Depression manifests itself in different ways, depending on the age of people. Until the mid-twentieth century, it was believed that children and adolescents did not suffer from it. However, later this point of view changed to the opposite. Currently, some scientists believe that depression can develop in infants, if they remain without maternal support. American researchers believe that 2% of children under the age of 12 suffer from depression. In adolescence, this figure increases to 8% in boys and 10% in girls. Somewhat later, at the age of 13-19 years, the percentage of morbidity in girls increases significantly and reaches 16%. According to Schaffer D. et al. (1996) about 4.9% of children suffer from severe depressive disorders. In children, signs of depression are most noticeable in behavior, changes in activity, sad mood, the appearance of irritability, sensitivity, confusion, isolation, and a decrease in interest in ordinary games and studies. In some cases, poor learning and developmental delays can be hidden symptoms of depression. In children, depression is quite often manifested by complaints of general malaise, weakness, fatigue, pain in different parts of the body. The ideas of self-accusation are frequent, when a child considers himself to be stupid, ugly and worthless. For depression in childhood, mixed states of irritability and aggressiveness are typical.
In adolescence, patients are capricious, irritable, impulsive, often find flaws in their appearance, consider themselves losers and limited people who are not able to benefit either themselves or their loved ones. It should be noted isolation, the desire for loneliness as an important sign of the onset of depression in adolescence, there are often searches for the meaning of life, disappointment in the chosen profession, a painful attitude to money and an inability to enjoy those things that pleased earlier.
At middle age, the classic symptoms of depression are more pronounced, however, grudging and anger may appear. Elderly patients often complain of disorders of the internal organs.
Depression cannot be attributed to the “typical” companions of old age and it is not the inevitable consequence of age-related changes. It is quite difficult to identify depression in old age, about 40% of cases of this affective disorder are missed by doctors.
From the point of view of the psychopathology of the depressive state in the elderly, somatic symptoms, hypochondriacal experiences, phobias, anxiety, the inclusion of dysphoria and cognitive impairment come to the fore. Confusion and lethargy can be confused with manifestations of amnesia and disorientation. The peculiarities of affective disorders in old age include the relatively frequent occurrence of dysthymia after an episode of depression. In old age, such manifestations of depression are well expressed, such as a negative view of the future, difficulty of perceiving positive events, attributing success to external factors, and failures to own insolvency. If a depressive psychosis develops, delusions of guilt and sin may come to the fore.
The effectiveness of treatment of depression in the elderly and senile age, according to the results of modern research, is about the same as in the young. In the process of aging, somatic factors, organic brain damage, changes in the cardiovascular system, and psychosocial characteristics of a person’s life contribute to the onset of depression.
Fear of loss of independence, insufficient social support, loneliness, social isolation, loss of influence and respect, change in living conditions and habitual social connections are the frame in which depressive symptoms develop in old age. In terms of the development of the latter, severe mental injuries are especially dangerous: the death of a spouse, change of residence, financial collapse.
In psychotherapy of elderly and senile depression, support and encouragement of the patient is especially important.