Many older adult suicides due to depressionby Heather MurphyPublic Relations Of the 30,000 suicides annually in the United States, 70 percent of those in the 75-plus age group have diagnosable depression. But older adult suicide is not what most people hear about, said Barbara Haight, professor and former associate dean for research at the College of Nursing. “People aren’t as interested in those 65 or older that commit suicide because most people view it as an adult making a decision to do something. Older adults ‘sound rational’ when they talk about suicide, and the concern is not there like it is for adolescents and young adults.” Haight recently concluded a study involving depression and older adults. “Our original hypothesis was to seek out and treat minor depression before it developed into clinical depression, and thus possibly resulting in suicide,” she said. Haight and her colleagues were also interested to know if depression did indeed work like a continuum, with minor depression at one end and suicide at the other. “Could an individual ‘skip’ clinical depression and become suicidal? That was something that we wanted to look into,” Haight said. Haight based her study on the Centers for Disease Control’s focus to prevent suicide in all individuals. She conducted an intervention for depression in older adults, the life review. The review gets the individual to reminisce about life and then reframe it by analyzing choices and decisions that were made throughout a lifetime. It reintegrates events that make a person unhappy or upset into a more acceptable picture. The design for the study included two groups, a “friendly visit” group (where life review was not used and participants simply chatted) and a “life review” group. During the study, Haight and her colleagues taped stories told by the participants and shaped them into qualitative data outlining differences in suicidal tendencies. “Older adults like us a lot, they didn’t consider our visits as therapy,” Haight said. “It made them feel good to tell their stories and have someone listen.” As a back-up, Haight referred any participants whose life review did not seem to help to Charles Kelmer, Institute of Psychiatry, and co-investigator of the study. “The life review process was tested as an intervention to treat minor depression in order to prevent the progression to major clinical depression and resultant suicide. Minor depression is not recognized as an illness so people in this category are untreated though they are ill in their own right,” Haight said. “Through intervention, we were able to significantly lower Beck depression scores, but more importantly, we were able to characterize the condition as the ‘curmudgeon syndrome,’ containing features such as denial, irritability, anger, self-isolation, apathy, attention deficit, and poor adjustment to aging.” Haight found that in most older suicides, the individual will see his or her physician about four months before the suicide takes place, usually complaining of persistent symptoms that won’t go away, fatigue, and so on. An older adult may suspect something is physically wrong instead of the possibility of depression. Common barriers to the diagnosis of depression in older adults include denial of a problem, lack of money, no insurance, and fear. “By confirming clinical observations with subsequent life review data, we hope to create a picture of minor depression more readily recognizable by providers in primary care settings and contribute to the prevention of suicide in older people,” Haight said. Symptoms of Major Clinical Depression
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