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(18.07.2025) Apparently content on the outside - desperate on the inside. Older people often suffer from depression or have suicidal thoughts because they no longer feel needed. Seek help in good time. There is a good chance of recovery.

Shortly after Peter L. retired, his wife died unexpectedly. The 68-year-old, who had never had any mental health problems before, lost his courage to face life and felt worthless and useless. He often lies awake at night and circles around the same thoughts. Increasingly listless, he rarely leaves the house, and his painful osteoarthritis of the knee reminds him that he can no longer do what he used to do - although walks with his wife were a beloved ritual.

Seek help early on

Caught up in his worries, he increasingly resorts to a glass of wine. His children would not understand how he was really feeling, so he now avoids meeting them. Feeling increasingly forgetful, he consults his family doctor. He suspected the onset of dementia and referred L. to the Department of Psychiatry and Psychotherapy at Freiburg University Hospital for further diagnosis and treatment. Here, however, he was not diagnosed with dementia, but with senile depression.

Incipient dementia and age-related depression - often similar symptoms

As depression in old age often shows similar symptoms to incipient dementia, those affected and their relatives should seek professional help at an early stage. "It is difficult for laypeople to differentiate between the two, especially as age-related depression can be a precursor to dementia. For an exact diagnosis, we often need additional examinations such as detailed mental capacity testing, an MRI or nuclear medicine examinations," says senior physician Prof. Dr. Sabine Hellwig, neurologist and psychiatrist with a research focus on dementia and affective disorders in old age at the Department of Psychiatry and Psychotherapy.

Mental illnesses are often associated with shame in older people

Depression is one of the most common mental illnesses in older people. It is not uncommon for it to be associated with biographical triggers such as the death of a partner or the loss of a career, but also with physical illnesses such as a stroke or Parkinson's disease, or with alcohol and medication abuse. Despite their frequency, they are often not recognized or even accepted as inevitable and therefore not treated adequately.

Mental health problems are often very shameful for older people, which is why they are reluctant to seek medical help. "We can help these patients very well with both tolerable medication and psychotherapy and give them back a lot of joy and quality of life," says Dr. Meret Heibel, ward physician on the special ward for geriatric psychiatry. "In addition to other long-established therapy methods such as electroconvulsive therapy, we can now also use newer methods such as magnetic stimulation (rTMS) and ketamine administration to treat geriatric depression," Heibel continues.

Well cared for all round

On the special ward for geriatric psychiatry, an interprofessional team of psychiatrists, neurologists and nursing experts work together with the hospital's social services to care for elderly patients with severe mental illness. There is also close cooperation with all specialist departments at the university hospital so that concomitant physical illnesses can be treated in an uncomplicated and professional manner.

Specialist therapies such as physiotherapy to improve mobility and coordination are an important part of the interdisciplinary treatment of patients. "We offer holistic support to enable our patients to enjoy a high quality of life as they grow older," summarizes Hellwig.

Specialized consultation hours

Since January 2025, the Department of Psychiatry and Psychotherapy at the University Medical Center Freiburg has been offering a geriatric psychiatry consultation. Older patients aged 60 and over who have developed mental illnesses such as depression, anxiety disorders, delusions or memory disorders for the first time in old age can receive a geriatric psychiatry second opinion, clarification of an inpatient treatment order and the coordination of further diagnostic clarifications if required. Appointments are made via the institute's outpatient clinic following referral by a GP or specialist.

Information on the geriatric psychiatry consultation can be found here: www.uniklinik-freiburg.de/psych/ambulanzen/pia

Do you need someone to talk to?

The telephone counseling service can be reached on the free hotline 0800-111 01 11 or 0800-111 02 22

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