Depression in the elderly can be a common psychological finding. However, often times, depression is just a symptom of underlying medical issues. Due to the idea of impending mortality and loneliness occupying a majority of aging, it is easy to overestimate the rates of depression in the elderly. However, there are many health conditions that mask as depression, and if they are not properly treated, then these health conditions may worsen. Below are a list of other health conditions that may manifest as depression, along with other symptoms. If you or anyone you know is experiencing any of these other issues, please speak with your health provider right away.
Hypothyroidism
Hypothyroidism is the condition where the thyroid gland is not producing enough thyroid hormone. Thyroid hormone is a hormone that is responsible for many physiological processes that happen in the body. Where there is too little of it, that is called hypothyroidism. This can be due to the fact that the thyroid gland is not receiving proper stimulation, and therefore not making any thyroid hormone. Or, it can be due to the brain not producing enough thyroid stimulating hormone (TSH) which is responsible for stimulating thyroid hormone production in the thyroid.
Without thyroid hormone, you may feel lethargic, gain weight, cold, and just bad. This can look like depression because these individuals may not want to do anything because they don’t feel good. They may just want to wrap up in a blanket and lie in the same spot all day long. Without recognizing that their thyroid levels are low, they are at risk for a complication called myxedema coma. This is a stupor-like state where individuals are so low on thyroid that several systems begin to dysfunction. It’s important, that if you or a loved one is diagnosed with depression, that you make sure physicians checked your thyroid level.
Hyperthyroidism
The opposite of that is hyperthyroidism. Hyperthyroidism happens when the thyroid turns off its ability to see the stop signal from the brain and continues producing thyroid. When there is too much thyroid in the body, then all of the systems are on overload. The heart is beating like crazy, you may feel jittery and anxious, it’s hard to sleep, and you may be losing weight. You also may feel hot all the time, and again, just not feel very good.
There is a specific disease for elderly with hyperthyroidism called apathetic thyrotoxicosis. This is when the symptoms, as described above, do not happen in elderly patients. Instead, too much thyroid manifests as apathy, lethargy, weight loss, sunken face, and no swollen thyroid gland, called goiter, that is normally seen. This can be mistaken for depression and lead to a thyroid storm, which is a very dangerous condition. Again, if your loved one has been diagnosed with depression, please make sure their thyroid hormone has been checked.
Dementia/Alzheimer’s
Alzheimer’s and dementia are neurodegenerative disorders that manifest in memory loss and forgetfulness. Eventually, brain tissue deteriorates to the point of being unable to manage basic functions such as breathing and eating. Dementia and Alzheimer’s can be very hard to catch early because it is hard to tell the difference between momentary forgetfulness and a memory problem.
Depression may also be confused with Dementia and Alzheimer’s. Because those disorders involve changing of the brain, it may lead to behavior changes which may be associated with depression. In fact, depression-like symptoms may be an early indicator of dementia. There are various cognitive function tests you or your doctor can do to assess for any changes in cognition. Assessing these may be very helpful for identifying these disorders early and intervening as soon as possible. This is no cure, but you may be able to slower or delay progression of the disease the earlier it’s caught.
Parkinson’s
Parkinson’s disease is another neurological disorder that is characterized as a movement disorder. Individuals with Parkinson’s have a slow, shuffling gait as well as a tremor that can make it hard to make fine motor movements. Eating, pointing, and doing tasks that require fine motor skills can be very difficult. Walking may slow significantly and even talking may become very difficult for these patients. As the disease progresses, individuals may start to exhibit depressive like symptoms. It can be hard to continue as normal when there is something wrong that is hard to identify. Therefore, before jumping to a depression diagnosis, it’s important to see if there have been any movement changes or any new or worsening tremors. This may help direct clinicians to a diagnosis and treatment plan most appropriate for this patient.
Substance abuse
Another disorder that may present itself as depression is substance abuse. Older individuals are very capable of abusing substances. They often have nowhere to be, may even be dealing with underlying depression, and get their hands on alcohol, drugs, pills, etc. It’s hard to identify substance abuse and alcoholism in older adults because if they are inactive anyways, how can one tell the difference between a regular nap and a drunken nap?
There are a few questionnaires that physicians may ask to identify the risks for drug and alcohol abuse. As family members, if you notice there is a decline in function and mood, it may be worth it to look through your family member’s items and identify any abnormal number of pill bottles, discarded alcohol containers, or evidence of illicit drugs. Increasing drug use can lead to further exacerbations or demonstrations of dementia.
If you or a loved one are having trouble managing daily life, Diverse Health Services can help. Please click on our services button to see if there is something we can offer you, whether that be assistance with activities of daily living, company, food prep, etc. we have something that may be a good fit for your family.
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