Lifestyle Choices

The reduction of certain chemicals (biogenic amines) in the brain is thought to be related to depressive mood. There is some evidence that the level of biogenic amines falls in the ageing brain,which could increase susceptibility to depression.

As the brain gets older, more and more brain cells die. At the same time the arteries may get narrower, so that the blood and oxygen supply to the brain is limited. The brain becomes more vulnerable when the oxygen supply is reduced because of a respiratory condition, or when diet is inadequate. These and other factors may be related to longer reaction times, more inflexibility, increasing caution and decreasing ability to adjust to new situations, all of which are commoner as you get older. But it is important not to assume that these effects are physically caused, as depression causes the same effects and is changeable. The loss of the capacity to adjust to new situations may make any changes, such as moving house, much harder than before the advent of old age.

When old people get severely depressed, it may not be obvious. Sometimes the most dramatic symptoms are agitation, hypochondriasis (the belief that you have a physical ailment when you haven’t), and paranoia (the belief that others are against you): these surface symptoms may mask an underlying depression. When depressive symptoms are more obviously there, it may be very hard to tell whether the old person is demented or depressed. Dementia, or senile dementia, is a physical deterioration in the brain, which causes deterioration in memory and mental function (this is sometimes so bad that the person has no idea what day it is, or even what year, or where he is) and eventually a change in personality (particularly the loss of social inhibitions, the person becomimg inappropriately emotional and self-centred).

In severe depression in younger adults, mental function may be slowed down and concentration poor, but basic memory and intellectual functions remain intact. In severe depression in the elderly, memory and intellectual functions are often severely affected, so that the picture looks like dementia. More confusion is created by the fact that depression in the elderly may cause such loss of appetite that starvation provokes a dementia. On the other hand, dementia may cause depression because of the difficulty in accepting the fact that mental function is going, and because the physical changes involved may affect personality. If you or a relative are depressed, and especially, if also confused, consult your doctor.

Illness in old age

When you are over 70, you are likely to become ill at least at some stage of your old age, and you may get depressed as a result of not being able to handle or express your feelings about your condition. Some illnesses cause depression physically, and many drugs may precipitate depression physically. Finally, poor diet, combined with diminished absorption in the intestine, may lead to vitamin deficiencies; vitamin B deficiencies may cause fatigue, apathy and depression. The drug and dietary factors can very easily be changed.

Being Positive

All in all, old age produces a lot of potential difficulties, but many of these can be changed, and even when they can’t, a negative attitude to them can.

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