Sun, 23 Mar 2003

When depression strikes elderly family members

Maria Endah Hulupi, The Jakarta Post, Jakarta

During a reunion, Sarah told her friends how she had grown tired of taking care of her 64-year-old mother.

"I'm tired because after a stressful day at the office, I have to go home and take care of her. I just don't understand her anymore. She's been acting very strange lately," Sarah said.

But in her heart, Sarah understands that her mother needs her by her side more than ever after the death of one of her dear friends.

"I know it's hard for her and I can still remember how father's death two years ago affected her. She is showing similar signs of sadness," she said, adding that her mother refused to talk, eat or socialize.

Depression is a normal human emotion, according to a psychiatrist from the University of Indonesia, Danardi Sosrosumihardjo, who explained that the treatable condition can affect people of almost any age, including the elderly.

The condition can be triggered by the use of certain drugs, organic factors affecting the brain and psychological factors.

It can occur unnoticed, but the loss of loved ones, deteriorating health and physical changes as one grows old are among the common psychological causes of depression among the elderly.

"The death of a loved one, a spouse, family members or friends, or when their children leave them to start their own family, can instill feelings of loneliness, which can become serious and lead to depression," Danardi said, adding that (financial) insecurity, physical impairment due to illness and inactivity after retirement are also among the triggers for depression.

Although most sufferers do not talk about it, people with depression may show some symptoms, including persistent sadness, hopelessness, loss of appetite, confusion, inability to enjoy hobbies or favorite activities, problems sleeping, fatigue, inability to concentrate and social withdrawal.

They may also complain of headaches, stomachaches, breathing problems and unexplained pain. "In serious cases, thoughts of death and suicide occur," Danardi said.

Depression occurs in phases, manifested in the inability to accept a sad event (denial), anger and disappointment (protest), and finally the acceptance of reality (detachment).

During such difficult times, Danardi said, other adult family members need to show compassion and support because people suffering from depression need someone to talk to who will listen to them.

"It's hard to do this, especially during the denial and protest phases. For this, people need to brush up on their attending skills, since forcing them to just forget a sad event or their ailments will just worsen their situation," he said. "They may feel better if we let them cry instead, as an expression of sadness."

It is only after depressed people start accepting reality that relatives can help pull them out of their profound sorrow and bring their feet back to the ground.

"Tell them that the deceased is no longer in pain or that it is normal to lose stamina when one grows old. Encourage them to lead a better lifestyle to prevent the onset or ease their suffering," he said.

When family members notice changes that might indicate depression, Danardi said, and if these changes persist for over two weeks, they are advised to seek professional help, because if left untreated depression can worsen the symptoms of other illnesses.

"Doctors may give counseling, antidepressants and psychotherapy. The sooner they seek help the better they will respond to the therapy and counseling," he said, adding that counseling for family members is also important.

Family members are advised to encourage their depressed elderly relatives to take up positive activities, like starting a hobby, exercising or attending religious or social gatherings.

"Activities like a hobby will stimulate their minds and make them happy, and when it involves physical activity it can help maintain their stamina as well. Inactivity can intensify feelings of loneliness or worthlessness," he said.

Apart from patience and understanding, adult family members need to encourage depressed relatives to be more expressive in communicating what they feel inside or what they want.

"It is healthier than keeping the feeling to themselves. Sometimes elderly people don't get what they want because other people don't know what they want, which can be depressing, too," he said.