Not easy to spot, treat depression in seniors

SINGAPORE - I am glad last Sunday's editorial ("When seniors give up") addressed the issue of suicide among seniors.

This should be treated not as an individual problem but one that involves the whole community.

The editorial highlighted that family doctors often fail to detect depression among the elderly, and instead treat them for headaches and insomnia.

A good, open relationship between doctors and patients may be needed in order for depression to be detected at an early stage.

Doctor-hopping and an unwillingness on the patients' part to open up during consultations may hamper early diagnosis.

A patient with depression may show vague symptoms like tiredness, inability to concentrate, loss of interest in ordinary activities and difficulty in sleeping. So the condition may not be easily picked up.

Early detection itself may not solve the problem.

The treatment and management of depression may take time, and require the support and understanding of family members.

The depressed often have financial and relationship problems.

Counselling and psychiatric sessions would incur financial cost, which may deter patients from agreeing to such treatments.

The social stigma associated with depression aggravates the problem.

Family members may treat such patients harshly, not recognising that the patients do not wish to remain in such a condition, but they cannot help feeling down.

Patients' compliance with the medication regime is another major issue. The fear of addiction and long-term treatment causes patients to stop taking their medications abruptly, hence triggering another depression crisis.

The editorial rightly pointed out the need for community action and support in the management of depression and prevention of suicides.

Depression is a growing problem globally, and the fast-paced environment in our modern world often leaves individuals feeling lonely, disoriented and disillusioned.

This invariably predisposes them to the development of depression.

Depression, like dementia, can also be caused by silent strokes in the elderly that render them changed in their personality and social interaction.

The organic causes must be dismissed before depression as a diagnosis per se is concluded.

Quek Koh Choon (Dr)

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