Preventing or Alleviating
isolation-Induced Depression

It is important to remember that isolation on its own does not equate to isolation-induced depression. A person might choose to be isolated for some reason. The isolation may also be short-term. In addition, some people respond more positively to isolation than others.

If a person is experiencing isolation-induced depression, there are several ways it can be addressed.

Seek Social Opportunities

The obvious solution to isolation-induced depression is to reduce or eliminate the isolation. Naturally, this can be easier said than done. There are a variety of reasons a person becomes isolated, but they are not usually by choice. Remember that this is caused by unwanted or undesired isolation. That means finding ways to provide social interaction may take effort and creativity.

First, identify why the person is isolated. It could be living in an area where there aren’t other people or that requires transportation to get to social gatherings. It could be that the person has mobility or medical issues that interfere with interactions. It might be the person’s reluctance to engage , for whatever reason. In order to reduce isolation, opportunities for social participation must be found.

Interactions should be relevant and interesting. They should be physically and emotionally within the person’s capacity. It is helpful if activities are scheduled at regular intervals. If they involve going somewhere else, reliable transportation that the person trusts should be arranged. If it involves someone coming to the person’s home, care should be taken that both the home and the person are prepared in a way that the person is comfortable. In fact, all of these tips rely on ensuring the experiences are comfortable for the individual involved.

The key is to pursue managed social interactions. This is especially true if the person has been isolated for an extended period of time. Presenting too many interactions or those that the person is not capable of handling could be physically and mentally overwhelming.

The easiest place to start may be right next door. If the person lives in a house or apartment, engage with a neighbor. This person doesn’t need to become a best friend, but someone to speak with on a regular basis. A brief conversation two or three times a week may be enough. The neighbor can also provide a welfare check, simply making sure the person is OK. This could be accomplished with a phone call but remember every once in a while, a face-to-face visit is helpful.

The act of seeing someone’s face has a positive effect on the human psyche. In addition, an in-person visit provides an opportunity to ensure the elder isn’t having personal care issues, and that they and their living environment are safe and clean. While video calls allow us to see each other, we cannot assess their environment beyond the field of view of the device, so it is limited in that capacity. Finally, remember that these interactions with the elder can be shared by more than one person.

If a person lives in an independent living facility, check the social calendar or talk with an activity coordinator. Choose one or two activities to get involved in. Some sort of one-on-one communication is what is required. Attending group functions is OK, but it is important to ensure someone specific will spend time with the person so they don’t feel isolated in the group, which can easily occur when joining established groups.

Another way to connect, especially those who are not close geographically, is to use the phone to make a regular call. Yes, the good old-fashioned telephone still works. Nowadays, we can also use technology like video chat to actually see the person. This is perhaps the most important advancement in connecting with people in decades. This can be accomplished with most smartphones as well as tablets or computers. There are several services, and many are free. Don’t forget, the traditional ways work as well. There is nothing that brightens a person’s day than receiving a card or letter from someone in the mail.

Senior centers and churches often sponsor activities and events. Some also provide transportation. Check these community resources and see if there are any interesting opportunities in the community. In addition to social interaction, these activities also get the person out of their house and into the community.

Finally, it might be some combination of these that work best. For example, if there is a group that sounds interesting, but due to geographic location or physical mobility limitations it would be difficult to attend, ask about joining via a phone or video call. This does not require any special preparation or equipment. If a person can simply call you once the meeting begins on the facility or their own cell phone, you can listen in and even speak up once in a while

Make it a goal to identify one or two groups or people you enjoy interacting with each week. AgingInPlace.org recommends, “Place these items on your calendar and commit to them the same way you’d commit to keeping a doctor’s appointment. This helps reinforce in your mind that these actions are also a priority when it comes to total health and wellness.”

While scheduling social interactions may seem foreign, the onset of isolation-induced depression means that, for whatever reason, those interactions have not been occurring, so scheduling helps remind us of its importance.

Engage Your Brain

Isolation is a physical situation. Loneliness is a mental state. A powerful way to reduce loneliness when we can’t resolve the physical isolation is to divert our brain. The best way to do this depends on us. What is interesting? What is enjoyable? What tasks have been on the to-do list but never get done? The possibilities are endless. The key is to find something to do that engages our brain. Consider things like:

Reading or listening to books (favorite or interesting genre or author)
Gardening (indoor, outdoor, containers, even using silk or ”fake” plants that are seasonal)
Cooking (make something you used to like but haven’t made in a while, modify old recipes, watch cooking shows and try their recipes, make or bake something as a gift)
Crafting (sewing, needlework, knitting, scrapbooking, woodwork, painting)
Photography (around the house, neighborhood, parks, organizing them and creating scrapbooks, maybe even giving them as gifts)
Doing crosswords or puzzles
Playing games with family, friends or others via online games like Words with Friends or Trivia Crack

Read the Digital and Trend-Forward Games for Seniors article (PDF)

Brush up on a second language you know or learn some conversational words in a new language. Many free resources are available online.
Pick a project that has needed to be done but just hasn’t been completed. Break it down into manageable steps or phases, set a goal for completing each step.

It does not matter if these activities are new or those we have been interested in at some time in the past. Now is the time to find the things we like, and if we don’t like them, that’s OK too. Actively engaging our brain daily helps pass the time and minimize awareness of isolation.

Move your muscles

The good news is, sometimes we can get a two-for-one. Actually, we might even be able to get a THREE-for-one If we engage our brain in ways that are also physically active, and if we do them with at least one other person. We can use three tools at once to fight depression.

It is common for physical issues or medical conditions to make physical movement more challenging. Movement is important but we must be sure we attempt it in a safe way. The act of standing, for example, takes a lot of muscle strength, balance, and energy. We can work with a physical therapist to identify appropriate and safe activities or exercises if we have physical or medical conditions.

When we discuss physical movement related to depression, it goes beyond the normal strength and aerobic benefits commonly discussed. Physical activity stretches and utilizes muscles. It loosens joints. It energizes nerves. It improves connections in the brain related to balance and movement. It releases substances in our brain and body that make us feel better.

Many are surprised that it does not take a lot of physical movement to diminish depression. Research published through the US National Library of medicine found that 20-minutes, three times per week is enough to make us feel better. This should be taken into consideration when thinking about activities and social interaction opportunities .

Like all of our activities, we should find something we enjoy. Not every exercise is for every person. We also need to be mindful of our physical capabilities, especially balance. Many people find low-impact activities like walking, exercise classes (at a senior center, living facility, church, YMCA or gym), swimming, water classes, yoga, Silver Sneakers® classes, or golf to be activities that can be enjoyed and undertaken at a safe, comfortable level.

“Success is the sum of small efforts, repeated day in and day out.” -Robert Colli

Being active has always been most effective when we integrate it into our daily routine. For those experiencing isolation-induced depression, it should be considered as part of our overall plan. If our physical activity is also a social activity that uses our brain, and is just part of our regular schedule, all of it becomes a matter of habit rather than effort. Any one of these is beneficial but all three together is a powerful tool in the fight against depression.

NOTE: Check with your healthcare provider before beginning or changing exercise.

Nourish your body

Another thing that elders are used to hearing is that they need to eat right. Like physical movement, good nutrition is important for those experiencing depression.

The foods we eat can have a significant impact on our mental health. The , Harvard Medical School shared that “diet is such an important component of mental health that it has inspired an entire field of medicine called nutritional psychiatry.”

There are some foods that have been specifically linked with depression. They include many of the foods we would probably guess high-sugar snacks and desserts, high-fat dairy, potatoes, processed grains, red meat, and processed meats (like lunch meats, salami, and sausages).

So, what should we eat for our mental health? Harvard notes that a depression-lowering diet would involve eating more:

Fish
Fruits
Vegetables
Seeds
Nuts
Whole grains (unprocessed is best)
Low-fat dairy
Olive oil

We usually start getting defensive when dietary recommendations are provided. What is important is to look at both of these lists. If we are eating a lot of the foods associated with depression, reduce the frequency and/or quantity of those. Many of the foods in the first list are what we consider “comfort foods”. In reality, they may be detrimental to our mental health after the initial satisfaction is gone.

Being mindful of what we eat and how it may be affecting our mental health is the first step. Making small changes to improve our choices happens after that. Make small dietary changes for success.

Reinforce your esteem

Most of us were probably taught early on that when we go outside our homes, we should be appropriately dressed, and our personal hygiene attended to. When a person lives alone, recognizing the need often diminishes over time. There may be physical and medical reasons a person may not be able to fully address all of their hygiene needs every day. It is also OK to stay in our pajamas once in a while.

Depression is often indicated by a lack of personal care, however. On its own, it may interfere with positive socialization. In severe cases it becomes self-neglect. The first step is to regularly bathe and wear clean clothes . In addition, when we are clean and dressed, we are more likely to feel like going out, or having others come into our home. As we know, this is a critical part of reducing isolation-induced depression. When we feel physically better about ourselves, it raises our self-esteem. Depression has a hard time when it comes up against self-esteem.

Some simple tips to make sure we can feel our best based on our hygiene include:

Utilize home health or personal care services
Utilize a Homemaker program to provide laundry service
Able to reach clean clothes including undergarments, tops, bottoms, socks and shoes
Make sure there is a safe way to attend to personal hygiene when alone(bathing, toileting, washing hair, doing laundry, and accessing clothes)
If mobility is an issue, put together a small hygiene kit, using a large zip-top bag, zippered cosmetic or travel bag, shoebox with a lid etc., and keep within easy reach
Depending on personal preferences, a kit might include:
- Facial cleansing cloths
- Moisturizer
- Sunscreen
- Lipstick or Chapstick
- Fingernail clippers
- Fingernail file/Emory board
- Comb or brush
- Razor and shaving gel (for men)
- Deodorant
- Toothbrush and toothpaste or disposable tooth cleaner
- Cosmetics, if used
- Eyeglass cleaner , for those who were glasses

For many seniors, the act of fully bathing can be physically exhausting, and time consuming. The effects of depression can make bathing more hazardous. We must make sure we are safe performing these activities, then set a schedule so we remain clean and dressed, feeling better about ourselves on a regular basis. That in itself can make us feel much better!

Body, Mind…Don’t Forget the Soul

It is critical to take care of the physical aspects of our well-being, but we can’t neglect the unseen part of every person that is important to good health. When we refer to our soul, our spirit or our faith, it is not intended to align with any particular belief. We are referring to the psychological attributes and needs of an individual.

Addressing these needs is a very personal process. Methods to do so will require input from the person involved. Some ideas might include:

Asking a person who shares their beliefs to make a home visit
Arranging for the elder to be able to go to a place where their beliefs are practiced
Providing reading, audio or video materials
Identifying if any activities or event from their chosen beliefs are available via internet streaming.

Having physically and mentally engaging things to do is important. Ensuring our bodies are nutritionally satisfied is also required for physical and mental health. Another aspect we can’t neglect is our spiritual health. This involves both our value as an individual and our faith, in whatever form that faith may take.

Fortify your value

We have addressed a variety of physical and emotional needs. They are critical elements of our overall well-being. The final part involves our sense of value. A common way this relationship has been represented over the decades is through Maslow’s Hierarchy of Needs, which identifies Esteem as the ultimate level of a person’s health.

Self-esteem and value are closely related. Self-esteem is how we feel about ourselves. Value is how we see ourselves in relation to others. We can feel valued as a parent. We can feel valued as an employee. We can feel valued as a spouse or partner. When we age, we often are removed from the activities and situations that made us feel valued. Our kids grow up. We retire from our jobs. The death of a spouse eliminates a significant part of our life where we did things for another.

When we are isolated, our ability to do for others may be extremely limited. Significant research has identified that being “needed” or providing something of value to others is important. Studies have identified numerous health benefits including feeling happier and having higher self-esteem. The Journal of Epidemiology research has found that having a hobby and a “purpose in life” can extend life expectancy in older adults. This is why volunteering is so important. It allows us to tamp down depression, feel valued and allow us to reach that highest level of human need, self-actualization.

In large cities and small towns, there are always volunteer opportunities. Schools are a good place to start. Assisting in almost any way brings us in contact with other adults as well as children. Even the sounds of children usually have a positive effect on us .

Libraries are also a good choice. Whether shelving books, organizing periodicals, directing patrons or reading to children, the options are usually numerous.

Local museums, historical societies, cultural centers, and visitor centers often utilize volunteers. These options allow us to share information we know from living in our communities. They provide social interaction, require little physical ability, and allow us to use our brain to recall information, solve problems by answering questions, and are an invaluable service.

If we have a hospital or clinic nearby, look for a volunteer program there. Most hospitals have one in place, but even clinics or outpatient centers may have need of someone. Delivering flowers and cards, helping patients fill out menus, helping the nursing staff organize waiting rooms and answering phones and providing visitor information all help medical and professional staff focus on their work. In return, we get to feel good about helping.

If we enjoy being outdoors, see if our parks department uses volunteers as park ambassadors, walking through the park to answer visitor questions and noting any maintenance issues that should be taken care of is a valuable service. We may also be able to help with planting or light cleanup in the park. Botanical gardens, and zoos can also provide these types of opportunities.

We can also keep it simple. If we are in need of someone to help alleviate isolation, there may be someone else close by who needs the same assistance. Checking on each other by phone, getting together a couple times a week to talk, play a game or work on a craft are all mutually beneficial. In fact, just taking a walk together is fantastic! While we don’t think of this as volunteering, it provides the same sense of value to someone else we are looking for.

If we have a senior center in our community, we can volunteer to help with check-in for activities or congregate meals, directing people to where they need to go, welcome and orient those presenting classes or lectures and various other activities. This also allows us to meet others of our own age.

If we are familiar with our community, we probably already know some of these places. Give them a call and ask how you can become involved. We can also ask family or neighbors if they know of any local needs. Sometimes we don’t know where to look or who to ask. Technology offers a simple way to find them.

There are numerous sites where we can look for volunteer opportunities. If there is something in our area, that’s great! A few clicks and we can find out the information we need. There are also a lot of listings for things we can do from our home. Some of it involves writing or making phone calls, but if we find an organization that strikes us as interesting, the connection can be easy to make.

There are many resources. Some are national but there may be others specific to your location. For example, RSVP has a Senior Corp program that is specifically designed for volunteers over the age of 55. Depending on where you’re located, you could be connected with volunteer opportunities such as teaching English to immigrants or tutoring and mentoring disadvantaged or disabled youth. If we have business experience, we can try SCORE which is the Service Corps of Retired Executives. They provide free business mentoring to small businesses. There really is something for everyone in all communities.

By this time in our lives, we all have knowledge, skills, experiences and interests we can share with others. In doing so, we make connections, become more active, use our brain, elevate our value which makes it difficult to remain socially isolated and depressed. Through these actions we can reach our own pinnacle of health and satisfaction.

Seek professional guidance

Fact is, sometimes we need a professional. We may be a good cook, but that doesn’t mean we can cater a formal meal for 20 people. We may be a talented woodworker, but that doesn’t mean we can frame our new house. We may attempt all of the self-help suggestions provided so far, but they may not be enough. Sometimes we just need the assistance of a professional. It is interesting the we are willing to consult with our doctor if we break our leg. We should not be hesitant or embarrassed to seek professional assistance for depression either. Depression is no more a personal statement about us than thinking that way because we need our appendix removed.

If these tools don’t relieve our depression, if the depression is severe, and especially if we experience hallucinations or suicidal thoughts, it is time to call a professional.

Traditional therapy works. Cognitive behavioral therapy (CBT) can be very beneficial in older adults. The objective is to help us change negative thinking patterns that can make us feel worse about ourselves. Regardless of the treatment approach, it is important to work with a therapist with whom we feel comfortable. There are several ways to find a therapist including:

Asking someone we know for a referral
Their positive experience can hopefully help ensure ours as well
Use our insurance company’s website provider listing to find a local therapist
Make a call to our insurance company and see which counselors they recommend. This also helps us check on plan details, and ensures the counselor we choose is included in our plan coverage,
The internet is also a valuable resource to consider, because we can perform an online search for therapists via reputable sites like Psychology Today. Just pick our state, narrow by city or county, and we’ll be provided with a list of options. We can also check out review sites like Yelp or do a Google search and see what others have to say about therapists in our area. Read through a few of them and look for patterns to get a basic idea of what we can expect if we choose a particular mental health practitioner. Reading biographies or resumes can also give us insight into their personality, treatment philosophy, other interests, philanthropy and more.

Many times, seniors aren’t being treated for our depression because we choose to keep it to ourselves. This can be out of fear of what our family and friends will think of us. It is also common that we don’t recognize depression in ourselves or have the tools to remedy it on our own.

When depression occurs, lack of treatment can exacerbate the condition. This is why it is so important for us to intervene when we recognize the signs and effects of depression. It is also why it is so difficult with isolation-induced depression because there is often little or no contact with others who can intervened on our behalf.

One final professional option may be appropriate under certain circumstances. That is to provide a caregiver. They can attend to hygiene, nutritional and exercise needs. They provide social interaction when they are on the premises. They are able to monitor daily activities and health status. They have knowledge to determine whether mental and/or physical health is on the decline and can quickly intervene and seek additional assistance if necessary.

Disclaimer: Information is for general education purposes only. It is not intended to provide medical or therapeutic advice. It is provided as a courtesy only. No content on the ICOA website, social media platforms, e-mail communications or links therein should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician

Preventing or Alleviating isolation-Induced Depression