Social Issue of Depression
The social issue of depression and suicide in older adulthood has an impact on lifespan development. The purpose of this essay is to define and show the extent to which this problem of depression and suicide in older adulthood is in America. It will also show the differences in cultural background, gender, and socioeconomic status that impact the chances of the elderly being diagnosed with depression. Next, it will use the biopsychosocial approach, to look at the issue of depression and suicide. This essay will also dive into the impact of depression and suicide have on individual development for the elderly as they age.
Lastly, in this essay, it will talk about the certain implications when addressing the issue of depression and suicide in social work practice and social policy. 1)Description: Two million Americans age sixty-five out of the thirty-five million aged sixty-five and older are plagued by depression. Only ten percent out of those two million seek help from a medical professional. Late-life depression has become more and more of an issue as the rise of people aged sixty-five grow and this is not a normal part of aging. Studies conducted in 2010 show that about thirty-five million Americans are age sixty-five and as time passes the number is supposed to double in 2030 (Mental Health America, 2015). There are certain reasons why there are larger numbers in the population of sixty-five and older. Studies conducted show these numbers doubling are likely to be caused by the reduction in infant mortality rates, the number of baby boomers out there, and the fewer babies that are being born.
The biggest age group growing is eighty-five and older (Mental Health America, 2015). More and more are living longer compared to before, that is why there are higher numbers of certain variables that can affect lifespan development. These certain variables like depression and even later suicide. Elder adults constitute for at least twenty percent of suicides in America. Depression in elders has higher chances of suicide rates. American Psychiatric Association defines depression as a major depressive order that has a negative effect on the way a person feels, thinks, and acts. Depression can lead to many issues that can affect a person emotionally and physically. There are differences in depression in young adulthood to late adulthood.
Depression is the most common form of impairment and disability for the elderly. This leads to an increase in health risks, loneliness, deprivation of social function, a decline in cognitive function, and lastly the deadliest of them all it is a precursor for suicide. 2. Context of Diversity: As the number of elderly is growing in America, when looking closer at those two million elderly with depression, one must not look at just the issue of depression in elderly, but also look at it from the context of diversity. Which means one must look at the different cultural backgrounds, gender, and socioeconomic status of an elder. There are statistical gender differences of depression and suicide in men and women.
For white males sixty-five and older, the suicide rate is six times the suicide rate is in America. In an article called Systematic Review of Social Factors and Suicidal Behavior in Older Adulthood, it states that In the U.S., up to 75% of older adults die as a consequence of their first suicidal act, which may be explained by age-related increases in planning, physical frailty, and method lethality. Further, U.S. older persons are less likely to report thoughts of suicide to others and to use mental health services (F?¤ssberg, Orden, Duberstein, Erlangsen, Lapierre, Bodner,Waern, 2012). Men have higher rates of committing suicide but have lower rates in the population of elderly men with depression compared to women. The commonness of major depression in men and women is quite different.
A Study was conducted called The Cache County Study and was done in Utah to see the prevalence of major depression in Elderly people. They conducted it between the ages sixty five to hundred. With at least four thousand six-hundred individuals who were not demented, they concluded that the commonness of depression in women was 4.4 percent, and in men, it was 2.7 percent (Steffens, 2002). Even though the suicide rate is higher in white men, there is a greater chance of depression for women aged sixty-five and older. Women are twice more likely to get depression than men. The reason for this being is the hormonal changes that happen for women as they get older. In an article called Depressive Symptoms and Cognitive Decline in Nondemented Elderly Women, it conducted a study on women who were white and not demented. Over the course of four years, they did follow-ups and cognitive tests. The results found that out of the six-thousand women they did their prospective study on, 3.6 percent had six or more depressive symptoms and only sixteen out of the 211 that were depressed were actually taking antidepressants for their symptoms.
With their results, they compared women with less depressive symptoms with women with multiple symptoms of depression and found that women with multiple symptoms were older, less educated, and tended to be not married. Malnutrition was also associated to depression and an increase in depressive symptoms in elderly women. The women with fewer depression symptoms exercised and had good health. Higher rates of depression also come from becoming a widower, which gives both men and women who are widowed a greater chance of being diagnosed with depression (Yaffe, Blackwell, Gore, Sands, Reus, & Browner, 1999). In the context of looking at an elderly person’s socioeconomic status and its relationship to depression, studies have found that those of lower socioeconomic standing had higher chances of having depression. Out of the older adult population, about 14.7 percent live below the poverty line. Living below the poverty line gives the elderly, fewer options and less money when it comes to sustaining income as an older adult. No job retired, the cost of living can rise and coverage for healthcare costs is harder to pay.
The main factor that defines older adulthood is their socioeconomic status. Looking at ethnic minority groups, 19.2 percent of older elderly African Americans live in poverty, and 18.1 percent of older Hispanics live in poverty. This number is double that of how many whites who live in poverty which is 8.7 percent (American Psychological Association, 2016). The elderly population consists of many different cultural and racial backgrounds. In the elderly population, depression has been a key issue to not just correlate with socioeconomic status but also one’s personal background.
Depression has a huge impact on certain minorities like African Americans and Latinos. Looking at studies shown African American Women and Men suffer and have higher rates of depression not only due to their socioeconomic status but also their mentality toward depression and their oppression here in America. The population of elderly African Americans is going to triple around the year 2050 (Pickett, Bazeliais, Bruce, 2012). African Americans compared to Caucasian elderly people, it was found that Elderly African Americans had higher rates of depressive symptoms, due to psychological stressors like poverty, racism, discrimination, and violence. African Americans experience bigger distress compared to Caucasians leading to more issues with mental health.
Also, African Americans with more health conditions had higher rates of depressive symptoms, then those without health conditions. In the article called Late-life Depression in Older African Americans: A Comprehensive Review of Epidemiological and Clinical Data, it states that There were significant correlations between both socioeconomic status (SES) and educational attainment with depression among older African Americans (Jang et al., 2008). African Americans with lower SES had significantly higher rates of depressive symptoms compared to Caucasians. (Pickett, Bazeliais, Bruce, 2012). There was also a statistical difference in elderly African American who had higher education, and higher income than Elderly African Americans who had no education and had a low income. These higher education and higher income Elderly African Americans were less likely to have depressive symptoms.
Latinos are one of the fastest elderly population growing, in 2006 it was about six percent of the elderly population, and by 2050 it is supposed to almost quadruple (Aranda, 2013). Due to lack of language, the ideals of masculinity, discrimination, and for some being an illegal immigrant it causes Latinos to have double the rate of depression compared to African Americans and Caucasians. Latinos have a limited access to health care due to not being legal or the barrier of language. Because of the cultural background, latino men are more likely to refuse or even believe they suffer from depression.
In an article called Depression-Related Disparities Among Older, Low-Acculturated US Latinos, it states that Correlation data indicate that elevated depression rates in older Latinos are associated with female sex, older age, low income, low social support, high stress, chronic financial strain, functional decline, and low acculturation (Aranda, 2013). This shows the impact it has on the elderly Latino community and how it impacts their lifespan development. 3. Biopsychosocial approach Depression and Suicide is not a part of aging as a person goes through adolescence, young adulthood, middle adulthood, and into the last stage of older adulthood. Biological, social and psychological systems all interplay to either heighten the chance of depression or lessen it for the elderly. From a biopsychosocial approach, biological changes that happen to an elder as they age are the starting cause to effect an elders psychological and social system which will increase or decrease the chance of depression.
An elder with more disability and is incapable of daily simple tasks necessary to live independently have higher chances of depression. Older adulthood means increase wrinkling, reduced agility, reduced speed, unsteadiness of hands and legs, and difficulty moving make an elderly person’s life harder mentally and socially. In an article called Effects of Depressive Symptoms on Health Behavior practices among Older Adults with Vision Loss, it stated that a study was conducted in order to see the correlation between vision impairment and depressive symptoms. It was found that 18.1 percent lose their vision by seventy years old. 63.4 percent of the visually impaired participants said that they felt more depressive symptoms after becoming visually impaired. (Jones, Rovener, Crew, Danielson, 2009).
Those who lost their vision could not drive, could not go out play games, or do the daily activities they used to because of vision impairment which interplays with affecting their social system, and psychologically making them feel less for not being able to see. Those who suffer from a chronic illness have higher pain rates, less mobility, anxiety, and feel discomfort on the daily. In another article called Depression and health status in elderly hospitalized patients with chronic illness, it had stated that patients without depression suffered from a chronic illness for only up to 6 years, while those who were diagnosed with depression suffered from chronic illness for up to 8 years (Unsar, 2010). Due to being less mobile from chronic illness or disability, it causes for isolation and loneliness in later adulthood. This chronic pain and illness cause the elderly to not go out and lose interest because of loss hope.
These biological changes happening impact individual development. More negativity psychologically will cause isolation which is the biggest factor to leading to depression and even later suicide. Every elderly person is different and individual development will vary but biological risk factors will greatly impact social ability and elderly persons psychological health. Since biological, psychological, and social systems interplay there are certain protective factors that will interfere with the chance of depression. Protective factors like having good access to care and resources, having a good support system for one’s social system, having a good kinship with family, elderly knowing their identity and being more confident in oneself then feeling useless and pessimistic.
Being self-sufficient to live independently, and lastly being open about mental instability if issues arise it is easy to aid and care for elderly with issues of depression then with those who keep quiet. 4)Social Work practice implications and social policy The issue of Depression and suicide have certain implications for Social Work Practice and certain social policy. As stated before only ten percent of the elderly population with depression seek medical professional help. This impacts the ability of a social worker to help the elderly. The mentality of the elderly on depression is crucial in whether they are going to go out and get help or not. Mental Health America states that About 58% of people aged 65 and older believe that it is normal for people to get depressed as they grow older. They also stated that sixty-eight percent of the elderly population knows very little about depression (Mental Health America, 2015). The best way for prevention through social work is doing certain workshops about late-life depression.
These workshops can consists of symptoms, information of protective factors to lessen the chance of depression which will help the elderly population have access to better information on how to deal with depression or even prevent it from over clouding an elderly person life. To repeat, depression is not a normal part of aging and can be easily prevented if there was no stigma against Elderly’s role in society. That is why many do not come forward and talk about their mentality. Biological factors have been the main cause for heightening the likelihood of depression, the intervention, and prevention of depression through medical social work profession comes into play in order to aid patients through the process.
Medical social workers have been the best way of intervention and prevention. With the use of aid, information, and knowing more information about the medical field compared to social workers who do not work in the Medical profession. The population of the elderly is growing rapidly as stated earlier, that is why Medicare is very important. It is healthcare that helps cover the cost for the disabled and the elderly.
Medicare Part A covers certain hospital inpatient mental health care. It also has a 190 inpatient care in a psychiatric hospital while part B has more coverage given outside of a hospital, which includes visits to the doctor, clinical social worker, and clinical psychologists. They also cover depression screenings, diagnostic tests, group or individual psychotherapy, medication, and family counseling. (eHealth Medicare, 2018). Due to Part B being only if an elder is willing to pay impacts the ability of coverage an elderly patient can have when dealing with mental health issues. It all comes down to issues of money when dealing with the elderly populations mental health. The cost is too expensive for an elderly’s limited income. This can cause less and less elderly people to seek help for them having symptoms of depression or thoughts of suicide. Although there will always be hindrances to impact social work practice, there are always different forms of prevention and intervention.