[Reporter Cai Kaiheng/Report from Taipei] "I have been feeling pain all over my body recently, especially my stomach has been feeling uncomfortable all day long..." Many filial children often take their parents to gastroenterologists and orthopedists, and undergo a lot of examinations but cannot find the cause. In the end, they are even suspected of becoming stubborn and suspicious as they age. Xue Yuanzhi, a physician at the Department of Psychosomatic Medicine at the Songde Campus of Taipei City United Hospital, pointed out that in the past, people only paid attention to whether their elders had high blood pressure or stroke, but often missed their "worryings." In fact, compared with the 4.7% prevalence rate of depression among the general population, the prevalence rate among the elderly can be as high as 13.3%, and even more than half of the elders have experienced symptoms of depression.
Xue Yuanzhi explained that from the perspective of brain science, when neurotransmitters such as serotonin and dopamine are out of balance, it will not only make people feel depressed, but also "lower the brain's pain threshold." This means that as long as there is a slight physiological stimulation to the body of the elders, the pain received by the brain may be amplified, causing heart palpitations and anxiety. Coupled with the reduced interpersonal interaction after retirement, other symptoms of depression are not easily noticed, and these "physical discomforts" become their only way to seek help.
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Xue Yuanzhi explained that many family members often complain that their elders have become "lost" as they age, have difficulty communicating, or forget things, and worry that they will suffer from dementia. Xue Yuanzhi pointed out that depression and dementia often appear together, but there are still differences between the two. If an elder's high blood pressure or chronic disease is under stable control, but suddenly develops unexplained fatigue, pain, gastrointestinal discomfort, or becomes more frequent in going to the hospital, he or she should be vigilant.
Xue Yuanzhi said that another obvious change is the overall decline in life functions. For example, an elder who was originally very fond of cleanliness suddenly doesn't like to take a bath or clean up the housework, or he completely loses motivation in the activities he was most passionate about before, such as walking, visiting the vegetable market, growing flowers and grass, etc., and just wants to sit on the sofa and watch TV all day long. This is often a warning sign of depression.
Xue Yuanzhi also reminded that dementia usually "slowly" deteriorates memory over several years; while depression sometimes occurs suddenly. Elders may suddenly start complaining "I can't remember anything" within a few months, and the pace of progression is completely different.
When elders hear that they need to see a psychosomatic doctor or take psychiatric drugs, they are usually very resistant. They are afraid of being labeled and worried about drug addiction. Xue Yuanzhi said that usually the medical team will adopt a mild strategy of "starting with a low dose and slowly increasing the medication" to minimize side effects. In terms of communication, doctors will not emphasize the word mental illness, but will focus on the "physical symptoms" that the elders are most concerned about.
Xue Yuanzhi gave an example. He would tell his elders: "This medicine helps regulate the balance of neurotransmitters in the brain, just like taking medicine to control high blood pressure. It can also help improve your gastrointestinal discomfort, allowing you to sleep better at night and have more energy during the day." He would also patiently explain that after the condition stabilizes for a few months, most people can gradually reduce the medication, and it does not necessarily require long-term lifelong medication. This kind of "fine-tuning" of the quality of life can best resolve the elders' defensiveness and allow the medicine to fully exert its effect in regulating sleep and relieving pain.
Xue Yuanzhi pointed out that to help parents get rid of depression and grow old happily, "regular exercise" is the most effective protective shield proven by research. The World Health Organization recommends that any level of exercise is better than no exercise. You should accumulate at least 150 minutes of moderate-intensity exercise such as brisk walking and mountain climbing every week. This can be combined with exercises such as Tai Chi that can train muscle strength and balance, and can also prevent the falls that the elderly are most afraid of.
In addition to getting active, the elders should also be encouraged to "go into the community and maintain their daily routine." Xue Yuanzhi suggested that elders can be encouraged to attend community colleges, long-term care centers, or volunteer in the community. By having a fixed goal of going out during the day, by learning new things and chatting with neighbors, the elders will rediscover the sense of value that "they are still useful." In addition, if your parents cannot see clearly or hear, remember to get them glasses or hearing aids in time, because poor facial features will make the elders less willing to go out and socialize. If they are closed for a long time, depression will easily come to their doorstep.
In the face of aging, in addition to taking care of your body, don’t forget to take care of your mood as well. From regular exercise and maintaining a daily routine, to going out into the community and interacting with people, every seemingly simple daily routine may become an important force in protecting mental health and accompanying the elders to age healthily and live happily.
