Beyond the Bright Lights Holiday Blues Widespread among Senior Citizens

Most Americans anticipate the holidays as happy, joyful, uplifting events that foster expressions of friendship, sharing, and love. Christmas and Hanukkah are quickly followed by New Year’s, traditionally a time to take inventory and make resolutions to change things for the better. Bright lights, late nights, and good cheer make for a time of remembering and reflection.

However, these positives often obscure the fact that this is also a prime time of the year for two very debilitating conditions: stress and depression.

Recently, in a checkout line at a grocery store, I overheard two ladies in their 50s talking about their holiday plans.

One of them said to the other, “I always have all my family and friends over for Christmas Eve. Thirty people come for dinner, and we have quite a party! Of course, the last few years have been dampened by my mother — she always acts so sad and tired, but what can I expect? She’s eighty!”

“Oh, I’ve been there, done that,” said the other.

Unfortunately, it’s not uncommon for people to talk about a serious depressed state if it were normal in the elder population. In fact, it’s a myth that depression is a normal part of aging. It is estimated that as much as 15{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of the population over 70 could be diagnosed as clinically depressed on any given day.

The Blues and Depression

While it is true that holidays often can unleash ‘the blues’ in anyone, it is also true that the additional stressors of the holidays can unmask actual clinical depression. So how are ‘the blues’ and depression different?

At some point in our lives each of us has reason to experience the blues. This is a temporary condition, often brought about by loss or an overwhelming sense of loneliness or isolation. The feeling is often triggered by a single significant life event or series of events and will often right itself with loving care and attention and, if necessary, short-term medication and/or counseling.

Depression, however, reaches much deeper into our physical self, rooted as it is in biochemical changes, genetics, or both. If untreated, it can have devastating consequences.

Depression is a medical condition that can be treated, but first it has to be recognized and properly diagnosed. Treatment is for the long run. Available medications can be effective modes of treatment, alone or often in combination with counseling.

Why are seniors prime candidates for untreated depression? There are many reasons.

First, elderly people have a much longer list of personal relationship losses to manage than most, often including a spouse, children, friends, and co-workers. The longer they live, the longer the list, and the sense of personal loss grows.
In addition, they have a much longer list of other personal losses to manage — loss of a career and significant social networks, loss of income, loss of health and functional ability, and often loss of their driving privileges and/or lifelong residence. And what is not already lost is often at risk for loss, causing endless bouts of worry and stress.
Next, the current generation of senior citizens has been taught to be stoic. My father, who suffered from clinical depression beginning in his early 70s, denied depression, telling me, “getting old isn’t for sissies.” This is a classic dismissal for this generation of elders: suffer in silence, and don’t worry the kids. Similarly, for this generation, depression can carry a stigma; it’s something they have been brought up believing is mental illness, bringing further fears that they will be viewed as mentally deficient or, worse, out of control.
Also, in reality, depression makes people want to be left alone, and they often lack motivation to get up and deal with these feelings.
Finally, today’s lifestyles have created many situations where parents and children are geographically distant. And even when they are not geographically separated, the pressures of work, children, and social obligations allow less time for regular and meaningful support to parents, sometimes leaving them with feelings of reduced worth and isolation.

The symptoms of depression can vary among individuals; however, some common red flags include preferring isolation to social engagement; loss of appetite or weight; prolonged or unusual fatigue; a lack of attention to personal or household appearances; difficulty concentrating, remembering details, or sleeping; excessive sleeping; excessive worrying about financial, personal, or physical health; marked increase in minor physical complaints, expressed feelings of sadness that extend beyond a two-week period; and an inability to manage daily living tasks.

No Holiday Cheer

Why do symptoms often intensify during the holidays? For one thing, memories of losses and the stress of increased demands during the holiday period can be the triggers that force a latent depression to surface.

What to do? The first intervention should be a caring conversation with the depressed loved one. Suggestions for treatment will probably be initially rebuffed, but don’t be deterred. Mobilize all the resources you need to help the elder see that seeking help can significantly improve quality of life.

Next, secure an appointment with the elder’s primary care physician, who can guide you in identifying and securing appropriate avenues for help. If you are geographically distant or otherwise unable to guide the depressed person through this process, contact a professional case manager to work with your loved one.

Marge Pietras, RN, BSN, is a partner in All About You, LLC, a case-management and home-care service company located in Westfield and serving Hampden and Hampshire counties. She is a registered nurse with 38 years of professional nursing and case-management experience.