In older adults, depression and many psychiatric illnesses are just as prevalent and common. Suicide is a major complication of major depressive disorder, which is present in the elderly. And major depression or a depressive illness is the main reason many of the elderly may experience suicidal ideations or intentions and maybe even attempts.
In terms of preventing suicide, we want to make sure there is not an underlying diagnosis of depression. However there are many other things that can be associated and create the risk of suicide in the elderly:
Multiple physical illnesses—chronic pain and ongoing pain—there are a lot of co-occurring and co-morbid conditions that a patient may experience.
Chronic diseases like heart disease, lung disease, kidney disease, also neurological diseases, stroke like diseases. Underlying depression from these can further predispose person for a suicide intent or ideations.
Social isolation is a major factor. As we’ve all gone through a pandemic in the last 18 months, this isolation is further exacerbated, and tipped the balance toward such tendencies.
Widowhood is another example.
Functional decline—as we all age, there is some functional decline.
Loss of income and retirement can also predispose certain individuals with episodes of depression.
There could be a family history of depression or a person may have had depression in the past.
Certain personality characteristics can predispose a person for depression and creates more of a vulnerability toward suicide.
The best place to start is with your primary care physician. Eighty percent of the depression/80% of the psychological/emotional issues are actually dealt with in the primary care physician's office.
There are screening tools primary care offices use, especially in our collaborative treatment model, that can pick up some of these issues related to depression and risk for suicide in the early stages. In medicine, the earlier you pick up anything the better the outcome. So your primary care physician is the right place to approach for this issue.
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