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DW
4 days ago
- Health
- DW
Late-life depression: Learn to spot the signs early – DW – 07/25/2025
Depression goes undiagnosed when symptoms are mistaken for age-related physical illnesses. We need to treat mental health issues earlier in life. It is perhaps the last place you would expect to find a generational divide, but even in mental health, we (those of us of a certain age) are told, "We (those of us of a younger age) are more aware of mental health than you" — as if awareness alone could remedy depression. There is actually some truth to this. "There are shifts in younger generations and also in older generations. But unfortunately mental health is still very stigmatized for older adults," said Pascal Schlechter at the Institute of Psychology, University of Münster, Germany. "It's quite a big step [for some people] to admit, 'I have a mental health problem and I want to talk about it.'" But it's not only older patients who lack awareness or a willingness to talk about depression. It can also be their doctors, who may misdiagnose a mental health problem as a physical one, common when you grow old. "If a 30-year-old tells you they've stopped going out and are withdrawing [from social interaction], you would ask them, 'Is anything wrong with your mental health? Are you depressed?'," said Schlechter. "But with an older person, you might say, 'You're fatigued. It's just part of the normal aging process. Just rest.'" To view this video please enable JavaScript, and consider upgrading to a web browser that supports HTML5 video The generational divide closes when we talk about symptoms of depression — there is little to no difference in depression between younger and older adults. While at Cambridge University in the UK, Schlechter co-published a paper on the development of depressive symptoms in older adults, based on the results from a longitudinal study that tracked the progress of more than 11,000 people over a period of 16 years. Schlechter and colleagues found the same symptoms in older adults as in younger adults: Patients expressed they , or that , they , had , or felt . However, they noted: "In older adults, depression often presents with more somatic symptoms than in younger populations." When we spoke in July 2025, Schlechter added: "Medical or somatic symptoms may be part of a depression, but [older adults] often misattribute these symptoms to their aging process. This can lead to delayed recognition, [and as a result] their depression may manifest more chronically." So, there is that difference: Whether it's due to a lack of awareness among patients and physicians, or stigma, depression can be worse for older people. That may be because the depression is combined with — or, in part, "triggered" by — a somatic (physical) illness, or symptoms of depression were left unaddressed earlier in life — perhaps also due to a lack of awareness or stigma. As with most illnesses the earlier depression or anxiety are diagnosed, the better the chances of treating them. Some social factors also contribute to depression. As we enter late life, we are often forced to adjust to changes in our social status, our identity through work or elsewhere in a community, and people start dying around us. We may even experience abuse from our carers, as highlighted information from the World Health Organization on depression — another, potential contributing factor. All these things can bring what may have been a mild, latent depression to the fore in a chronic and severe way. There is a sense when talking to experts in the field that physicians may prefer to tackle physical ailments in older adults than mental ones. No matter what age a person is, depression is difficult to treat. But when older adults present with both physical and mental health problems, it is even harder. "In both poorer and richer health systems in Europe, one of the main instruments we have to deal with depression is medication," said Albino Oliveira-Maia, who heads the Neuropsychiatry Unit at the Champalimaud Foundation in Lisbon, Portugal. "When treating older adults [with] medication, [there is a] higher likelihood for interaction with other medication and for toxicities [to occur]," Oliveira-Maia told DW. "That might mean physicians pay more attention to physical health problems than mental health." But medication is not the only treatment for depression — there are also a range of psychotherapy options, or so-called talk therapies, including cognitive behavioral therapy, and many others, specific to a patient's situation. To view this video please enable JavaScript, and consider upgrading to a web browser that supports HTML5 video One aspect of depression we have not touch on yet is suicide. Suicide affects all groups of people, young and old, male and female. But regulation often prevents people from participating in research if they are known to have suicidal thoughts or show suicidal behavior. And that means there is a lack of understanding and knowledge among researchers. "This is obviously an ethical concern," said Oliveira-Maia. "It's an act of generosity to participate in a research program, so we need to protect the people. But in doing that, there are sometimes consequences that lead to slower progress for some of the patients that are most in need." People over 65 years can also be excluded from trials if they have existing medical conditions, such as vascular lesions in the brain, said Oliveira-Maia. Scientifically, this makes sense, even if only from a cold, unemotional perspective: If people die or their illnesses worsen during a trial, it can make it impossible for other teams to verify the results — which is a standard process and safety net in research, especially in the development of new medication. Both Schlechter and Oliveira-Maia have reservations about awareness campaigns, and specifically about self-diagnosis, which can go either way — a younger person may be more inclined to say, "Yes, I have a mental health problem" even if they don't, and an older person may deny all the signs. "For younger generations, there is more public awareness due to social media. And there are good campaigns that provide valid information," said Schlechter. "But there's also a lot of misinformation out there." Oliveira-Maia, meanwhile, is concerned about people misdiagnosing themselves, whether they are young or old. "While [they are] valuable, there is also some data to suggest that the awareness campaigns can in themselves lead to misclassification in that some people that are healthy can value their normal symptoms of sadness and anxiety as a mental health problem." The solution, as always with any illness or symptom that concerns you, is to speak to a health professional you can trust.
Yahoo
28-01-2025
- Health
- Yahoo
European watchdog takes aim at online gambling, gaming among youths
Online gambling and gaming can cause depression and other mental health issues in young people, which the Council of Europe rights watchdog is trying to counter with a new project encouraging good policy and awareness raising. The 46-member bloc, which launched its project at the start of a two-day conference in Rome on Tuesday, is seeking to help countries tackle the problem as online gambling and gaming grow in popularity among young people. "It is only a minority (of adolescents) who experience addiction-like symptoms," Orsolya Kiraly, a researcher at the Eotvos Lorand University's Institute of Psychology in Budapest, told the conference. "But in these cases these lead to severe negative consequences and functional impairment," she said. Excessive online gambling and gaming are particularly dangerous for children, whose brains and personalities are still developing, she said. The dangers include mental and physical health problems ranging from family conflict and sleep disturbances to bad eating habits and poor physical hygiene, Kiraly said. The Council of Europe's Pompidou Group, which coordinates anti-drug and addiction policy and is in charge of the new project, said in a 2024 report that gambling and gaming products were deliberately crafted to make the activities "as immersive and addictive as possible". Detailed research on the topic is not yet widely available, but the World Health Organization has already identified disorders from online gambling and gaming as public health concerns. - 'Conflicts of interest' - Gambling disorders could affect 26.4 percent of adolescents who are gambling on online platforms, and 16.3 percent of those gambling using sports betting, Kiraly said, citing recent research. More video games, meanwhile, are incorporating gambling-like features, including "loot boxes" -- items that can be bought within video games that contain other unknown objects. Boys are more affected, while girls are more at risk of addiction-like disorders from social media, Kiraly said. "There is a great need for more research in this area," she said. "The industry has a lot of data but they don't share it or they share it only with researchers who have conflicts of interest." The global gaming industry could exceed $300 billion in revenue by 2028, doubling since 2019, according to a 2024 report by the consulting group PwC. Italy is one of the largest gambling markets in the world, with 148 billion euros ($125 billion) spent in 2023, up from 89 billion euros in 2012, said Elisa Benedetti from Italy's National Research Council. - Adults 'desperate' - The Council of Europe hopes to help states to fix a problem that most of its members do not even have strategies for yet. Experts said one of the issues was the contrasting ways in which people of different ages deal with the stigma and the difficulties. Simona Pichini, director of the addiction centre at Italy's National Health Institute (ISS), pointed out that the national Italian gambling hotline most often received calls from adults. "When do they call? When they're desperate, when they arrive with no money, no house, outside the family. They call at the end of the problem," she said. It was a marked contrast with young people. "Not youngsters. They don't perceive the problem," she said. ams/ide/jxb/js
