Wrinkles, Wit and Wisdom …………..

It was time to leave OPD.Mind full of kid’s stationary list to shop for and here I saw that guiltily smiling innocent face with 3 prominent Ws ‘Wrinkles, Wit and Wisdom’.

Aahhh!!! Mrs.ABC again without an appointment and odd time of OPD. I could see the neatly folded chit of her recent complaints in her hand. I was guessing how many folds this chit must have today, when I heard the words, “Sorry doctor, I will just take 2 minutes of yours.” I took out the cell and texted “I will be home in 30mins more”

There’s a senior citizen resident society near my clinic and I have got many more such patients. The apartment accommodates the residents who are above 60 of their age. I call this specific apartment a brain hub. A cream layer of highly intelligent, successful champs in their respective fields or professions, most of them financially independent with huge valuable experience of life with them. Living on their own in their specially designed flats. All needs are doorstep away and are taken care of.

 Apart from their different physical complaints almost all of them have the same thing in common, need to talk and need to communicate.  Sometimes they talk endless regardless of their physical complaints. They want to speak out about many personal problems, general things and joys. I think this is the success of any doctor when his or her patient can relate, trust and open up to empty the mind bin out. It’s always adorable to be in conversation with these people. I make sure I, be the quality listener for them.

Guys, for any physician this part of consultation are important as the elders at this age are susceptible for geriatric depression or old age depression in simple words. These sessions can be very helpful to identify the psychological state of patient. As many physical ailments are either associated or is the output of the emotional pathologies.

Aging and body changes, dependability, restricted mobility, thought gap between younger generations in family more or less add emotional insecurity in almost all elderly people. Identifying, accepting and early working upon the mind storm is essential to reduce the further damage.

Identifying the risk group of old age depression

• Single male or female, unmarried, divorced or widowed
• Being female
• Lack of a supportive social network
• Stressful life events
• Physical conditions like stroke, diabetes, cancer, dementia, and chronic pain.
• Certain medicines or combination of medicines
• Damage to image of body(e.g. amputation, cancer surgery)
• Family history of depression
• Fear of death, suicide thoughts
• Living alone, social isolation
• Other illnesses
• Past suicide attempt(s)
• Recent loss of a loved one
• Financial dependability on other members in family
• Severe family disputes

              General symptoms of old age depression

• Insomnia (difficulty falling asleep or staying asleep)
• Oversleeping or daytime sleepiness
• Behavioural changes like sudden anger, crying , overreacting or cutting off from family and society
• Excessive talking or total silence
• Irregular diet or skipping diet
• Suspecting nature
• Despite of medicine non responding physical state
• Fatigue
• Social withdrawal and isolation
• Weight loss or loss of appetite
• Abandoning or losing interest in hobbies or other pleasurable pastimes
• Increased use of alcohol or other drugs
• Over faith and worshiping god or showing total unfaith These are some of the signs that family, friends and family doctor should not overlook

Solutions other than medicines

Since treating the depression in old age with medicine is very difficult because of contraindications and restriction of many medicines due to severe adverse effects on health.

• Taking help of psychologist or psychiatrist is important.
• Counselling is the important most part of the treating course.
• Sharing small routine time together, seeking their advice and making them feel that they are needed in family will help them gain self respect.
• Engaging with self help groups, small kids and pets are very helpful to make the elders delighted and overcome the depression
• Family, social support plays key role. All at this age these people want is security in their relationships in family, recognition for their achievements and deeds for family.

 

        Ayurveda view on old age depression

Old age is supposed under the dominance of Vaat dosha. Vaat dosha with its      properties increases the catabolism in old age. It reduces the intracellular nourishment in every system. Brain and neurons are also affected due to its ruksha(dry) property. This Vaat dosha also reduces the satwa (tolerance with emotions) resulting in behavioural problems and inability to take conscious decisions in old age. Dementia and insomnia are some of the symptoms due to the increased Vaat dosha.

While treating these manas (psychological) conditions Ayurveda concentrates on Vaat dosha and its shaman (pacification).

To pacify this Vaat dosha the opposite property having medicines, food and therapies are used.

• The Abhyang ( Body massage) with Vaat pacifying oils prepared using herbs and aroma oils is very much helpful to combat the insomnia , fatigue and general debility in depression
• It also improves the sensory and motor functions and relieves the stress .

• Shirodhara is the choice of therapy in all psychological ailments . It pacifies the Vaat dosha and works on the nervous system . Shirodhara increases the cognitive acts.
• Nasya (nasal drops of herbal preparation)
• Regular Head massage and foot massage pacifies the vaat dosha and relives some of the symptoms.
• Basti therapy,Basti have very encouraging results on overall health in geriatric patients as it works on Vaat dosha and initiates the smooth functions of major systems.

Ayurveda diet for depression

            Importance of food need not to be explained. Let the food be thy medicine and the medicine be thy food . What we eat affects our mind. Food can make us feel good, agitated, dull or energetic. Choosing of what one eats is important.

The Satvik (mild simple fresh), the food that doesn’t increase the vaat or pitta dosha is advisable in old age and depression patients

Leftover, dry, ready to make, added with preservatives and other artificial flavours are generally not recommended.

Regular intake of Cow ghee, cow milk with dry ginger powder, yellow and green mug daal , seasonal fresh fruits and vegetables are recommended . The food that may cause indigestion and heavy to digest should be avoided or consumed in small quantity.

Ayurveda physician decides the prakriti (individual body type) and prescribes the food and dos don’ts about the food.

Lifestyle

• Being social and involving in social activities can engage the mind and channel the positivity in self
• Self help groups and related activities
• Yoga, physical exercise and meditation is very important .
• Nurturing the hobbies deliberately should be looked for
• Various therapies like music , art can be considered as well.

Individual prakriti, panchkarma, food according to dosha and herbal medicines are powerful tools of Ayurveda while dealing with depression and other health conditions.Little awareness and to shed the hesitation about the various psychological insufficiencies and impaired state is the need of the time. These simple things adapted can be helpful in dealing the emotional roller coaster ride by the old grown child.Proper help from proper source in time can make the journey of life better.

Discussions, queries and experiences on this topic are welcome!!