Depression and Suicide in the Elderly
Old age is one of life's thresholds that few of us in midlife are emotionally and psychologically prepared for.
Harold is 86, a retired lineman for the phone company. His wife of 60 years died last year, leaving him alone in the home they shared for many decades. He used to be a hunter and outdoorsmen — an activity that helped him cope when Helen died. But after injuring himself in a fall, he's been relegated to using a walker around the house.
He passes the days watching television game shows and staring out the window onto land he can no longer walk. It's sunset (about the time he and Helen used to sit down to their evening meal). He's decided he can't endure another day alone in this house. Taking his hunting rifle down off the wall, he opens the box of shells in his lap and loads the chamber …
Old age is one of life's thresholds that few of us in midlife are emotionally and psychologically prepared for. We'd like to believe we'll never have to experience the full impact of time's whittling away of our bodies. We may stave off the symptoms of old age with exercise and diet, or simply deny the facts by applying hair color and skin serums.
But in fact, barring catastrophic illness, car accidents or devastating Acts of God, most of us — more than 90 percent, according to one statistic — will die incrementally of chronic diseases like diabetes or hardening of the arteries. A comparative few can expect to go as we'd like: at home in our sleep, or from a sudden heart attack while doing a task we love.
Likewise, as we get older we'll experience with mounting frequency the passing of friends and loved ones. Old age and loss go hand in hand.
Our Fear of Aging
We avoid thinking about getting older because old age conjures up our worst fears: of being trapped in a bed or wheelchair, of being a burden, of losing our ability to think and reason — of being alone.
Thus we shouldn't be surprised to learn that depression is epidemic among the aged. According to one study, 20-25 percent of the elderly in nursing homes are clinically depressed.
Every day in the United States, 17 adults over the age of 65 commit suicide — the highest suicide rate of any demographic group. And unlike younger people — those for whom an attempted suicide is more often a "cry for help" — elderly people who attempt suicide usually succeed.
"The elderly are usually more intentional about what they're doing," says Dr. Elisa Thompson, a specialist in human development and aging issues. "They are more likely to use firearms or other lethal means. They also tend not to leave notes."
According to Dr. Thompson, those who do leave notes often state such reasons as despair, the desire to escape suffering, economic and financial problems and a fear of burdening family members.
Yet treating depression in the elderly can be difficult thanks to cultural stereotypes and attitudes among an older generation that often views depression as a character weakness — not the disease it actually is. An elderly person's stoicism ("I just need to toughen up, that's all") may mask symptoms and prevent them from asking for help.
Even when they do ask, help may be hard to find. Suicide hotlines are often manned by young people untrained in how to counsel depressed older adults. Finally, and perhaps saddest of all, is the reality of physical isolation. In a world so fearful old age, there may be no one physically close enough who recognizes the symptoms and can help the depressed elderly person get the help they need.
Treating Depression in the Elderly
The good news is that depression is treatable. Depending on the severity and exact nature of an elderly person's depression, there are a number of things friends, caregivers and family members can do to ease a loved one's feelings of despair and emotional "heaviness."
Medication should be given every consideration as a treatment option. Today's new generation of antidepressants can perform wonders for those who are chronically, clinically depressed. Many of the new drugs correct chemical imbalances with a minimum of side effects.
Many elderly people, used to contributing to the world, wrestle with feelings of having no purpose. Employment (paid or unpaid) makes an older person feel that their life has meaning again. It doesn't matter what the job is: stuffing envelopes or helping to serve meals at the local senior center. Serving others makes all of us feel better.
As we age, we suffer losses — of spouses, loved ones, our freedoms, etc. It's natural to grieve these losses. It's not natural to be unable to express our feelings of loss out loud. A friend or caring volunteer can play the role of compassionate listener to someone going through a painful loss. Just by listening — not necessarily offering "solutions" — we honor the hurting person's feelings and help ease them through the normal stages of grief.
Offering the Hope of Christ
When someone is clearly clinically depressed and not thinking rationally, a caregiver can gently counter negative attitudes with a different, more hopeful perspective. This is where God's Word can come into the picture as a reminder that "suffering is for a day, but joy comes in the morning."
The hope of Christ is for all people in every age and stage of life. The Bible is rife with words of hope and comfort for suffering people. Be prepared to share those words with a depressed elderly person.
What the Community Can Do
According to Dr. Thompson, there are a number of things communities can do to raise awareness of this issue and ease an elderly person's emotional pain:
Staff suicide hotlines with older adults or young workers with geriatric training.
Advertise services for the elderly (transportation, community meals, in-home services, etc.) in churches, pharmacies, retirement centers and community dining halls.
Hospitals and communities with programs for the elderly can train "advocates" to set up appointments, make helpful phone calls and ensure that homes of at-risk elderly adults are free of weapons, expired medications and dangerous household products.
Clinical depression, unlike the occasional case of "the blues," is a real, treatable illness, with symptoms as predictable as the symptoms of any other disease. Yes, Christians can become depressed. They also can — and do — commit suicide.
Trouble is, only about one in six elderly sufferers of depression get help. If you know an elderly person who you suspect is clinically depressed, don't brush it off. Talk to the person and contact a physician — or sit with them while they make the phone call. Do whatever is necessary to get them the help they need.
Copyright 2002 by Roberta Rand. Used by permission. All rights reserved.