Insight Into Depression in Seniors: How Medicare Can Help

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Many people have a misunderstanding of depression and the severe effect that it can have on one’s mental and physical health. 

The COVID-19 pandemic has especially affected older adults’ mobility, as they are being advised to continue social isolation. This extended isolation has sent many into despair and real loneliness

What does depression look like?

When you have depression, you have trouble with daily life for weeks at a time. Doctors call this condition “depressive disorder” or “clinical depression.” Depression is a real illness. It is not a sign of a person’s weakness or a character flaw. Despite common belief, one cannot “snap out of” clinical depression. 

Most people who experience depression need treatment to get better. For some, depression may occur only once during their life. For most people, they will experience multiple episodes or seasons of depression. 

Depression is different for everyone, but the most common symptoms are: 

  • Feelings of sadness, emptiness, or hopelessness
  • Angry outbursts, irritability, or frustration, even over small matters
  • Anxiety, agitation, or restlessness
  • Excessive crying
  • Slowed thinking, speaking, or body movements
  • Feelings of worthlessness, shame, or guilt, fixating on past failures or self-blame
  • Trouble thinking, concentrating, making decisions, and remembering things
  • Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts, or suicide
  • Sleep disturbances, including insomnia or sleeping too much
  • Tiredness and lack of energy, so even small tasks take extra effort
  • Reduced appetite and weight loss or increased cravings for food and weight gain
  • Unexplained physical problems, such as back pain or headaches
  • Loss of interest or pleasure in most or all normal activities, such as sex, hobbies, or sports

For many people with depression, symptoms usually are severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities, or relationships with others. Some people may feel generally miserable or unhappy without really knowing why.

Depression symptoms in older adults

Depression is a common problem among older adults, but it is NOT a normal part of aging. In fact, studies show that most older adults feel satisfied with their lives, despite having more illnesses or physical problems. 

However, important life changes that happen as we get older may cause feelings of uneasiness, stress, and sadness.

Triggers of depression could be the death of a loved one, moving from work into retirement, adjusting to the move into a nursing home, or dealing with a serious illness, all of which can leave people feeling sad or anxious. After a period of adjustment, many older adults can regain their emotional balance, but others do not and may develop chronic depression.

Depression is not a normal part of growing older, and it should never be taken lightly. Unfortunately, depression often goes undiagnosed and untreated in older adults, and they may feel reluctant to seek help.

Symptoms of depression may be different or less obvious in older adults, such as:

  • Memory difficulties or personality changes
  • Physical aches or pain
  • Fatigue, loss of appetite, sleep problems, or loss of interest in sex not caused by a medical condition or medication
  • Often wanting to stay at home, rather than going out to socialize or doing new things
  • Suicidal thinking or feelings, especially in older men

When should I see a doctor?

If you feel depressed, make an appointment to see your doctor or mental health professional as soon as you can. If you’re reluctant to seek treatment, talk to a friend or loved one, any health care professional, a faith leader, or someone else you trust.

Therapy for Depression

Psychotherapy, also called “talk therapy,” can help people with depression. Some treatments are short-term, lasting 10 to 20 weeks; others are longer, depending on the person’s needs.

Cognitive behavioral therapy is another type of talk therapy used to treat depression. It focuses on helping people change negative thinking and any behaviors that may be making depression worse. Interpersonal therapy can help an individual understand and work through troubled relationships that may cause depression or make it worse. Other types of talk therapy, like problem-solving therapy, can be helpful for people with depression.

Medicare has you covered

Medicare beneficiaries should not have to pay anything out of pocket for a depression screening from their primary care doctor. Medicare Part B (Medical Insurance) covers one depression screening per year. The screening must be done in a primary care doctor’s office or primary care clinic that can provide follow-up treatment and referrals. Depression medication is also covered by Medicare Part D. Get with your doctor to understand what medication might be best for you. 

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Medications for depression

Antidepressants are medicines that treat depression. There are many different types of antidepressants. They may help improve the way your brain uses certain chemicals that control mood or stress. You may need to try several different antidepressant medicines before finding one that improves your symptoms and has manageable side effects. 

Most antidepressants are generally safe, but many come with certain side effects and may have adverse effects with the medications that you are currently on. Talk to your doctor about your options, for they will know what you should take according to your health history and current medications.

Note: Antidepressants take time, usually two to four weeks, to work. Often symptoms such as sleep, appetite, and concentration problems improve before mood lifts, so it is important to give the medication a chance to work before deciding whether it works for you. If you begin taking antidepressants, do not stop taking them without the help of a doctor. Sometimes people begin taking antidepressants and start to feel better, so they decide that they no longer need the medication. 

When you and your doctor have decided it is time to stop the medication, usually after six to 12 months, the doctor will help you slowly and safely decrease your dose. Stopping antidepressants abruptly can cause withdrawal symptoms.

When to get emergency help

If you think you may hurt yourself or attempt suicide, you need to seek professional health immediately. Feelings of hopelessness need to be taken seriously. Reaching out to a close friend or loved one can seem embarrassing or shameful, but it is the right thing to do and is the same thing you would do if you were having any other medical problem. Remember that depression is a real illness and needs to be treated as such. 

If you’re having suicidal thoughts:

  • Call your doctor or mental health professional.
  • Call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255). Use that same number and press “1” to reach the Veterans Crisis Line.
  • Contact a minister, spiritual leader, or someone else in your faith community.
  • If you have a loved one who you believe is in danger of suicide or has made a suicide attempt, it is important to make sure that person is never alone. 
  • Always call 911 or your local emergency number immediately, if you believe your loved one is at risk of harming themselves. If you think you can do so safely, take the person to the nearest hospital emergency room.

Related Sources:

Extended Isolation Sending Seniors Into Despair

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