ISOLATION-INDUCED DEPRESSION IN SENIORS
More than 6.5 million Americans aged 65 and older are dealing with depression on some level, according to the National Alliance on Mental Illness (NAMI). For some in this range, these feelings of sadness or despair didn’t appear until later in life, such as when faced with a loss of independence or increased disability due to the aging process. Yet, the NAMI says that for most people who are older and battling depression, it has been an ongoing struggle for quite some time. The National Institute on Aging (NIA) says that there is one factor that can potentially increase depressive symptoms beyond the more common causes of depression in older adults such as genetics, altered brain chemistry, a history of depressive issues, and high levels of stress. It is isolation.
What is Isolation-Induced Depression?
Isolation-induced depression appears because of a lack of social interaction. In other words, if the elder doesn’t have a strong support network or spends a large amount of time alone, isolation (and subsequently depression) can sometimes set in. Some studies have even found that perceived isolation—the feeling of being isolated even if you aren’t—can also have negative effects. Psychology Today notes that social isolation can occur by choice, like when the person makes a conscious decision to not be around others. This type of intentional isolation can be temporary, such as when someone’s engaging in a short-term home repair project and can’t be disrupted for a few days or weeks. Or it can be more permanent in nature, which is when the person is typically referred to as a “shut-in.” In other cases, social isolation isn’t so much a choice but more of a direct result of other circumstances, many of which beyond anyone’s control. For instance, if it’s the middle of winter and snow and ice starts to accumulate on the roads, the senior may have a difficult time getting out, which creates a lack of social interaction until the roads become clear. Or, if the senior has poor health, it may make it more difficult to go out in public or make social calls, leaving the senior with a lot of time alone.
A Growing Problem
It’s likely that the number of seniors struggling with depression will grow in the years ahead. The U.S. Census Bureau anticipates that the number of older Americans will more than double by the year 2060, increasing from 47.8 million to 98.2 million in total. To make matters worse, in many cases, these seniors are not getting the treatment they need for this potentially debilitating mental health condition. The NAMI indicates that this is partly because many people associate depressive feelings with the “normal” aging process, particularly if there is an illness or a change in living arrangements involved. However, NAMI stresses that depression and aging do not go hand in hand. Growing older does not mean that a person should be sad. The NAMI further states that, other times, seniors aren’t being treated for their depression because they choose to keep their sadness to themselves. This is primarily out of fear of what their family and friends will think of them if they learn that the senior is feeling down.
Additional Effects of Isolation on Senior Health and Happiness
Not only does this type of social isolation potentially lead to depression in the older population, but it can have other effects as well. Some of these are mental in nature, whereas others are more physical.
Mental Impact of Social Isolation
Research published in the Journal of Clinical & Diagnostic Research shares that social isolation can lead to loneliness, which can then lead to a variety of psychiatric disorders. Depression is one, but loneliness can also increase one’s risk of personality disorders in addition to brain-based conditions such as Alzheimer’s disease. This study goes on to say that 40 percent of individuals over the age of 65 report feeling lonely at various times in their lives. Although individuals in this age group have usually developed effective skills at dealing with this type of feeling, many pieces of research have found that these skills aren’t as helpful for those over age 70. This is especially true for seniors who are female, widowed, and living alone.
Social Isolation and Physical Health
Studies have found that social isolation can impact a senior’s physical health, too. According to one piece of research, these physical effects include:
- An increased risk of cardiovascular disease with difficulties related to atherosclerosis, hypertension, coronary artery disease, stroke, heart attack, and cardiac failure
- Increased risk of type 2 diabetes and obesity
- Abnormal activity in the endocrine system (hypothalamus, pituitary gland, and adrenal glands)
- Reduced immune system function, increasing the risk of conditions such as the Epstein-Barr virus
This piece of research also found that social isolation decreases sleep quality. This can compound the senior’s depression further, with the National Sleep Foundation reporting that “sleep problems may cause or contribute to depressive disorder.”
The Connection Between Social Isolation and Death
Social isolation can even potentially mean the difference between life or death. For instance, research published in the Annals of the New York Academy of Sciences shares that social isolation is “as strong a risk factor for morbidity and mortality as smoking, obesity, sedentary lifestyle, and high blood pressure.” Why is engaging with others so important to our health that it actually has the ability to end our life? The authors of this research, who were from the University of Chicago and Ohio State University, reveal that some experts attribute the impact of isolation to a phenomenon called the “social control hypothesis.” This hypothesis says that our relationships with others can affect our life choices, and we are more willing to take positive actions toward our health and wellness if we feel we have someone to answer to, or if someone is prompting us to take these steps. However, the authors also share that there are other evidence-based reasons that may explain why socially isolated individuals may die sooner than those who are more socially active. They note that isolation has been connected to an increase in oxidative stress, decreased immunity, and poorer inflammatory control, all of which make it harder for the body to fight off serious, life-threatening conditions. The NAMI adds that sometimes depression leads to death by the person taking his or her own life. Unfortunately, this occurs even when the individual has reached out for help. Twenty percent of those who commit suicide have seen a doctor the day of the suicide, 40 percent have seen a doctor sometime during the previous week, and 70 percent during the month they chose to take their own life.
How Depression Affects the Family Unit
Isolation-induced depression isn’t only tough on the senior—it’s hard on the family unit, too. Being shut out of the senior’s life or being asked to not visit is at first difficult to hear, but then it can also create worry if the family member or friend is unable to visually see whether the loved one is doing okay. Having limited contact also makes it harder to determine whether the senior’s mental and/or physical health is on the decline. There’s no one there to pick up on subtle changes to the way the senior talks, or behaves. That can create a treatment delay, allowing the senior’s mental and physical health to get worse before being seen.
Signs of Senior Depression
How do you know if you or the senior in your life may be suffering from depression that is above and beyond the “normal” blues that all of us experience from time to time? The NAMI indicates that depressive symptoms in seniors can sometimes be slightly different than those exhibited by someone who is younger in age, so a few of the signs to watch for with people who are older include:
- Acting confused
- Having delusions or hallucinations
- Trouble remembering
- Loss of appetite
- Increased irritability
- Difficulties sleeping
- Slowed movements
- More demanding behaviors
Complains more often (sometimes about pain, other times the complaints are more vague in nature) It’s also important to realize that research has found that women are twice as likely to be depressed than men, and that “their disease follows a more chronic course.” Thus, older females should be watched more closely for these particular signs.
Tips for Preventing and Relieving Isolation-Induced Depression
If aging shouldn’t automatically bring about depression and social isolation has all of these negative effects, what can you do to help yourself or a loved one prevent or relieve isolation-induced depression? Fortunately, there are many options to consider.
Make Social Interaction a Priority
Given that social isolation can lead to depression in older adults, one of the best ways to avoid or get rid of this type of depression is to prioritize social interaction. This involves actively looking for ways to spend more one-on-one time connecting with others. If you’re part of a retirement community or in an assisted living facility, this may be a relatively easy step to take, because you should have a social calendar you can look through to see what types of activities interests you. Whether it’s getting together with other seniors to watch a movie, or play cards or a board game, these are great ways to increase social activity without having to travel too far from home. If you live alone or in a facility that doesn’t offer these types of amenities, find a church or organization that holds local events and see what is on their schedule for the weeks and months ahead. Newspapers and other community publications often have a listing that shares times and dates for these gatherings, allowing you to find one that may interest you. Alternatively, make it a point to visit with family and friends one or two days a week. This keeps you from being socially isolated while also giving you the opportunity to strengthen the relationships that matter most. Once you’ve decided which social interactions you want to take part in or which family members you want to see, place these items on your calendar and commit to them the same way you’d commit to keeping a doctor’s appointment. This helps reinforce in your mind that these actions are also a priority when it comes to total health and wellness.
Regularly Engage in Mentally Satisfying Hobbies
Research has found that having a hobby and a “purpose in life” can extend life expectancy in older adults. Therefore, if you don’t already have an activity that you do on a regular basis that satisfies you mentally, now is a great time to find one! Unsure of which hobbies you’d enjoy during the times when others aren’t around? The options are endless and limited only by your likes and dislikes. Here are a few to consider:
- Reading or listening to books written by your favorite novelist
- Gardening or landscaping
- Doing your favorite crafts (woodwork, crocheting, painting)
- Taking pictures of household items or local scenery and framing them to either keep or give away as gifts
- Doing crossword puzzle books
- Playing with new cooking recipes
- Learning a new language
Whether you’ve done things like these before and liked them or never tried them but wanted to, regularly engaging in activities that capture your attention is a great way to pass time when you’re on your own. It transforms those moments into times that you actually look forward to.
Volunteer Your Time
Another way to curb social isolation and its depressive effects is to volunteer your time. In fact, research has found that doing things for others without expecting anything in return can provide a number of positive health benefits, some of which include feeling happier, having higher self-esteem, and experiencing less psychological distress. Volunteering has also been shown to improve life satisfaction rates and social well-being. What type of volunteer work can you do as a senior? One option is to spend your time with other local seniors who may have a difficult time getting out. Visit with them in their homes so they too aren’t socially isolated and depressed. If they’re able and willing, you may even want to take up an activity that the two of you can do together, such as playing cards or doing a craft. To find other volunteer opportunities in your area, you can also connect with online groups offering this type of service. For instance, RSVP has a Senior Corp program that is specifically designed for volunteers over the age of 55. Depending on where you’re located, you could be connected with volunteer opportunities such as teaching English to immigrants or tutoring and mentoring disadvantaged or disabled youth. Some libraries use volunteers to read books to children after school or during the summer months. See if yours has a program like this. If not, you can always work with them to create one, as a study published in the journal Pediatrics in April 2018 found that reading to children decreased their hyperactivity and reinforced positive interactions. In other words, it provides just as many benefits to them as it does to you!
Increase Physical Activity
Increasing physical activity can also help ward off isolation-induced depression. It doesn’t take a lot of movement either. Research in this area has found that a 20-minute session conducted three times per week is enough to make you feel happier. Depending on your level of ability and current physical condition, a few relatively low-impact exercises to consider include:
- Walking either outdoors or indoors on a treadmill
- Exercise classes at your local gym or recreational center
- Water classes or open swimming
- Yoga or Tai Chi
The U.S. National Library of Medicine says that it also helps to find ways to add physical activity into your regular day. For instance, if you’re going to get groceries, walk down all of the aisles at the store, even the ones where you don’t need anything. Or if you’re somewhere that has stairs and you only need to go up or down one or two flights, choose to walk instead of taking an elevator or escalator. Ask a friend to join you and you can enjoy double the benefits: the benefit of exercise along with the benefit of social interaction. Or, if you belong to a gym or recreational center, strike up a conversation with other members and you could gain a workout partner that way. As always, be sure to check with your doctor before beginning a new exercise program or engaging in physical activity that your body is not used to. This helps ensure that it is safe for you. Plus, if you have any medical issues or past injuries, your physician can offer advice on how to best implement that particular physical activity into your daily regimen without aggravating prior conditions.
Modify Your Diet
Most people don’t think of diet when it comes to depression, but the foods we eat can have a huge impact on our mental well-being. In fact, Harvard Medical School shares that “diet is such an important component of mental health that it has inspired an entire field of medicine called nutritional psychiatry.” Foods that have been associated with depression specifically include processed meats (like salami, sausages, and lunch meats), red meats, refined grains, sweets, high-fat dairy, butter, and potatoes. So, what should you be eating instead? Harvard notes that a depression-lowering diet would involve eating more:
- Whole grains (unprocessed if possible)
- Low-fat dairy
- Olive oil
This doesn’t mean that you can’t eat foods that don’t appear on this list ever again. However, staying aware that your diet may be impacting your mental health can help you realize when the foods you’re eating may be making you feel worse instead of better.
Seek Outside Help
If the depression is severe or isn’t being relieved with any of these self-help options, it may be time to search for outside help. The NIH notes that cognitive behavioral therapy can often help ease depression in seniors because its goal is to help the person overcome negative thinking patterns that often make them feel worse. However, other types of therapy can help as well, with the duration of therapy being dependent on the individual person and his or her needs. To find the right therapist for you, Psych Central suggests that you first ask someone you know and trust for a referral. A positive review by a friend, family member, or anyone else you know who has worked directly with this professional goes a long way when you’re looking for someone who can hopefully provide the same positive results for you. If you don’t know anyone who can make this type of referral, another option is to call your insurance company and see which counselors they recommend. This step should be taken in any case, even when you receive a referral, so you don’t end up with a huge bill because your plan doesn’t cover that particular counselor. The internet is also a valuable resource to consider, because you can perform an online search for therapists via reputable sites like Psychology Today. Just pick your state, narrow by city or county, and you’ll be provided with a list of options. You can also check out review sites like Yelp or do a Google search and see what others have to say about therapists in your area. Read through a few of them and look for patterns to get a basic idea of what you could expect if you choose a particular mental health practitioner.
Stopping or reversing any type of depression, such as isolation-induced depression, first requires realizing that it exists. Next, it takes performing regular actions to reduce the likelihood that it can take hold, and there are many options to consider. The key is to find the one(s) most appealing that would be a joy to fit into your life. And don’t forget the most important piece of the equation, which is making social interaction a priority. It may feel difficult at first, especially if you’re used to spending a majority of your time alone. However, getting out into the world and engaging with others provides a lot of value for you and anyone you interact with.
Million Americans Aged 65 and Older are Dealing With Depression on Some Level
If the elder doesn’t have a strong support network or spends a large amount of time alone, isolation (and subsequently depression) can sometimes set in.