Physical fitness is affected by a variety of factors – mental health and age being just two. Aging, like change, can’t be prevented. It’s a part of life. With age comes gray hairs, aching bones, loss of loved ones, inability to work and declining mental abilities. Just thinking about it can be depressing.

According to the National Institute of Mental Health, depression affects more than 6.5 million of the 35 million Americans who are age 65 or older, and less than one third of them seek treatment because they wrongly believe depression is a part of aging.

“The difference between depression and old age is that treatment of depression may result in a higher quality of life for the individual,” says Joyce Beck, LPCC, PRN at Portage Path Behavioral Health, in Akron Ohio. “Healthy older people who are not depressed are able to connect socially with others, remain physically active, and engage in enjoyable activities.”

Depression goes untreated in the elderly for a myriad of reasons, primarily the fact that general practitioners often attribute it to aging, a belief most patients share. Furthermore, today’s elderly were born in 1939 or much earlier, a time when depression and mental illness were highly stigmatized.

“It was considered evidence of a weak moral character, or a poor physical constitution,” says Barry Scanlon, a private psychiatrist in Georgia. “Many of today’s seniors don’t (or won’t) talk about a concern such as depression when troubled by it.”

Beck feels that even if older adults are aware that something is wrong, they often aren’t able to articulate that it is an emotional problem. “They are unable to label it as depression and untreated depression may lead to further feelings of hopelessness and suicidal thinking,” she says.

Misdiagnosis by primary care physicians can occur because symptoms can be characteristic of the side effects of many medications taken by the elderly, as well as some illnesses like Parkinson’s or dementia. According to Beck, depressed older adults may withdraw socially, experience problems with short-term memory and the ability to concentrate, and express inability to enjoy what once was enjoyed, symptoms common in both depression and dementia.

Symptoms of older adult depression are often different from those seen in younger adults. Memory problems and confusion are common, as well as social withdrawal, loss of appetite, sleep pattern changes and irritability. Older adults tend to complain vaguely, and sadness is either not felt at all, or not vocalized. Often, any complaints are attributed to physical ailments, so friends and family miss the signs of depression.

Finally, even when older adults recognize that their emotional health is suffering, they can’t (or believe that they can’t) afford proper treatment and don’t know where to turn.

What are the ramifications of all of these undiagnosed cases of older adult depression? While Americans age 65 and older only account for 13 percent of the population, they account for a disproportionably large portion of the suicides – 18 percent. Tragically, 20 percent of these suicide victims see a doctor the day they die, 40 percent see one that week and 70 percent see one that month.

“Many physicians look at aging as a biological process, but in addition to biology, there is the social aging that refers to changes or losses of roles, and psychological aging that results from the combined effects of biological and social aging,” says Linda Bradley, a clinician at Portage Path. “If physicians aren’t assessing these changes, an emotionally unhealthy older adult can become susceptible to feelings of anxiety, depression, guilt, lower self-esteem and feelings of powerlessness.”

Beck agrees that older adults need to be screened more carefully by their primary care physicians, especially since the elderly are unlikely to seek help elsewhere. One solution, says Beck, is increased education and training about depression in the elderly, and to make depression screening a part of the regular physical check-up.

If you or someone you know may be struggling with depression, free depression screenings can be accessed at www.portagpath.org. 

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