Depression

by Jan Simpson

“Depression is not a normal or necessary part of aging,” writes Melinda Smith in her extraordinary article, “Depression in Older Adults and the Elderly.”  While citing the causes of depression that include loneliness and isolation, medication, and recent bereavement, Melinda distinguishes between normal grief and depression and provides insight into depression clues in older adults who may not fit the typical picture of depression in a younger person. For example, according to the author, these behaviors can signal major depression even without feelings of sadness:

  • physical complaints that have worsened,
  • anxiety or irritability,
  • constant hand wringing or pacing,
  • and lack of interest in personal care.

If you suspect that your parent or older loved one may be depressed, I recommend that you read this article. Professional help should also be pursued.

According to the National Alliance on Mental Illness (NAMI), about 6.5 million Americans age 65 and older suffer from depression. Older women are twice as likely as men to become seriously depressed in part because biological changes may make older women more vulnerable while the stresses of caregiving for an ill loved one and children elevate the risk.  According to NAMI, some conditions such as a heart attack, stroke, hip fracture or macular degeneration and procedures such as bypass surgery are associated with the development of depression. Unfortunately, it’s not easy to get professional help for a depressed loved one, especially one who resists treatment. And suggesting treatment to an older parent may be perceived as overstepping boundaries in your relationship.

In the Wall Street Journal this past September, Elizabeth Bernstein offered some guidance in “A Way Out Of Depression: Coaxing a Loved One in Denial Into Treatment Without Ruining Your Relationship.”

While there are 15 million American adults with a depression disorder, “50% of people with bipolar disorder and schizophrenia don’t believe they are ill and resist seeking help; people with clinical depression resist treatment at similar rates.”  This isn’t just the result of general stubbornness or pride—there’s actually a scientific reason, too: Anosognosia, an impairment of the frontal lobe of the brain, which governs self awareness, is common in depressed adults and leaves a person with an inability to understand that he or she is sick.

Xavier Amador, a clinical psychologist and author of “I Am Not Sick. I Don’t Need Help!” has developed strategies for helping schizophrenics  comply with treatment using an approach that may also work with a depressed parent.  Instead of demanding that those sick seek treatment, see a psychologist, or start taking medication, the key is to find common ground.  He says to L.E.A.P:  Listen reflectively; Empathize strategically; Agree on common ground; and Partner on shared goals.

“It’s the difference between boxing and judo, says Dr. Amador. “In boxing you throw a punch and the person blocks you. In judo, a person throws the punch and you take that punch and use their own resistance to move them where you want them.”  As the brother of someone living with schizophrenia, Dr. Amador writes with empathy and reflects decades of personal experience dealing with resistance to care.  I found his advice pragmatic and actionable.

In my own family’s experience, we discovered that my parents’ internist was less skilled in managing depression and anxiety than a geriatric psychiatrist who finally prescribed the right medication and care. Unfortunately, we only found that psychiatrist after a distressing emergency hospitalization. We didn’t know then about NAMI, the National Alliance on Mental Illness, who have local branches that provide support and information about resources and care.

Do you have a loved one who lives with depression? If so, please consider sharing any resources you found to be helpful.

©Circle of Life Partners™