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Depression in the Elderly

Although depression is very common in the elderly, it shouldn’t be considered a normal part of aging. In fact, 6 million Americans over the age of 65 experience Major Depression, but it is estimated that less than 10% actually get treated. Current initiatives are trying to fix this gap in treatment by increased screenings and education of caregivers at all levels. Read on for more information on this very important topic of depression in the elderly.


Symptoms of Depression in the Elderly

Generally, the symptoms are what you might expect in someone with depression, but there are some differences in the symptoms experienced by the elderly as compared to younger people. Here is a list of what to look for:



· The person experiences a persistently sad mood

· You note that confusion has increased

· Feelings of hopelessness, worthlessness, and/or helplessness are observed or reported.

· The person complains of Irritability, restlessness, or is feeling grumpy.

· You notice that the person no longer wants to do the things that they previously enjoyed doing.

· The person is experiencing low energy or complains of feeling tired more than usual

· Insomnia- please see below for further information on this topic.

· The person seems to be moving slower than usual

· He or she complains of difficulty concentrating and/or decreased attention span.

· Changes in appetite and see, perhaps weight changes as well (this is usually a weight loss without any attempt to lose weight).

· The person is having thoughts that he/she would be better off dead or is experiencing suicidal thoughts

· Complaints of body aches and pains, headaches, cramps, or digestive upset.




Contributing Factors

There are several factors that contribute to and increase the risk of an elderly person developing depression. These include:



1. Elderly people are more apt to develop depression later in life if they experienced it when they were younger.

2. There are several medical conditions associated with depression in the elderly including history of stroke, hypertension, heart attack, Afib, diabetes, cancer, dementia, or chronic pain

3. Certain medications or combinations of medications including high blood pressure medications, corticosteroids, Benzodiazepines, Parkinson’s medications, stimulants, anticonvulsants, GERD medications, and medications to lower cholesterol levels.

4. Social isolation due to deaths of friends, siblings, and spouses. Also the elderly are often forced to relocate due to financial concerns or decreasing independence.

5. Decreased body image as caused by amputation, surgeries for cancer or other physical conditions, history of heart attack, etc)

6. Increasing dependence on others due to declining health and overall debility

7. Substance abuse

8. Fear of death

9. Chronic or severe pain





Treatment

Treatment of Major Depressive Disorder in the elderly usually consists of a combination of medications, counseling, and perhaps electroconvulsive therapy or other treatments. The important thing is to get an accurate diagnosis and treatment from someone knowledgeable in the treatment of the elderly as some medical conditions might mimic the symptoms of depression. An example of this is side effects from medication interactions or even a simple infection such as a UTI (urinary tract infection). Physical problems and illnesses should be ruled out first by the person’s physician.


The medications used to treat Major Depression also tend to act differently with an elderly person. You might have unexpected and potentially harmful side effects. Some side-effects you might notice are sedation, increased confusion, and decreased blood pressure when standing up. These symptoms could cause dizziness and a decrease in balance and could pose a significant fall risk. Falls in the elderly can cause bone fractures and other problems up to and including death and so should be taken very seriously.



Insomnia is also of special concern because although it is a symptom of depression, it can also be a cause of depression in the elderly. This should therefore be taken seriously if complained of and referred to a trusted doctor for treatment.


Generally speaking, a mix of medications and therapy are very effective in the reduction of symptoms and in improving the person’s quality of life, so please do not avoid treatment out of fear of these side effects. Cognitive Behavioral Therapy, life review, reminiscence therapy, or interpersonal therapy which examines the quality of relationships in a person’s life are all effective treatments for depression.


For More Information

If you would like to talk with me about receiving Depression Treatment for you or a loved one, please contact me today. I'd love to hear from you.


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