UNDERSTANDING DEPRESSION AND SUICIDE
Conclusion
The image of an old woman sitting by the window, watching the world and people go by, has a deeper and more telling message.
The woman — who can be someone’s mother, grandmother, sister or friend — may be experiencing depression.
“Depression in the elderly is often unrecognized. When we see our elderly sitting by the window, we immediately think that they are just in deep thought… thinking, remembering the past,” said Dr. Glenda Basubas, a psychiatrist for more than 20 years.
“But have we bothered to ask how they are or what they need?” Basubas asked an audience composed of doctors, health-related professionals and other concerned citizens in a convention of elderly-friendly communities held last October 5 and 6 at the Cebu Grand Convention Center.
The event was organized by the Golden Center of Cebu Inc. as it celebrated its 15th anniversary.
The Philippine Statistics Authority defines elderly individuals or senior citizens as those aged 60 years old and over. They made up 6.8% or around six million of the country’s 92.1 million household population in 2010. This number has increased today as the country’s current population is now at 100 million based on the 2015 Census.
“Depression in the elderly increases risk of cardiac arrest and death following a heart attack. It also reduces’ elderly persons ability to rehabilitate,” said Basubas.
When untreated, depression increases the risk of suicide with the age range of 80 to 84 years old as twice more likely to commit the act.
Basubas, who deals with people suffering from depression and personality disorders, said there are several factors that cause depression in the elderly.
These include: emotionally painful events, past depression, low income, decrease in quality of lifestyle, declining health, disabilities and limitations, lack of social contact, feelings of loneliness, side effects of medication and retirement.
Retirement can be viewed as the loss of job for elderly people who are not financially prepared to face life after being employed for several decades.
Mario’s story
This happened to Mario (not his real name) when he reached the mandatory retirement age of 65 years old.
With six children who were all studying at the same time while he was working for a private company, Mario said he barely had any peso left to buy himself a new shirt.
When retirement knocked on his door five years ago, Mario, now 70, admitted feeling nervous and inadequate. Four children finished college with two of them having families of their own. The other two finished high school but found jobs in export processing zones in Lapu-Lapu City.
But he was worried about what he will do after 45 years of working and earning money for the family.
While packing all his office belongings in five large boxes, Mario could not help but feel anxious. He did not have any savings or insurance. His retirement money would just be enough to pay for loans and debts they incurred to send their children to school and pay for the house and lot which they live in.
“I descended into this dark hole. I stopped talking to my wife. I felt very useless and worthless. I was the family’s breadwinner and suddenly, I was waiting for my children to give us money. It was very degrading,” he shared.
With what little money he had, Mario started drinking which upset his wife and children. Hurtful words were said to each other. In the end, Mario thought it was best to end his life because, he felt, that nobody needed him and he was just causing people headache.
He decided to hang himself using the rope that was used for his granddaughter’s cradle.
But just as he was about to tie the rope around his neck, a neighbor, a habal-habal (motorcyle-for-hire) driver, saw him.
“Nagdagan-dagan ang drayber. Nagsyagit. Maghikog ang tiguwang! Maghikog ang tiguwang! Nanggawas ang mga silingan. Uwaw kaayo,” he recalled.
(The driver ran towards me. He screamed, ‘The old man is going to kill himself! The old man is going to kill himself!’ The neighbors got out of their houses to check out what was happening. It was very embarrassing.)
His family brought him to the parish priest who explained to him the sanctity of life. He listened.
Though still unhappy, Mario has found a way to make use of his idle time by volunteering as a lay minister.
Emotional support
Ironically, Mario’s condition was dismissed as “gawa-gawa lang” (made up) by veteran host and fellow senior citizen Joey de Leon, who like Mario is 70 years old.
On national television, De Leon dismissed the importance of support for people experiencing depression. For his comments, the TV host was criticized by people both online and offline. De Leon eventually apologized for his misunderstanding of the condition.
While his scathing remarks caused anger to many, he also unconsciously opened public discussion on depression and even, suicide.
For elderly individuals suffering from depression, Basubas said it is essential to offer emotional support.
Little things mean a lot to the elderly, she said.
“It is important that we treat our grandparents, the elderly members of our family and community with love and care. Often times, we neglect them.
When we see them sitting by the window, we are quick to say that they are just being “old.” We don’t realize that they may be depressed and have suicidal tendencies,” said Basubas.
Treatment
“When we talk to patients, we ask them if they have plans of committing suicide. Patients with a suicide plan requires emergency psychiatric evaluation,” she said.
Anyone is at risk of dying by suicide, said Basubas.
That is why she continues to encourage all healthcare workers to maintain a high index of suspicion for the presence of depression or depressive symptoms in patients.
Basubas believes that the human person is made up of spirit, mind and body.
She emphasized a holistic and individualized approach in the treatment of depression.
“The role of spirituality is very strong. In treatment, it’s not only bio-psychosocial but also spiritual,” she said. A God-centered family is also essential in preventing the occurrence of suicide.
Basubas also cited the Filipino’s humor as a defense mechanism and as a sign of being mature.
“Humor enables a person to bear what is unbearable. Luckily, we Filipinos are humorous by nature,” she said.
Moving forward, Basubas, who is part of the Philippine Mental Health Association Cebu Chapter, revealed plans to partner with the Cebu provincial government to roll out a comprehensive mental health program.
As only one of two doctors in her batch of 80 people who decided to pursue psychiatry as a field of specialization, Basubas teaches in four universities to inspire others to pursue a career and calling just like hers.
“This is why I never gave up teaching. I want to help mold them to become good doctors and then convince them to become psychiatrists,” she said.