KILLING ME SOFTLY: Though depression can occur in people of all ages, it can be particularly devastating for the old

Sanjit Bandopadhyay was the headmaster of a well-known school in Durgapur. But after his retirement he had to come back to Calcutta to stay with his son. Since then life has never been the same for him. At the age of 75, he has to start his life afresh in a city where he has hardly any friend to talk to. Failing to adapt to the situation, he has become a victim of ‘old age depression’.

Sunita Devi shares a similar fate. She had lived in a joint family for the past 50 years. But ever since her husband retired, life has taken a sinister turn. Although she leads a comfortable life staying with her son in Salt Lake, she misses the warmth and security of a joint family. Left on her own after her son and daughter-in-law leave for work, a sense of utter loneliness creeps in, leading to a state of depression.

Fast life

More and more elderly people are becoming prey to depression. In most cases, they are not being able to cope with the isolation and fast pace of modern life. “One in seven persons aged over 65 suffers from depression, but 70 to 90 per cent of such patients receive no treatment for it,” says Dr J. R. Ram, consultant psychiatrist, Apollo Gleneagles Hospital, Calcutta. According to a study conducted by the National Sample Survey of India, about 61 per cent of the elderly rural population in West Bengal have psychiatric illnesses (women showing significantly higher rates of affliction).

“With young people moving abroad or to other states in search of a better career, elderly people take refuge in old age homes. Since they have no one to talk to, they feel lonely and insecure. They fear that there is no one to take care of them,” says Dr Ranadip Ranjan Ghosh Roy, honorary secretary of the Indian Psychiatric Society, Calcutta.

Primary causes

“Many common stressful events can be seen as an explanation for depression among the elderly. These include the death of a spouse or a close friend, retirement with no other activities, having to move from a family home or familiar neighbourhood, loss in vision, hearing or mobility and developing a chronic or life-threatening illness,” says Dr Ram.

Any of these factors can result in temporary feelings of grief, but if they persist for more than, say, six months, clinical depression is the more likely diagnosis.

The classical symptoms of depression are:

• Nothing appears to be interesting to the patient

• Getting agitated at the slightest instance

• Skipping meals and abstaining from a daily schedule.

• Not reacting to anything happening in his surroundings.

• A suicidal tendency.

There are three common forms of depression ? reactive depression (which can occur at any age), endogenous depression (generally affects middle-aged people) and psychotic depression (primarily affects old people).

Social stigma

According to Dr Ram, depression can hit people of all ages, but it can be devastating for elderly people, who are less likely to seek proper treatment. The problem lies in the failure to recognise the symptoms of depression and the social stigma associated with it. Many elderly people still consider it to be a sign of weakness and they feel ashamed to consult a psychiatrist.

Psychiatrists say depression can be firmly dealt with if the elderly manage to take life as it comes. It is an illness of the brain, and should be diagnosed and treated just like any other disease by proper medication, supportive therapies and counselling.

Treating an elderly person suffering from depression is a challenging job. Counselling is generally regarded as an effective way of handling the disease. It can also do away with certain physical symptoms and ensure longevity.

Treatments for depression have made great progress over the past few years. There are various therapeutic possibilities in the modern medical era. There are now many new effective anti-depressants to choose from, including those with minimum side effects, and even the much-feared “electroshock” therapy is safer today. Experts say that more than 80 per cent of the elderly population respond well or completely to any kind of therapeutic approach.

“Untreated depression can shorten life span. It is also hard to live with. This leads to a withdrawal of family and social support, which in turn feeds depression. It should never be ignored,” says Dr Roy.