Depression, Aging, and the Faith Family
Our church can make a difference.
ALINA M. BALTAZAR and SHANNON TRECARTIN
“Even when I am old and gray, do not forsake me, my God, till I declare your power to the next generation, your mighty acts to all who are to come” (Ps. 71:18).
He was all alone. His wife of more than 60 years had recently passed away. His children had long grown and gone. Though his family checked on him regularly, visited him, and invited him out as often as they could, he was still on his own for the first time in his life. Though he was tempted to retreat into his grief and depression, he turned to his church as his main source of support.
The church provided emotional, social, and physical support and a sense of purpose in multiple ways. He had a close relationship with his pastor; was a head elder; taught Sabbath School; visited sick, new, and missing members; was involved in lay preaching; was on the church board; attended Wednesday night prayer meetings; distributed Signs of the Times magazines to downtown businesses; helped keep up the church grounds; attended every church function possible; was often invited over for Sabbath lunch by church members; received support from others who had lost their spouses; and witnessed to his neighbors. Although he’d lost his wife, he was surrounded by support from his faith family. He was not alone.
The global population of people aged 60 and older is expected to nearly double from 12 percent in 2015 to 22 percent in 2050.1 People are living longer all around the world and represent a substantial proportion of the Seventh-day Adventist Church. Given these statistics, we can expect that the proportion of older adults in our church communities will continue to rise.
Older adults are an essential part of the worldwide church and contribute almost daily in preparing for weekly services, the maintenance of church facilities, supporting the church financially, and nurturing its members. But from time to time they need our help as a faith family.
People who are actively involved in religious practices tend to have fewer symptoms of depression.
Depression, sadness, and grief are not the same things. Sadness and grief are normal reactions to common challenges of growing older. These challenges may include sensory decline (changing vision, hearing, and taste); physical changes (decreased stamina and strength); and cognitive changes (memory decline and speed of processing information). Similarly, life stressors such as loss of loved ones and decreasing independence can lead to feelings of loss and unhappiness. Depression, however, is not the same thing as sadness, and is not a normal part of aging.
Risk of Depression
Global estimates suggest that 2 to 3 percent of older adults who live in a community setting experience a depressive disorder during old age. The risk increases substantially among the frail and those who live in institutional settings (about 10 percent of all older adults).2 In the United States, it’s estimated that as many as 48 percent of nursing home residents have depression.3
Some of the risk factors for depression among older adults include having a chronic illness, disability, functional decline, and social isolation.4 In addition, multiple changes in life situations may contribute to this illness.5 Moves from home to a retirement or nursing setting, children moving away, and loss of a spouse can trigger or exacerbate depression.
Signs of Depression
Older adults who have depression often show signs of sadness, anxiety, or a sense of “emptiness.” They may lose interest in activities they usually find enjoyable. Feelings of hopelessness, worthlessness, and helplessness are common symptoms. In addition, appetite changes, sleeping difficulty, trouble concentrating, and irritability may be present.
In order for clinical depression to be diagnosed, these symptoms need to have been present for at least two weeks. Depression can also manifest physically as aches and pains, headaches, and digestive problems without obvious medical causes. Most important, suicidal thoughts and attempts can occur. Because older adults have the highest suicide rate among all age groups in many developed countries, depression should not be overlooked.6
Depression is often misunderstood and overlooked in elderly individuals because of the misperception that it is normal to be depressed when losses and illnesses occur.7 In addition, older adults may feel ashamed about this mental health challenge because of the stigma that has been attached to it. Depression can be seen as a sign of weakness, and as a result is rarely discussed.8 Sometimes the need for help is complicated by the thought that answers to mental health challenges can be found in God alone, and not through His human agents as well. There can be a reluctance to seek counseling or use medication that is not considered to be “natural.”9 Professional and religious-based interventions targeting this medical illness exist, however, and have been found to be effective with older adults.10
Church Involvement and Depression
With individuals having fewer children in many industrialized nations, and children having to move far away from home in pursuit of financial survival, older adults are becoming more reliant on the community for support.11 The church has been known to play a vital role in the community by identifying individuals with mental health challenges and providing education, support, and referrals to community services.12
A systematic review of research provides support that religious involvement is related to lower rates of depression.13 People who are actively involved in religious practices tend to have fewer symptoms of depression. The church is unique in its ability to provide emotional, social, physical, and spiritual support, along with providing a sense of purpose.
This is good news for older adults who actively participate in the church, but it is a concern for those who are not able to physically attend or participate in church activities. This is where the faith family can get involved in reaching out through homebound ministries. This can help frail older adults feel cared for and not forgotten.
Treatment of Depression in Older Adults
Along with social, emotional, and physical support, and a sense of purpose that can be provided by the faith family, living a healthful lifestyle can also help keep depression at bay. As with so many other diseases, eating a healthful diet; positive thinking; a healthy spiritual life; and getting daily fresh air and sunlight, exercise, and sleep can help treat depression.14 Unfortunately, the nature of aging and depression often interferes with these activities, and so professional help may be required.
An individual suffering from depression should consult a medical professional to first rule out a medical cause. Research has found that antidepressant medication and mental health counseling combined result in faster full remission of depression.15
Medication can take up to six weeks to take full effect, and psychotherapy can take up to 12 months or more; so depressed individuals and loved ones need to be patient, since recovery can take time. Like many other physical illnesses, depression in older adults is treatable, but benefits from a wholistic approach.
- World Health Organization, “Mental Health and Older Adults: Fact Sheet” (2016). Retrieved from www.who.int/mediacentre/factsheets/fs381/en/.
- S. H. Zarit and J. M. Zarit, Mental Disorders in Older Adults: Fundamentals of Assessment and Treatment (New York: Guildford Press, 2007).
- National Institutes of Mental Health, “Older Adults and Depression” (2016). Retrieved from https://www.nimh.nih.gov.
- T. M. Richardson, B. Friedman, C. Podgorski, K. Knox, S. Fisher, H. He, and Y. Conwell, “Depression and Its Correlates Among Older Adults Accessing Aging Services,”American Journal of Geriatric Psychiatry 20, no. 4 (2012): 346-354.
- S. M. Cummings, I. Ponnuswami, W. Wen Li, and H. J. Park, “Conclusion: Ageing and Mental Health in the Global Community,” in W. Wen Li, S. Cummings, I. Ponnuswami, and H-J. Park, eds., Aging and Mental Health: Global Perspectives (Hauppauge, N.Y.: Nova Science Publishers, 2016).
- J. B. Louma, C. E. Martin, and J. L. Pearson, “Contact With Mental Health and Primary Care Providers Before Suicide: A Review of Evidence,” American Journal of Psychiatry 159, no. 6 (2012): 909-916.
- S. M. Cummings and S. M. Trecartin, “Mental Health and Ageing: The United States,” in Li, Cummings, Ponnuswami, and Park.
- B. Sedlacek, D. Sedlacek, and B. Couden Hernandez, “A Voice for the Voiceless: The Challenges of Mental Illness and the Hope of Mental Health,” in R. Maier, ed., Church and Society: Missiological Challenges for the Seventh-day Adventist Church (World Missions Department, Seventh-day Adventist Theological Seminary, 2015).
- W. D. Taylor, “Depression in the Elderly,”New England Journal of Medicine 371, no. 13 (2014): 1228-1236.
- E. O. Chow and H. C. Ho, “The Relationship Between Psychological Resources, Social Resources, and Depression: Results From Older Spousal Caregivers in Hong Kong,” Aging and Mental Health 16, no. 8 (2012): 1016-1027. See also M. Haas, “A Geriatric Peace? The Future of U.S. Power in a World of Aging Populations,”International Security 32, no. 1 (2007): 112-147.
- C. J. VanderWaal, E. Hernandez, and A. R. Sandman, “The Gatekeepers: Involvement of Christian Clergy in Referrals and Collaboration With Christian Social Workers and Other Helping Professionals,” Journal of Social Work and Christianity39, no. 1 (2012): 27-51.
- R. M. Bonelli and H. G. Koenig, “Mental Disorders, Religion, and Spirituality, 1990 to 2010: A Systematic Evidence-based Review,”Journal of Religion and Health 52, no. 2 (2013): 657-673.
- N. Nedley, “Depression: The Way Out (Armore, Okla.: Nedley Publishing, 2002).
- R. Manber et al., “Faster Remission of Chronic Depression With Combined Psychotherapy and Medication Than With Each Therapy Alone,” Journal of Consulting and Clinical Psychology 76, no. 3 (2008): 459-467.
Alina M. Baltazar, Ph.D., L.M.S.W., is an associate professor and MSW program director for the Department of Social Work at Andrews University. Shannon Trecartin, Ph.D., L.M.S.W., is an assistant professor for the same department.