Aging and Depression
Coping with the losses that come with aging
Posted Apr 15, 2017
“Getting old is not for sissies.” ― Bette Davis
“When I was in my twenties everyone I knew was in psychotherapy, now everyone I know is in physical therapy.” – 70 year-old woman
“When I was in my twenties most of my friends were getting married; now most of them are widows.” –78 year-old woman
Some people point to the benefits of getting old: you get a seat on the subway; you have more time to travel. But most of us would rather stand up, if we can. And many elderly people have plenty of time to travel, but cannot afford it or don’t want to travel alone.
Getting old involves loss—loss of friends; loss of spouse; loss of siblings; loss of status; loss of hair; loss of physical mobility; loss of memory; loss of hearing; loss of eyesight; and sometimes loss of financial stability. So it is not surprising that aging and depression often go together. Of course, aging is going on from birth and we have losses throughout life—for some people major ones. But when we talk about “aging,” we usually mean “old age.” And when does that start? As many acute diseases have become chronic, people are living longer. Nowadays many people say 60 is the new 40, so when does old age begin? Maybe 70? Or maybe it begins when the losses start mounting up—somewhere between 65 and 75. (For more on aging and depression, CLICK HERE.)
Feeling sad about these losses is a normal part of life. However, some people experience a sense of hopelessness that lingers and spreads—that is depression. It is important to distinguish between the two so that we allow people (or ourselves) the space to process the sadness of loss, but seek help when sadness turns to depression. How can you tell the difference?
Inability to fall asleep or stay asleep, lack of appetite, irritation at small inconveniences, social isolation, feelings of hopelessness, refusal to do anything that might make you feel better—these are signs of depression when they are in a cluster and last more than a few months. Of course, we can all identify with one or two of these indicators, the problem is when we can identify with several.
What can you do if you or a loved one is depressed? Of course, you can get help (join a support group, seek out a psychotherapist, etc.). However, there is a conundrum. One of the symptoms of depression is hopelessness—hence resistance to getting help is common. If you believe no one can help you, you will not try to get help or even accept it when it’s offered. In fact, depressed people often respond with anger toward those who try to help them. For example, my patient, John, gets angry at my suggestion that he could feel better if he took an anti-depressant. He says, “You don’t get it. You don’t understand. Nothing can help me.” My suggestion that he can feel better is experienced as a lack of understanding. This often adds to the social isolation of depressed people because their friends and relatives may get frustrated and give up trying after a while. It is painful to watch a loved one in misery and feel helpless.
So what do you do when a loved one is depressed and refuses to get help? Sometimes it is helpful get a trusted third party to speak to the depressed person—perhaps a doctor or minister. Other times it may help to join forces with others and have a group intervention—“Dad, you’re depressed. We understand why you feel so bad, but you need to get help.” There are no easy answers when someone refuses help. But you have to keep trying.