Depression and old age

One of the TV programs I like to watch if I can is “the Apprentice”, where smart young, ambitious business men and women compete to become the next apprentice of the show’s host, leading entrepreneur, Lord Alan Sugar. One of the catch phrases I have heard him use, when trying to goad a wannabe apprentice, is: “I wonder if you are just a one trick pony?” By that he had been intimating they may be good at something, but that was all they were good at, and that he is looking for a well rounded candidate who has other attributes to bring to his organization.

There is a temptation in writing this blog to concentrate on one or two issues and ignore others, One of my particular interests is homelessness and, because it relates, immigration too. Other than updating my earlier winter night shelter post and starting to prepare something for later regarding immigration, a subject rarely far from the news, I feel it is good to open up yet another subject not touched on so far. Just as with the Apprentice, having these other tricks is important for a wannabe, or in my case an actually being, community activist. Nevertheless, while I would like to display my other tricks, it is also quite right to focus on one’s own specialisms.

I spent 90 minutes today in the Sainsbury café at Rayleigh waiting for my wife to finish a meeting and part of that time I spent going through the day’s newspaper. The standout article as far as I was concerned had the title “Depression in old age is the next big health crisis” (Times, 8/04/2014). I have written about depression and old age in my earlier writings, available via the “writings” tab of this website, but not in conjunction. Me getting old and with the early onset of dementia, and I am a depressive by nature too, brought the subject much closer to home.

The article quotes psychiatric experts who point out that “millions of older people suffer from undiagnosed depression in a silent epidemic that constitutes our next big public health problem”. The article states that 9 out of 10 older people who are suffering from depression get no help at all and any unusual behavior is often confused with dementia, including by medical professionals.

The article points out that many older people do not get many opportunities to speak to others and their depression is often hidden by agitation, forgetfulness and unexplained physical pain, and in many cases this is present alongside dementia. It is suggested that depression might be brought on by an assortment of factors: such as bereavement, loneliness and a loss of physical independence, and the interventions that can help might include: anti-depressant drugs, talking therapy and social support. The experts also made a number of startling assertions that got me thinking:

  1. This is a condition that overtakes every element of your whole life and bites away at every aspect of your existence.
  2. The mindset that it is a normal at this stage in life to disengage with the world and start to close up needs to be countered by the notion that the elderly could and should be encouraged to get what they want from old age rather than be written off.
  3. Losing interest in the world was not a normal part of aging in the past. (I suspect in the past we valued the elderly more and family life was such that the elderly was much more part of it.)

The issue of depression and old age is brought close to home to me for another reason. My mother died last June, aged 90, and she had, for her last few years, dementia. Sometimes her behavior suggested, and sometimes she expressed this verbally, except we were not listening as attentively as we ought, that she was depressed, at least for some of that time. As a family we did what we could to give her a good quality of life in her twilight years and as is usually the case we feel we could have done more. The point I want to make is that I can see now how it was easy for us as a family, and those who cared for her, to see her depression as part of her dementia. I can’t do anything about the past but I can do something in the future, and just as I will continue to speak and act on behalf of those with a dual diagnosis, in my line of activism it is often people that suffer from both mental illness and the effects of substance misuse, and make the point that both conditions need to be addressed in tandem.

I think that if people are ignored, dismissed and written off, as old people tend to be, and at the same time their ability to change things becomes more limited, it is easy to see how they can become depressed. I felt challenged as to how to respond personally, as it is quite easy to see myself becoming yet another depressive oldie cast aside by society, and how I should treat older people. While I think I have dealt with older people quite well in my various interactions in the past, to my shame I could have done a lot more. The key is to recognize old people and cherish and value them. To our shame, this often runs counter to our self-seeking modern culture. Yet the truth is, society is healthiest when old and young both can contribute.

As with any form of depressive behavior, it is not enough to tell the sufferer to get a grip, look on the bright side of life, etc. A good dose of tender loving care might well work better. We should remind ourselves that life is short and we need to make the most of it. For me, being young seems like yesterday and then I was optimistic, idealistic, ambitious and vigorous. While never quite ready to conquer the world, I had a good stab at it. But even when old, there are things we can all do that matter, even if we need to pace ourselves and recognize limitations. This is what keeps me going.

As I ponder the above, I can think of a long list of “things to do”, often fairly ordinary, but I need to do them. Carpe diem (seize the day) is something I try to do and encourage others to do also. This can never be more true than when our days are numbered. I find increasingly these days a desire to leave a worthwhile legacy. We must not lose heart and we must encourage other older people to do likewise. We must affirm their worth and treat them with respect.