Depression in old age is often preventable – how to recognize the first signs

She had always been full of life, she said. But after her husband Wolf fell ill with cancer after 40 years of marriage, and she herself had just been hospitalized with an infection, that changed. "I experienced too much bad stuff because of these illnesses. Now I thank God that he guided me through life so beautifully until two years ago."

Speaking to " Welt am Sonntag ," she said: "I somehow see death as my friend. Falling asleep peacefully and quickly, a swift, beautiful death," that's what she could imagine. "It's not possible at the moment," she added. She has her husband, for whom she is very afraid. She is also worried about the younger generation.

Elke Sommer also expresses positive feelings in the interviews. For example, she enjoys her life in California, the "beautiful property with pool, tennis court, and flowers." Overall, she is at peace with her life. However, there have also been periods when her health problems made it nearly impossible for her to leave the house.

When negative thoughts arise due to such life circumstances, very few people over 60 seek psychotherapeutic help. They make up just six percent of patients. Yet these circumstances can trigger what is known as geriatric depression, which in most cases can be treated effectively.

"Depression is the most common mental illness in old age," explains neurologist Mimoun Azizi in his guest article on FOCUS online . It is "often accompanied by a high rate of suicidality." Azizi is the head of geriatrics/neurogeriatrics at Celle General Hospital and a specialist in psychiatry and psychotherapy.

Depression does not affect older people more frequently than younger adults. The German Depression Foundation writes : "According to a study on adult health in Germany by the Robert Koch Institute (DEGS), 8.1 percent of all people aged 18 to 79 will suffer from depression within one year. Looking only at those aged 70 to 79, the figure is 6.1 percent."

However, milder forms of depression, or those in which not all symptoms are present, are two to three times more common in older people.

Depression in old age is not always easy to recognize. In addition to the classic symptoms, age-specific characteristics also occur, as depression support organizations explain:

• In older people, health-related problems often take center stage and are perceived – due to depression – as more severe and threatening than they actually are. For example:
• Existing back pain or tinnitus as part of a depression is perceived as increasingly unbearable,
• The concentration and comprehension problems associated with depression are often linked to the worry of possibly suffering from Alzheimer's dementia.
• If a doctor fails to ask about the psychological symptoms of depression, such as hopelessness, suicidal thoughts, feelings of guilt , etc., the depression itself, as the underlying illness, may be overlooked. Without a proper diagnosis, the illness cannot be adequately treated.
• Those affected often focus their attention and concerns on existing physical complaints, which include pain of various kinds or sleep and digestive problems . Furthermore, older patients often have difficulty accepting mental illness as a separate condition like other (physical) illnesses.

Due to the varying symptoms, depression in older people is often diagnosed too late. "A delayed diagnosis negatively impacts treatment options and can significantly impair the quality of life of those affected," warns Azizi.

"Despite the growing importance of geriatric medicine and the associated challenges, this field continues to receive inadequate treatment in Western medicine. Therefore, there is an urgent need for improved diagnosis and treatment of depression in old age in order to improve the well-being and quality of life of older people."

The triggers for depression in old age are manifold. These can include the serious illness or even death of a partner, sleep disorders, or one's own physical limitations, for example, due to illness. However, depressive symptoms in old age are often mistakenly interpreted as an untreatable reaction to unavoidable life stresses, criticizes Azizi.

"However, it is crucial to correctly identify these symptoms, as they are treatable through medical and social interventions and generally have a favorable prognosis. Early detection and treatment can minimize the risk of depression in old age."

Those suffering from depression in old age can receive help, especially through psychotherapy and drug therapy.

Drug treatment, on the other hand, usually involves an antidepressant. Careful selection by the doctor is important in this case to avoid interactions with other medications.

Despite the potential challenges of treatment with antidepressants, this is particularly important for elderly people, emphasizes the German Depression Foundation : "Depression is a life-threatening illness in old age, even more so than in younger people."

Hopelessness is a symptom of depression. Many sufferers therefore believe that they cannot be helped. But that's not true! Support your loved one in going to the doctor, if they haven't already . Remind them that depression is an illness and that they are not to blame. But also remind yourself of all these things: You are not to blame. And: You too can and should seek help if you are feeling desperate.

Especially during difficult times, those affected often withdraw, don't want to see anyone, and don't want to do anything. This has nothing to do with you. Realize that this is the illness, not the person.

Do things regularly that make you feel good and recharge your batteries. Nurture your relationships. Treat yourself: a stroll through town, a trip to the cinema. Don't feel selfish about it. Only those who have can give.

Don't tell yourself, "Love has to withstand this." Be aware of your own limits. And communicate these to your partner: "I need space right now." "This is becoming too much for me." "I'm not discussing this any further."