How to tell when a relative is depressed

Originally posted in the Santa Monica Daily Press July 25, 2013

Dear Life Matters,

I am writing to you because my wife’s mother seems very lonely and we are both worried about her. I love my mother in-law and we do our best to have her come by or to visit her as often as we can. But we both work and we have three children to care for as well.

On top of this, we can’t tell if she might be depressed as well?

Can you help us in whatever small way with seeing the difference and how we can help her?

Signed,

Forever Grateful

Dear Grateful,

It is so refreshing to hear of your very real concern. It is really nice that you care.

Loneliness is a pervasive problem these days, but there is an extreme problem with chronic loneliness in particular.

Many folks suffer from situational loneliness after a loss, death, divorce or even a job loss where you no longer have the same contact with your co-workers. Situational loneliness is normal and usually passes after a bit of time.

But chronic loneliness is truly painful and can actually lead to serious health problems, both physical and mental.

According to a number of studies, social networks are rapidly declining. You may wonder how that can be with social media sites like Facebook and Twitter, which seem to offer us an easier way to stay connected. Sometimes the interactions aren’t substantial and these sites can give us a false sense of security. Because they are sometimes technology challenged, the elderly may have a harder time using those sites and can become even further isolated.

Interestingly though, research suggests that the loneliest group seems to be between age 40 and 50, which may be due to changing family dynamics, but might also some-what support the theory that social media is related to the decline of real in-person support groups. The younger generations may be more used to this, but I really think that only time will tell.

Not all can be blamed on the Internet and social media. With the mobility afforded to us these days, extended families and close networks have been declining for some time.

Whatever the reason for the decline in social support, chronic acute loneliness is like a deep pain in the heart and it often takes on a life of its own. What I mean by this is that it can become self-perpetuating, causing the person to feel and therefore behave in ways that increase isolation. There is good reason to be worried, as this can become dangerous. Not only is the pain of loneliness increased, but also the health risks of not having a social support system are enormous.

High blood pressure, sleep disorders, increased cortisol levels, weakened immune systems, substance abuse and even diabetes and Alzheimer’s have been associated with chronic loneliness.

All of this is very depressing, but is it depression? Loneliness can definitely be a depressing condition, but it is not necessarily depression, clinically speaking. I believe that it can lead to it but it does not always and it is a separate issue.

Depression            includes an obvious depressed mood, if not reported by the person, is observable by others. It includes changes in appetite, insomnia or hyper-somnia, weight gain or loss, hopelessness, loss of interest in things that used to interest the person, difficulty with concentration, fatigue and lack of energy, crying for no reason, and thoughts of wanting to die.

A depressed person might lie in bed all day, sleep long hours and forget to eat or have no appetite for it. Or they might not sleep and be filled with anxiety and agitation and not know what to do with themselves.

On the other hand, a lonely person might go out for a walk or stroll through the mall or grocery store, hoping for some social interaction but usually not knowing how to make it happen because loneliness does take on a life of its own. Their best friends might be the waitress at the coffee shop or the postman or the grocery store checker. Or they may actually have a number of social interactions that superficial in nature.

Those who are severely depressed might not want anything to do with people. So my guess is that your mother-in-law is lonely and while it might be hard for her to start something new, having become embedded in her lonely ways, getting her to go to church or temple, join a book club or Bingo game, anything that includes social interaction at least once a week might just get her moving toward building a social support network. Since so many people are in the same boat, these groups tend to bond rather quickly if you can just get the folks to go.

Pets are also an excellent idea for people who are alone and lonely.

You might also consider hiring a geriatric social worker to help you and to help her become more comfortable with starting new things and meeting new people. This professional could also tell you for sure if a clinical depression might be involved.