[Click! Health] "Parents Who Find Everything Troublesome May Be Suspected of Late-Life Depression"

Many elderly people experience depression as they gradually lose physical abilities and social relationships that were once taken for granted. If depression in old age is not treated in time, it can lead to intentional self-harm or suicide, requiring careful attention.

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According to Ansan Hospital of Korea University, depression in old age is often caused by social and economic factors such as retirement, the loss of close ones, conflicts with children, social isolation, and poverty. In the early stages of depression in old age, there may be no noticeable emotional changes, but insomnia, loss of appetite, and a general feeling of lethargy occur. Various aches and pains appear throughout the body, but medical examinations often reveal no abnormalities. With decreased concentration and blurred memory, it is sometimes mistaken for dementia.

Additionally, it often manifests as physical symptoms such as headaches, abdominal pain, and indigestion, leading to misdiagnosis as internal medicine conditions. Sometimes, families misunderstand these symptoms as malingering to attract attention. In such cases, 'masked depression' can be suspected, where the depression does not outwardly show, as if wearing a mask.

Professor Shin Cheol-min of the Department of Psychiatry at Ansan Hospital, Korea University, explained, "In masked depression, patients not only say they are not depressed but also show no depressive expressions on their faces. Despite a normal outward appearance, they complain of physical symptoms such as loss of appetite, indigestion, headaches, muscle pain, and insomnia, which are characteristic of masked depression."

Depression in old age responds better to treatment compared to other diseases. Generally, 70-80% of depression cases can improve with acute phase treatment. Effective treatments for depression include medication and cognitive behavioral therapy. Professor Shin explained that side effects of medications have significantly decreased compared to the past, so medication is now recommended even for mild depression.

Professor Shin said, "Due to the vulnerability of elderly patients to anticholinergic side effects, selective serotonin reuptake inhibitors are used more often than tricyclic antidepressants, and serotonin-norepinephrine reuptake inhibitors, which are also effective for pain, are prescribed for elderly patients with accompanying pain. Some patients worry about having to take medication for life, but with consistent treatment, they can maintain a good condition without continuing medication."

As with all diseases, prevention is the most important aspect of depression in old age. Maintaining a regular lifestyle and balanced diet, and relieving stress through exercise are essential. It is important to eliminate negative thoughts and try to think positively. Careful attention from the patient’s family is also necessary. If the patient talks about suicide, it must be reported to a doctor immediately.

Professor Shin emphasized, "Unverified medications can worsen depression and should be avoided. Above all, it is crucial to receive treatment before symptoms worsen. Families need to actively support patients so they do not stop treatment on their own even if symptoms improve."

Professor Shin Cheol-min, Department of Psychiatry, Korea University Ansan Hospital.
[Photo by Korea University Ansan Hospital]

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