Have you felt very tired recently? Had trouble sleeping, working and simply
getting through the day? Feel body aches and headaches, digestive problems
or cramps for no apparent reason? Have you lost interest in activities
you used to enjoy?
You might think these symptoms are a normal part of aging, but if you answered
“yes” to one or more of the questions, you might be experiencing
depression. As we get older, lots of changes occur: retirement, loss of
loved ones, medical and financial problems. It is normal to feel sad or
stressed about these changes. But after adjusting to them, most older
adults feel well again. If you don’t, you may need some help.
It’s important to know, too, that depression is not a character flaw
or a sign of weakness. It’s a medical condition that responds well
to therapy, whether that means talk therapy, medication or both. We asked
psychologist Moe Gelbart, PhD, executive director of the Thelma McMillen
Center at Torrance Memorial Medical Center and a clinical psychologist
for 42 years, how to identify the signs of depression and get help.
What are the signs of depression in an older adult?
I generally look for a change in sleep patterns and eating habits, weight
gain or loss and an inability to experience pleasure in things that used
to be enjoyable. A general hopelessness is common, and with it possibly
physical pain in the neck or back. Sometimes it’s easier for people
to discuss pain in their bodies than their emotions.
Many in the senior population are willing to discuss unhappiness but are
hesitant to admit to depression. They don’t want to see themselves as ill.
Are you more disposed to be depressed if you’ve had it in the past?
Older adults who have been depressed before are certainly more prone to
depression later in life. But there are factors unique to aging: illness
in themselves and friends, loss of a spouse and mortality right around
Retirement is a big deal, and it really pays to be mentally—as well
as financially—prepared for it. I’ve worked with people the
year before retirement so they are ready for that loss of feeling useful.
There’s financial stress too. Some people may not have the funds
to live the life they thought they would or the physical ability to do
the things they used to do. All of these can cause what I call situational
depression. People who regularly see their primary care physician have
an advantage because that doctor will notice the changes and can provide
screening for depression and referral to a specialist.
What are the treatment options?
Treatment options are the same as for younger people. Feelings are connected
to thoughts, so a specialist will generally start there and ask: “What
are you thinking?” Through cognitive therapy we examine that and
what part of those thoughts might be distorted—too extreme. We try
to help them see things in a different way. For instance, yes, maybe you
can’t afford to go to Europe, but a drive up the coast is a beautiful
option. It’s helping them see the glass as half full, not half empty.
It’s also helping them realize the importance of creating a social
support system. Having friends close by and a purpose in life that gets
them out of the house is a great antidote to feeling helpless and hopeless.
Staying physically active, exercising no matter how ill, doing whatever
you are capable of doing are all really key. It helps to find group activities:
yoga, a meditation group, a crafting meetup, a grief group if that’s
part of your sadness.
A big part of treatment also is medication. It can help someone who is
not able to function well get a jumpstart on feeling better.
What if I notice a loved one is acting depressed?
If someone you love seems to be experiencing depression, the first thing
is to be willing to communicate honestly without judging or attacking.
Tell the person how you feel, how you are concerned seeing them feel so
sad. Let them know you care and offering help. Directing them is not going
to be beneficial, but if you are connected and committed to helping, you
can ask, “Would you like me to do something for you?” If the
depression is severe and someone is talking about harming himself/herself,
you might have to be a bit more forceful.
Does Medicare cover treatment?
If you are on a Medicare Advantage plan, you do have access to behavioral
medicine, and Torrance Memorial offers many support groups and yoga and
meditation classes (just look at the Advantage calendar section).
Moe Gelbart, PhD, is director of Gelbart and Associates. He can be reached