Depression can be devastating to all areas of a person’s everyday life, including family relationships, friendships, and the ability to work or go to school. Many people still believe that the emotional symptoms caused by depression are “not real”. The concept of elderly depression as a natural phenomenon of ageing is probably less widespread than the sheer difficulty in general practice of accurately diagnosing the condition and the patient’s type and stage of depression: minor, major, episodic or chronic, double depression , depressive symptoms, or at the borderline between depression and dementia.
One hypothesis answering the question why the disability impact of depression should be so much lower among the elderly than in early adulthood or middle age, is that elderly attitudes towards their own problems gradually change with advancing age. Attitudes can change materially with positive or negative effect between the early and late phases of old age.
In most of care homes in Berkshire, residents with a depressive illness cannot merely “pull themselves together” and get better. Without treatment, symptoms can last for weeks, months, or years. A study of 2,633 adults in Chinese cities has concluded that the gender difference is insignificant, except in the 35-49 age group where the lifetime prevalence of major depression for men was 3.6% compared with only 2.3% for women. Even in the West, the gender gap is perhaps less conclusive than appears at first sight.
In our rapidly ageing society, it is high time for the complexities of elderly depression to be added to the roster of disease management. There is no practical evidence that such management can be applied to depression, for example in the form of ‘collaborative care’ as well as by way of a more integrated approach to the combination of medication with psychotherapy which can be particularly effective with elderly patients.
Bipolar disorder is a mood disorder in which feelings, thoughts, behaviors, and perceptions are altered in the context of episodes of mania and depression. Previously known as manic depression, bipolar disorder was once thought to occur rarely in youth. Late-life depression can have different causes, symptoms and treatment needs than that observed in younger persons. It is less likely to be grounded in family history, and more frequently associated with the medical and psychosocial problems of ageing or with cognitive deficit.
The combination of medical and social aspects of elderly depression is also putting increasing economic pressure on society’s financial burden in trying to provide satisfactory health care and long-term care.