|Tuesday, 17 September 2002|
Old age and depression in Sri Lanka
by Rashomi Silva
All of us have suffered from depression at one time or the other. The hectic pace of the modern world has driven man to a perpetual race leaving no time for oneself. Nevertheless life has to have a certain degree of stress to add flavour.
A monotonous life would not only be dull and boring but also blunt a man's ability and efficiency. However, too much stress can cause depression. Severe depression lasts more than two weeks or if the depression is part of your life can cut down your life expectancy and make you ill physically. Those who are in this unending race in childhood, youth and in manhood feel abandoned in old age due to lack of occupation and concern. This leaves him to dwell on his own worries sometimes trivial and sometimes serious.
Surveys conducted in the West show depression to be common in old age in at least ten out of every hundred citizens over 65 years of age suffer from the condition known as 'clinical depression' due to various causes. Sri Lanka with it's ageing population would do well to address the issues related to the elderly with due concern, says Dr. Chanaka Wijerathne, consultant old age psychiatrist of St.George hospital, Sydney. The most common symptom of the depression among the old and young are insomnia, eating disorders, loss of energy and interest, fatigue, annoyance and weeping over trivial matters.
The depressed may apt to be lonely by trying to avoid the company of the family and friends. At a higher stage of depression one may feel so helpless and may think of suicide as the only way out of the melancholy. Statics reveals younger men below the age of 30 and older men above the age of 65 are more prone to attacks of depression and have a higher rate of committing suicide, than their female counterpart. Major problem the elderly face is that others take for granted the depression in them thinking its natural to be depressed in the old age. The stigma attached to depression makes the depressed one to keep to himself without seeking medical advice. That is the biggest problem. Media has an important role to play in convincing the society that being depressed does not mean that one is insane. Dr.Wijerathne said.
A certain segment is more prone to develop depression in their old age as well as through out their life than the rest. In some cases this runs in families. If one has a parent or a sibling who suffers from depression there is a higher probability of developing depression. Lack of love, attention and concern during childhood and losing a parent or both parents in childhood contributes largely towards the depression in adulthood and in the old age. Medical problems, heart diseases, neurological problems, Parkinson disease and other diseases and conditions common in the old age can trigger the depression. Lack of blood supply to the brain is another agent of depression. Patients who had had by-passes, surgeries therefore have a higher chance of developing depression.
A sense of dependence, loss of loved ones such as spouse or close friends, troubled eye-sight, hearing difficulties, walking difficulties, and other difficulties common in old age can trigger depression. However Dr. Wijerathne is of the opinion that seeking medical advice may not be necessary in most cases. Meditation, taking up a hobby, spending time with grandchildren speaking to a close friend or a family member or to a consultant, counsellor or any other non-medical profession may help to overcome the stress/depression in its initial stages. If all these methods fail it is crucial to seek a medical opinion.
Hospitalisation is required only in a very severe case of depression.
Angoda Mental Hospital is over crowded. Mainly because the relatives of the patients are reluctant to take them home even after the patient has recovered. For a mentally depressed to be totally recovered it is very important to have the support of the family. It made the patient even more depressed as they understand they do not get the attention, recognition and the love from the family. In most developed countries Dr. Wijerathne said the hospital conducts education sessions for relatives, to make them understand the situation. Australia has recently introduced similar education sessions for schoolchildren. Sri Lanka should seriously consider the possibility of adopting similar techniques.
Introducing counselling to medical students' curricula may also be helpful. The General practitioner may also give a special training on counselling as most of the people with depression do not need the service of a specialist. The biggest massage that I can give to the public, says Dr. Wijerathne, is that don't take for granted the depression in elderly. It is our culture to respect and to be concerned about our elders. The health authorities, politicians and policy makers have a prominent role to play.
Produced by Lake House