Depression among the elderly are often misdiagnosed: Spotting symtpoms

Mental health challenges are escalating worldwide, and senior citizens are becoming particularly vulnerable. A recent report by the World Health Organisation (WHO) reveals a sobering truth: by 2030, one in six people globally will be aged 60 or older. Crucially, more than 15% of individuals aged 70 and above already grapple with mental health conditions, with many choosing to suffer in silence rather than seek professional help.

In Kerala, where the welfare and safety of senior citizens remain a key focus, the government established a dedicated Department for Senior Citizens to streamline welfare activities and coordinate support initiatives. However, analysts point out that beyond the administrative setup, more active ground-level programmes are essential to truly uplift the mental and physical well-being of the elderly. This is where experts suggest the focus must shift to holistic, empathetic care.

According to global projections, the population of individuals aged 60 and over stood at 1.1 billion in 2023. This figure is expected to skyrocket to 2.1 billion by 2050. As individuals transition into retirement and old age, they frequently experience a profound vulnerability to depression and anxiety. Even in countries like India, where many seniors continue to work, the creeping onset of mental health issues eventually takes a heavy toll, often exacerbating underlying chronic physical illnesses.

An alarming link to elderly suicides
The statistics for older adults are deeply concerning. Data from 2023 shows that 14.75% of people over 70 lived with mental health disorders, and 6.8% lived with these conditions until their final days. Most alarming is that senior citizens aged 70 and above account for 16.6% of suicides globally. A significant majority of these individuals suffered from untreated mental health distress. The social stigma of being labelled as having psychological struggles or the fear of being a burden often deters senior citizens from seeking help.

Understanding geriatric depression: The biological and social triggers
Mental health expert and counsellor Fr Mathew Jacob Benny notes that elderly depression is frequently misdiagnosed because people dismiss it as just a normal part of getting old. This misconception delays treatment and reduces the quality of life. Depression is multifaceted, influenced by the Biopsychosocial Model—a combination of biological, psychological, and social factors. Biologically, ageing alters key neurotransmitters in the brain like serotonin, norepinephrine, and dopamine. Coupled with chronic ailments such as cardiovascular disease, diabetes, Parkinson's disease, stroke, dementia, or persistent pain, the risk of depression spikes dramatically.

How to spot the symptoms in seniors
Depression in older adults does not always manifest as crying or visible sadness. Instead, they might express feelings of chronic fatigue, a sudden lack of interest in hobbies, poor sleep patterns, or a feeling that life has lost its meaning. Often, their complaints are purely physical—such as unexplained bodily pain or headaches—leading families to mistake clinical depression for a standard physiological ailment.

The path to healing and active ageing
Depression in the elderly is highly treatable if identified early. Tailored interventions such as cognitive behaviour therapy (CBT), interpersonal therapy (IPT), and behavioural activation have shown excellent outcomes. When necessary, under the guidance of a psychiatrist, mild antidepressant medications can also be highly beneficial. Alongside medical support, strong family engagement is crucial. Involving senior citizens in daily decisions, spending quality time in conversation, and encouraging social connections can significantly boost their emotional health.

Preventative measures and active steps
To prevent this mental health crisis from worsening, healthcare systems must introduce routine mental health screening for older adults at the primary care level. Society must shift its perspective from viewing old age as a period of absolute dependence to promoting healthy and active ageing. Above all, we must actively dismantle the social stigma surrounding mental healthcare. Ageing is not synonymous with depression, and ensuring the mental well-being of our elders is a true reflection of a compassionate society.