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 on the elderly by the Korea Institute for Health and Social Affairs, health and economic difficulties, disconnection of relationships, and loneliness were the main factors that cause depression in the elderly. In particular, a number of papers point to loneliness as a major factor exacerbating depression in the elderly, and among them, bereavement from a spouse and resulting loneliness have a significant impact on the aggravation of depression in the elderly.

Bereavement adversely affects the mental health of the surviving spouseㅣSource: Getty Imagesbank

According to a study by researchers at the University of Utah published in 1986, the death of a spouse worsens the mental health of those left behind, leading to depression. In addition, 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, pointed out Korea as ‘the country where bereavement has the greatest impact on mental health’ through his research. According to the study, on average, the increase in depression index among Koreans after bereavement was 2.6 times higher than that of the United States.

Although bereavement has a significant adverse effect on the mental health of the remaining spouse, the perception of depression caused by bereavement in Korea is very low. This is because of the social perception that regards mental health problems as individual problems. Experts say bereavemental depression can lead to other mental and physical health problems, so you should see a doctor when your depressive symptoms reach a certain level. Hidak’s psychiatrist, Su-ro Kim (Jangseong Christian Clinic), a counselor in the Department of Psychiatry, will look into depression in the elderly due to the bereavement of a spouse and how to overcome it.

The Reality of Depression in the Elderly in Korea

As is already well known through the media, our country’s aging rate 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 among OECD countries by 2048. This suggests that many elderly-related problems may 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.

In addition, considering the cultural characteristics that are passive in visiting the Department of Psychiatry, the increase in the proportion of the elderly living alone, and the increase in feelings of isolation and loneliness caused by the novel coronavirus infection (COVID-19), it is expected that the problem of depression among the elderly in Korea will become more serious in the future. can.

Spouse bereavement stress and depression

In the elderly, mourning due to bereavement is regarded as a high risk factor for depressive disorder because many factors overlap with depressive symptoms. In addition, regardless of the time elapsed after bereavement, it may act as an important factor in depression in the elderly. Risk factors for depression after bereavement include ‘inappropriate family coping methods’, ‘physical illness’, ‘insufficient support system’, and ‘anxiety symptoms’. Many and extreme choices are known to have serious consequences, including a sharply increased risk.

The bereavement reaction is a natural reaction after losing a loved one. The aggregate of emotional, physical, and cognitive responses that are ‘generally’ to the death of a significant person is viewed as the criterion for a ‘normal’ mourning or bereavement response.

A widowed person suffers acutely for two to six months after the death of their spouse. Although there is no set stage of mourning or the type of change over time that would define a ‘normal’ bereavement response, most older people recover significantly emotionally within a year or so after the death of their spouse. However, in some cases, the feeling of loss does not end and persists. It is defined as ‘pathological mourning’ when the mourning response persists for more than 1 year, and it is known that about 15% of widows have major depressive disorder or have a serious and chronic mourning response.

Men and women, who are more affected by bereavement

The effects of bereavement on mental health vary by gender. In particular, it may vary depending on ‘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 may decrease or the structural system of interpersonal relationships may be weakened.

On the other hand, men are more likely to die than women after their spouse dies. This increased risk of death may 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 better not to be too impatient about adjusting to life after a bereavement, but to make efforts to maintain a daily life. It is not good to spend too much time alone, so sharing your grief or talking about the deceased with a family member or close acquaintance is also a good idea.

Mourning is not about forgetting the memory of the deceased, but living with the memory of the deceased by remembering the deceased completely and relocating it in the heart. Nevertheless, if psychological pain persists or if you have difficulties in your daily life, you will need professional help.

Director Kim Su-ro (Jangseong Christian Clinic)ㅣSource: Jangseong Christian ClinicDirector Kim Su-ro (Jangseong Christian Clinic)ㅣSource: Jangseong Christian Clinic

Help = Dr. Su-ro Kim, a counseling doctor at Hidak (Department of Psychiatry at Jangseong Christian Hospital)

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