risk in older adults can help with prevention.
WHAT ARE SOME SIGNS THAT SOMEONE MAY BE CONSIDERING SUICIDE?
Before someone turns to suicide, they usually show warning signs beforehand. People who feel suicidal may:
- Show a sudden change in mood or behaviour
- Show a sense of hopelessness and helplessness.
- Express the wish to die or end their life.
- Increase their substance use and misuse.
- Withdraw from engaging with people and activities that they previously enjoyed.
- Experience changes in sleeping patterns.
- Experience changes in appetite.
- Give away prized possessions or make preparations for their death.
HOW CAN WE MANAGE DEPRESSION?
There are three main strategies to manage depression.
BUILDING SOCIAL SUPPORTS
Depression can make older adults feel disconnected from others and not want to maintain connections with loved ones. However, support from family and friends can be an important part of managing depression. Reaching out to friends and family, joining a social group, and being active in your community can help a person recover from and prevent future episodes of depression.
MINDFULNESS-BASED COGNITIVE THERAPY
Mindfulness-Based Cognitive Therapy (MBCT) is an evidence-based form of group therapy for preventing relapses of anxiety and depression. It combines cognitive therapy and meditative practices to help individuals become acquainted with mood disorders and develop more positive relationships with them. It is typically delivered in an 8-week group therapy program.
MINDFULNESS-BASED STRESS REDUCTION
Mindfulness-Based Stress Reduction (MBSR) looks at the stress of living and how it affects our experiences. In MBSR, participants learn to recognize habitual, unhelpful reactions to difficulty and learn instead to bring an interested, accepting and non- judgmental attitude to all experiences, including difficult sensations, emotions, thoughts and behaviours.
Depending on the severity and type of depressive symptoms, your doctor may also prescribe medications. It is important to take medications for depression as prescribed, just as you would take medications for any other medical illness. Self-medicating to treat depression can increase a person’s risk of addictions, falls and cognitive impairment.
WHAT ARE STRATEGIES TO SUPPORT SOMEONE WHO HAS DEPRESSION?
If you believe that you or a loved one has depression, the first thing you should do is talk to your primary care provider. Treatment can include talk therapy, stress reduction, learning coping skills, as well as family and social support and medication.
Changing certain behaviours can help a person with depression better manage their symptoms. Cutting down on caffeine and alcohol, smoking, and over-eating, as well as getting regular exercise can help manage depression.
Supporting a loved one who is struggling with depression can be challenging and difficult because the illness may make cause them to push you away. Reach out to them, spend time with them and let them know you care about them. Some other strategies to support someone you care for who has depression include:
- Playing games or doing activities that are interactive and stimulate the brain
- Arranging regular social activities, like going to shows, taking classes, or mentoring younger individuals
- Playing some of their favourite songs
- Scheduling one activity per day that previously gave them pleasure, is a good approach
- You might want to have them rate their mood on a scale of 1-10 before and after these activities to assess which are the most effective in improving their mood
WHERE CAN I FIND MORE INFORMATION?
CANADIAN MENTAL HEALTH ASSOCIATION
The Canadian Mental Health Association provides information and services for individuals who are struggling with a mental health issue and would benefit from support.
CANADIAN COALITION FOR SENIORS’ MENTAL HEALTH
Canadian Coalition for Seniors’ Mental Health shares information, resources and links to other organizations to promote mental health among older adults.
CONNEXONTARIO
ConnexOntario provides free and confidential health services information for people experiencing problems with alcohol and drugs, mental illness and/or gambling.
LATE-LIFE MOOD DISORDER CLINIC AT CAMH
The Late-Life Mood Disorder Clinic at CAMH provides psychiatric consultation for patients who have had long-standing mood disorders and are now over age 60, as well as individuals who develop a mood disorder after the age of 60.
WOODGREEN WALK-IN COUNSELLING SERVICE
WoodGreen’s Walk-in Counselling Service offers free, immediate counselling to address a wide range of concerns, such as anxiety and depression. No appointment or referral is needed, and there are no restrictions to access. It is open on Tuesday and Wednesday from 4:30 p.m. to 6:45 p.m.
Modified: 2020-12
We would like to thank the following for their support of our Education Resources to Support Healthy Ageing Initiative
- Mon Sheong Foundation and the Ben and Hilda Katz Foundation have generously provided funding to support printing and translation of our Education Resources to Support Healthy Ageing.
- The Ministry for Seniors and Accessibility supported this initiative with funding through its Seniors Community Grant Program.