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Late Life Depression & Suicide

Depression Does Not Have To Be A Part Of Getting Older 

This project is a requirement of the GOA Abnormal Psychology Course. Using the process of design thinking, a challenge in the world of mental health was identified, interviews and research were undertaken, and a solution prototype was developed. Below you will find information about the identified area of concern and my proposed solution. Please feel free to provide feedback on this prototype, using questions such as “How might we…”, “What if….?”, “I wonder….”, “I like…”, and “I wish.” Keep the comments positive, please. For more information on the process of Design Thinking, click here.

 

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BACKGROUND – When I was first thinking about the topic I would choose for this presentation about abnormal psychology, the first question that came to mind was: what group of people is most affected by suicide in the United States? Upon researching I quickly found out that people later in life had the highest suicide rates. I assumed it would be teenage girls but in reality it’s middle-aged and elderly men. I knew that if I had this misconception, then many others must as well, so I hope that this presentation can dispel  some myths and correctly inform you about Late Life Depression and Suicide. 

 

Did you know that people aged 45-85 are at the highest risk of suicide in the US?

yes
no
 
 
 
 
 
 

 

Have you ever heard of Late Life Depression?

yes
no
 
 
 
 
 
 

 

THE CHALLENGE is figuring out how to solve this issue. How can our generation be the one that decreases the prevalence of Late Life Depression and Suicide? The first step to solving any problem is recognizing there is one. And education is the best way of taking that first step. So here is all you need to know about Late Life Depression and Suicide:

 

What is Late Life Depression?

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Late Life Depression is something that many elders go through, but rarely seek help for. This condition is similar to depression seen in younger adults and teens, but has its own unique causes, symptoms and treatments as well.

It is especially important learn about this subject because of the lack of awareness of late life depression and suicide. Few people know that the elderly are at a higher risk of depression and successful suicide than any other group of people in America.

 

What are the causes?

  • Life changing events (ex: isolation, retirement, health issues, the death of a spouse/loved one, etc.)

 

  • As a result of aging, people may feel helpless against the onslaught of recurrent and uncontrollable physical illness and its effects on them and to changes in their social position, this is especially heightened in widowed or divorced females. 

 

  • Also, some medications that are often taken by elderly people can cause/worsen depression (ex. arthritis medication, hormones, steroids, and antihypertensive medication, etc.)

 

  • There is even a hypothesis out there that suggests that cerebrovascular injury is linked to late-life depression. Elevated levels of homocysteine lead to cerebral vascular disease and neurotransmitter deficiency, which then cause depressed mood. 

 

What are the symptoms?

– Loss of interest in activities

 – Low self worth

– Frequent thoughts of death; suicide attempt

– Weight loss and/or appetite loss

– Social isolation

– Sadness

– excessive sleep or Insomnia 

– Fatigue

– Feeling helpless or high anxiety

 

Other symptoms more specific to Elders:


– Confusion

– Vague Complaints of Pain  

– Irritability or demanding behavior

– Neglecting personal care

–  Memory problems

– Delusions

– Slowed movements or speech

 

 

 

Here are some of videos and statistics that will help you have a deeper understanding and

empathy for those who suffer from depression in late life:

 

Image result for elderly depression infographic

 

 

 

                                            Statistics                                            

Did You Know That:

  • 65% of elderly suicide victims have depression
  • The prevalence of of major depression in the elderly is between 60%-90%
  • Elderly depression affects nearly 6 million seniors, and only a small percentage seek help
  • In 2004, older American composed 12% of the population, but elders accounted for 16% of suicide deaths
  • In 2010, 16.00 of every 100 000 people aged 65 years and older died by suicide, which was higher than the rate of 11.26 per 100 000 in the general population
  • 50% of patients with Geriatric Depression Scale (GDS) scores greater than 6 died by 19 months versus 54 months for patients with GDS scores less than 7 
  • In patients who have had a stroke, the prevalence rate for major depression is1
    9.3% among hospitalized patients and 23.3% in outpatients.

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People 55 and older in the US made up nearly 40% of suicides in 2012

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Americans 40-59 years old (especially females) are the most affected by depression

 

 

 

 

 

 

 

Why are rates of suicide so high in elders?

“While older people make fewer suicide attempts than the young, they are far more likely to die from them.” – Paula Span, New York Times

Paula Span, who wrote an article in the New York Times called Suicide Rates Are High Among the Elderly, would argue that the elderly are more likely to die from attempting suicide because they are more likely to use firearms. According to Dr. Yeates Conwell, a psychiatrist who has studied late-life suicide says that, younger people have more physical resilience and use less lethal means“, therefore they have a better chance of survival. Additionally, Span shares how Patrick Arbore, founder and director of the Center for Elderly Suicide Prevention, says that “a lot of older people have problems asking for help“.

This the issue that desperately needs more attention. Statistics prove that rates of elderly suicide and depression are disproportionately high, yet elders are still unlikely to get help as a result of lack of awareness and the fear of admitting to having a stigmatized illness, like depression. Arbore says that, “men are good at masking it, because we’ve been conditioned to believe it’s not O.K. to express emotional pain“. All of these factors contribute to the disproportionately high rates of suicide among older people. The first step to solving this problem is to de-stigmatize elderly depression and destroy the myth that depression is an automatic part of getting older.  

I encourage you to read the rest of the article as it gives some great insight into not only the facts behind late life suicide, but what it is like to have a loved one affected by depression and suicide: https://newoldage.blogs.nytimes.com/2013/08/07/high-suicide-rates-among-the-elderly/   

 

 

THE SOLUTION-  Know what is fact, what is fiction, and how you can help a loved one. By knowing about the topics below, you will be better suited to combat Late Life Depression in loved ones now, or even in yourself later in life. 

 

Breaking Stereotypes:

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  • Although depression is not a consequence of normal aging, depressive disorders are common in later life and anyone suffering from it should get help, instead of accepting it as apart of the aging process
  • Despite what media decides to portray, depression affects more than just young adults and teens. Anyone can suffer from depression, but especially elders are disproportionately affected by depression and suicide

 

 

Attitudes towards elderly suicide

Generally society is more accepting of death when it happens to a person of old age to compared to adolescents because the years of potential life lost is much greater with younger people. Plus, the public pays less attention to death and suicide in the elderly because the media pays significantly less attention to it, therefore the public is not as aware. This is not just a social issue: even scientific attention to suicide relating to elders is lacking! Most studies on the risk of suicide with Selective serotonin reuptake inhibitor (SSRI) are focused on youth or middle-aged people. And in general, depression in the elderly are more likely to go untreated than any other age group.

  • Approximately 68% of adults aged 65 and over know little or almost nothing about depression.
  • Only 38% of adults aged 65 and over believe that depression is a “health” problem.
  • If suffering from depression, older adults are more likely than any other group to “handle it themselves.”  Only 42% would seek help from a health professional.
  • Signs of depression are mentioned more frequently by people under age 64 than people aged 65 and over.  These include “a change in eating habits” (29% vs. 15%), “a change in sleeping habits” (33% vs. 16%) and “sadness” (28% vs. 15%).
  • About 58% of people aged 65 and older believe that it is “normal” for people to get depressed as they grow older.

 

 

 

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Treatment

If late life depression goes untreated, the possible outcomes include higher mortality rates from both suicide and medical illness. So there is no time to waste when it comes to seeking treatment for this condition.

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Options include:

  • supportive measures and watchful waiting from loved ones (for milder cases)
  • Exercise (improves cardiovascular function, releases endogenous endorphins, and improves cognition and mental stimulation)
  • Pyschotherapy
  • Neuroplasticity-based computerized cognitive remediation, NBCCR (Theseintervention tasks target and activate dorsalneocortical structures to enhance their function, leadingtoimprovement indepression symptoms)
  • Pharmacotherapy (medication)Image result for exercise
  • SSRIs (Selective serotonin reuptake inhibitor)
  • Neuromodulation Interventions (are typically resorted to if none of the above and successful)
  • Electroconvulsive therapy (for severe, unremitting depression associated with marked physical or functional impairment, and for which a rapid definitive response is needed)

 

 

What can you do?

Look out for the signs:

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• Statements about death and suicide

• Reading material about death and suicide

• Stockpiling medication

• Rush to complete a will or make revisions to it

• Increased alcohol of prescription drug use

• Sudden interest in firearms

• Overt suicide threats

 

 

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BE SUPPORTIVE!

The first thing anyone needs to get through depression is a strong support system of people they trust

EMPATHIZE with them: First just listen and try to understand and validate their feelings instead of giving your input or advice right away

Show them you care

avoid minimizing their experience or telling them to see the “silver lining” of their situation

Encourage and help them seek professional health

Most importantly, make sure they know they are not alone

 

 

 

It might be scary to know that a loved one is facing depression or suicidal thoughts, but the first step to helping them is being there for them! Just by completing this presentation and educating yourself, you are one step closer to decreasing the prevalence of Late Life Depression and Suicide.

 

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Image result for callFriendship line for the Elderly:

(800) 971-0016 

National Suicide Prevention Lifeline:

1-800-273-8255

 

 

WHAT’S NEXT- please take the time to answer this little survey and tell me what ideas you have for next steps. I am thinking of bringing this issue up with my family first, and educating, especially my older family members about Late Life Depression and Suicide.  

 

After this presentation, how well-equipped do you feel to help a loved one (or yourself when you are older) navigate late life depression?

1 – not very
3 – kind of / more than I was before
5 – very

 

 

***Disclaimer: all symptoms and treatment  options are based on the Western perception of mental health and mental health treatment…so this illness has the potential to look different within foreign communities and cultures***

Thank you for your time and participation!!!

  
 
-works cited-
  1. Aziz, Rehan, and David C Steffens. “What Are the Causes of Late-Life Depression?”Www.ncbi.nlm.nih.gov, 1 Dec. 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4084923/.
  2. Espinoza, Randall, and Aaron H. Kaufman. “Diagnosis and Treatment of Late-Life Depression: Page 3 of 5.” Psychiatric Times, 30 Oct. 2014, www.psychiatrictimes.com/special-reports/diagnosis-and-treatment-late-life-depression/page/0/2.
  3. Pratt, Laura A., and Debra J. Brody. “National Center for Health Statistics.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 3 Dec. 2014, www.cdc.gov/nchs/products/databriefs/db172.htm.
  4. Span, Paula. “Suicide Rates Are High Among the Elderly.”Www.newoldage.blogs.nytimes.com, 7 Aug. 2013, 5am, newoldage.blogs.nytimes.com/2013/08/07/high-suicide-rates-among-the-elderly/.
  5. Worthington, Barbara. “Elder Suicide: A Needless Tragedy.” Elder Suicide: A Needless Tragedy, www.todaysgeriatricmedicine.com/news/exclusive_03.shtml.
  6. Esposito, Lisa. “9 Things to Do or Say When a Loved One Talks About Taking Their Life.” U.S. News & World Report, U.S. News & World Report, 7 Nov. 2014, 11:39am, health.usnews.com/health-news/health-wellness/slideshows/9-things-to-do-or-say-when-a-loved-one-talks-about-taking-their-life?slide=11.
  7. Depression In Older Adults: More Facts. www.mentalhealthamerica.net/conditions/depression-older-adults-more-facts.
  8. “Mental Health of Older Adults.” World Health Organization, World Health Organization, 12 Dec. 2017, www.who.int/en/news-room/fact-sheets/detail/mental-health-of-older-adults.

 

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COMMENTS: 7
  1. April 26, 2018 by Annika.Singh

    I really did not know anything about this topic before reading your presentation. It was super informative! I liked how many statistic you shared and some of the symptoms of depression that are specific to elderly people. I thought it was really interesting that such a high percentage of suicides were by people over the age of 55. You hear so much more about teen suicide, so it was really interesting to hear that. Really nice job! I really liked your presentation!

    • May 05, 2018 by Kelsey.Watkins

      Thanks you! it means a lot, I am glad that you feel more informed about this issue now !! I hope this information will stick with you so that if you ever come across this condition in yourself or others you have an idea of what to do.

  2. April 27, 2018 by Talia.Cieslinski

    This was such a great information tool, and I learned so much. This is not a topic that is talked about, and the perception of suicide for the elderly is so so different than how suicide and depression is perceived in younger people and I love that this is a tool to change that for the better.

    • May 05, 2018 by Kelsey.Watkins

      Awesome! I tried to pack in a lot of statistics to really prove the severity of this issue, so I am glad it helped convey the message for you

  3. April 27, 2018 by Julianna Aikens

    Amazing presentation!! It looks like you put a lot of time and effort into this project and it paid off!!

  4. April 27, 2018 by Saanya Kapasi

    This presentation was so well-written with lots of information and statistics, and yet it still maintains the importance of empathy. Often when talking about mental illness, we focus on adolescents and young adults, but this presentation brought great awareness to an issue that’s just as relevant. Wonderful work!

    • May 05, 2018 by Kelsey.Watkins

      Thank you so much! I am happy to know that you picked up on the importance of empathy that I tried to highlight. Honestly it is such an important life skill to use sensitive situations regarding mental health.

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