The main cause of depression in the elderly, “bereavement”, how to overcome it? … Director Kim Su-ro, Department of Mental Health [인터뷰]

According to a 2014 survey of seniors from the Korea Institute for Health and Social Affairs, health and economic difficulties, disconnected relationships and loneliness were the main factors causing depression in the elderly. In particular, numerous articles point to loneliness as one of the main factors exacerbating depression in the elderly and, among these, the bereavement of the spouse and the consequent loneliness have a significant impact on the aggravation of depression in the elderly.

Bereavement negatively affects the mental health of the surviving spouse ㅣ Source: Getty Imagesbank

According to a study by University of Utah researchers published in 1986, the death of a spouse worsens the mental health of those left behind, leading to depression. Additionally, in 2004, Professor Kristi Williams of Ohio State University, USA, also published a study showing that bereavement significantly worsens the mental health of the remaining spouse, regardless of gender.

Professor Apoorva Jadhav of the University of Michigan, USA, published in 2017, listed Korea as “the country where bereavement has the greatest impact on mental health” through her research. According to the study, on average, the increase in the depression rate among Koreans after bereavement was 2.6 times higher than in the United States.

Although bereavement has a significant negative effect on the mental health of the remaining spouse, the perception of bereavement depression in Korea is very low. This is due to the social perception that regards mental health problems as individual problems. Experts say bereavement depression can cause other mental and physical health problems, so you should see a doctor when your depressive symptoms reach a certain level. We will examine depression among the elderly caused by the death of a spouse and how to overcome it with the director of the Department of Psychiatry, Su-ro Kim (Jangseong Christian Clinic).

The reality of depression in the elderly in Korea

As is already known through the media, the aging rate of our country is very fast. According to the survey, it is 1.7 times the OECD average of 2.6% and is projected to become the oldest of the OECD countries by 2048. This suggests that many problems related to the elderly could arise in the future. Among them, depression among the elderly, which is also associated with cognitive decline, suicide and mortality, is emerging as the most serious social problem.

Furthermore, considering the cultural characteristics that are passive in the visit to the Department of Psychiatry, the increase in the percentage of elderly people living alone and the increase in feelings of isolation and loneliness caused by the new coronavirus (COVID-19) infection, yes. predicts the problem of depression among the elderly in Korea will become more severe in the future.

Stress and depression from bereavement of the spouse

In the elderly, bereavement due to bereavement is considered a high risk factor for depressive disorder because many factors overlap with depressive symptoms. Furthermore, regardless of the time elapsed after bereavement, it can act as a major factor of depression in the elderly. Risk factors for depression after bereavement include “inadequate family methods of coping with bereavement”, “physical illnesses”, “insufficient support system” and “anxious symptoms”. Many extreme choices are known to have serious consequences, including a large increase in risk.

The grief reaction is a natural reaction after losing a loved one. The set of emotional, physical and cognitive responses that are “generally” to the death of a significant person is seen as the criterion for a “normal” bereavement response.

A widowed person suffers acutely two to six months after the death of a spouse. While there is no set stage of bereavement or the kind of change over time that would define a “normal” bereavement response, most older people recover significantly emotionally within about a year of their spouse’s death. However, in some cases, the feeling of loss does not end and persists. It is called “pathological bereavement” when the bereavement response persists for more than 1 year and approximately 15% of widows are known to have major depressive disorder or have a severe and chronic bereavement response.

Men and women, more affected by mourning

The effects of bereavement on mental health vary by gender. In particular, it can vary according to “biological factors”, “social factors (life events, social roles and status, support system)” and “psychological factors (coping skills)”. Women have a higher risk of depression after bereavement than men. This is because after bereavement, women are more easily affected by negative emotions than men and their external activities can decrease or the structural system of interpersonal relationships can be weakened.

On the other hand, men are more likely to die than women after the death of their spouse. This increased risk of death can be attributed to the disappearance of the wife’s role in helping promote social relationships and promote health.

How to overcome bereavement stress

It is best not to be too impatient in adjusting to life after bereavement, but to make efforts to maintain a daily life. It’s not good to spend too much time alone, so it’s also a good idea to share your grief or talk about the deceased with a close family member or acquaintance.

Mourning is not forgetting the memory of the deceased, but living with the memory of the deceased, remembering the deceased completely and placing him back in the heart. However, if the psychological pain persists or if you have difficulties in daily life, you will need professional help.

Director Kim Su-ro (Jangseong Christian Clinic) ㅣ Source: Jangseong Christian Clinic

Help = Director Kim Su-ro (Department of Psychiatry, Jangseong Christian Hospital)