Depression and Distress

Anxiety at older age

Throughout our lives, everyone encounters situations that can trigger anxiety. Nonetheless, if anxiety significantly hinders daily functioning, it is advisable to pursue medical treatment. Older adults are at risk of suffering from anxiety and depression, affecting them and their lives, as well as the lives of their caregiving family members.

Many factors may trigger anxiety, with one prominent cause being the loss of a long-term spouse, particularly after years of shared life. Chronic diseases and pain can also cause anxiety. Older adults living by themselves and feeling lonely will usually suffer from severe anxiety more than others.

Types of anxiety among older adults

• A Generalized Anxiety Disorder: A state of excessive worry and apprehension that encompasses various areas of life
• Social anxiety: A person's excessive preoccupation with how they are perceived by others.
• Obsessive-Compulsive Disorder: A disorder manifested as persistent thoughts that induce anxiety. The person engages in repetitive rituals, such as compulsive handwashing, to alleviate their distress and overcome the disorder.
• Acute Stress Disorder: A developing anxiety disorder that involves a behavioral disorder typically erupting around one month after experiencing an extremely traumatic event.
• Post-Traumatic Stress Disorder: A prolonged duration of an acute stress disorder.

If you fear or suffer from anxiety or are at risk of a flare-up of existing anxiety, it is crucial to consult your family doctor to receive a diagnosis and appropriate treatment.

Depression at older age

According to the Ministry of Health’s current data, 2%–5% of older adults suffer from depression to various degrees. Untreated, depression may cause functional and cognitive decline.

It is important to learn about various risk factors associated with depression. For instance, if a person has suffered from depression in the past, they are susceptible to experience it again. Various factors, including a compromised medical condition, functional disability, sleep disturbances, experiences of grief or bereavement, limited access to medical services, and inadequate support, contribute to the increased susceptibility to depression.

How can depression be detected

Depression is a condition where mood fluctuations (from normal to diminished mood) persist for more than two weeks, accompanied by alterations in sleep patterns and appetite.

How is depression diagnosed

At an older age, there are various conditions that may indicate depression. These conditions require an accurate diagnosis by an appropriate medical expert:

• A decline in memory and concentration may essentially be a depression symptom.
• Alterations in sleep habits, appetite, and mood.
• Occasionally, depression presents itself through physical symptoms, which may involve complaints of various physical pains or deterioration of the patient’s underlying medical conditions.
• Deterioration in everyday, social, and familial functioning, requiring a diagnosis and considering the possibility of depression.
• Medications: some medications may cause depression as a side effect; for instance, beta blockers, elevated blood fat medications, etc. If you have started taking a new medication and you notice a shift in your mood, it is essential to identify its source and discuss your treatment with your family physician. Do not stop taking a medication abruptly without consultation.

Treating depression and anxiety at an older age

Treating anxiety and depression includes medication therapy, socio-behavioral treatment, or a combination of both.

Socio-behavioral treatment: engaging in conversations with a psychologist who utilizes diverse therapeutic approaches, for instance, cognitive-behavioral treatment, which is available at the HMO.

Holocaust survivors are eligible for service through the Foundation for the Welfare of Holocaust Survivors, as well as additional treatments such as biofeedback.

Medication therapy: modern medicine currently offers a range of medications, with the majority containing serotonin as a component. It is important to point out that most of these medications incorporate a substantial anti-anxiety component.

It is important to be attentive to the side effects of these medications. For instance, some of the medications have a positive impact on sleep, while others may enhance appetite. Particular attention should be given to the monitoring of blood salt disorders, which require supervision. Examining the list of regular medications is vital, and it is necessary to ensure there are no interactions, which should be assessed by a doctor. Some of these medications may exhibit initial side effects that warrant prior inquiry, such as the potential for suicidal tendencies.

Most medications begin to demonstrate their effects after a consistent intake for 4-6 weeks. Family members and caregivers should be mindful of this fact, as it necessitates commitment and the availability of spare time.

It is important to point out that tranquilizers from the benzodiazepine family may help with anxiety, and there are individuals who experience positive effects for long periods of time. However, it is essential to keep in mind that these medications can potentially exacerbate confusion and dementia in older adults.

What should we be attentive to when dealing with older adults with dementia

Older age patients with dementia answer questions more slowly and may provide answers that lack focus.

These patients occasionally have numerous requests from their doctor, including inquiries to assess medical conditions that may not be necessarily justified. Some of them imagine or exaggerate the medical condition, although they lack genuine control over it. The doctor should be particularly sensitive and diagnose them carefully, in order to avoid overlooking medical conditions that may be obscured by their tendency to misrepresent their health.

Medication therapy may cause various side effects, some of which can be mere discomfort, such as stomach aches, but some can be substantial, such as altered sodium levels in the blood. Therefore, if there is a negative alteration in behavior such as confusion, it is essential to inform the doctor and refer to an examination, where the list of administered medications should be indicated.

Most medications usually begin to demonstrate their effects after 4-6 weeks from commencing the therapy. It is crucial to be attentive if suicidal thoughts are expressed, ensuring that the patient does not have any intention of fulfilling them. Providing care, maintaining a safe environment, and being present with the patient as much as possible are essential measures to be taken.