How Do Antidepressants Relieve Depression In Older People
Studies have found that while antidepressants can be helpful in older adults, they may not always be as effective as in younger patients. Also, the risk of side effects or potential reactions with other medicines must be carefully considered. For example, certain older antidepressants such as amitriptyline and imipramine can be sedating, may cause confusion, or might cause a sudden drop in blood pressure when a person stands up. That can lead to falls and fractures.
Medications you might get include:
- Monamine oxidase inhibitors , like isocarboxazid , phenelzine , selegiline , and tranylcypromine
Antidepressants may take longer to start working in older people than they do in younger people. Since older people are more sensitive to medicines, doctors may prescribe lower doses at first. In general, the length of treatment for depression in older adults is longer than it is in younger patients.
How Is Depression Affecting The Elderly
Depressive disorders involve sadness, loss of interest or pleasure, feelings of tiredness, disturbed sleep or appetite, feelings of guilt or low self- worth, and poor concentration. Depression impairs the ability of an individual to function at work or school and cope with daily life.
In 2015, 4.4% of the global population is estimated to live with depression. Depression is more common among females than men .
In terms of age groups, prevalence peaks in older adulthood .
This strikingly number has encouraged us to focus on depression in the elderly, as it is often overlooked and untreated.There are various factors that can lead to depression as a consequence of life changes that come with ageing.
“One thing that is vital to understand when dealing with depression in older adults is that they are often having to deal with loss”, says Louise Morse, cognitive behavioural therapist at Pilgrims’ Friend Society. “Loss of physical and mental agility, perhaps, but always loss of family members, both older ones and younger ones . The combination of losses can be overwhelming. They lose people who help reflect back to them their identity: people they can bounce things off and trust, people with whom they have shared memories”.
There are signs, behaviours, and actions that should not be taken for granted or belittled as normal aspects of aging. Signs to look out for include:
Depression is treatable, with talking therapies or antidepressant medication or a combination of these.
How Is Depression In Older People Treated
Your doctor can help build a mental health treatment plan with you. This may include a variety of different treatment strategies and tools. Older age does not make treatments for depression less effective.
Your doctor may recommend physical treatments for depression. Some antidepressant medicines that work for older people can be very effective, especially for people with severe depression.
Electroconvulsive therapy is only used to treat some types of severe depression if medicines have not helped or if your symptoms are severe.
Psychotherapy, such as cognitive behavioural therapy , is popular, proven and an effective intervention for depression. If you have hearing difficulties, are vison-impaired or have other needs, let your therapist know so they can adapt your treatment treatment.
Self-help, alternative and complementary therapies can also be useful for older people with mild or moderate depression, such as:
- spending time with friends, family or the community.
- being physically active, either alone or with a group.
- participating in music therapy designed for people with depression
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Recognising Depression In Older People
Depression among older people can be easily missed. Older people may find it difficult to recognise or talk about feeling sad or depressed and may not reach out for help. Symptoms of depression that would cause concern in a younger person, such as insomnia or social withdrawal, may be disregarded in older people as just getting older.
Depression can affect memory and concentration, particularly in elderly people. People sometimes assume that problems with memory or concentration are due to age-related changes in thinking, rather than being due to depression. It is therefore important to think proactively about the possibility of depression and assess whether it may be present.
Lara Krawchuk Msw Lcsw Mph
Lara is the Founder and Clinical Director of Clinical Services at Healing Concepts, LLC.
As a psychotherapist specializing in supporting families facing illness, trauma, and grief, I am frequently asked for advice around supporting depressed seniors
The era of COVID-19 has significant impacts on vulnerable seniors. They are isolated and afraid with no clear end in sight. Some have lost friends to the virus or other illnesses, while others may be dealing with health problems and fear going to the doctor’s office. Much has been taken away from them. Loss and grief are all over the news, which can be overwhelming.
The first thing to consider when supporting a depressed senior is whether or not they have a history of depression or are reacting to the world they now live in. If they have a history of depression, it is advisable to encourage the struggling senior to reach out to any prior helping
relationships. A medication adjustment and a safe place to process worries and sorrows triggered by COVID-19 can be very helpful.
If this depression is new since the pandemic crisis emerged, it might actually be grief. This situation is littered with losses. Living losses include restricted freedom, decimated social connections, absent leisure activities, loss of control, financial distress, and lost hopes and dreams for the retirement years.
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Risk Of Elderly Suicide
According to the Geriatric Mental Health Foundation, seniors represent the age group with the highest risk of suicide. Over 25 percent of America’s suicides occur in people over the age of 65. Even though depression is more common among older women, many more older men die of suicide. In particular, white males over the age of 80 have the highest risk of dying by suicide. They are about six times more likely to kill themselves than people in the general population.
That’s why it is essential to communicate with depressed seniors and listen for clues of suicidal thinking. Ask them how they feel about life. Find out if they ever think that life isn’t worth living or if they ever plan or imagine harming themselves. If their answers are affirmative, make sure you find help for them right away, such as from doctors or mental health counselors.
If you feel that you or someone you love is in imminent danger of suicide, call 911 or go to a nearby emergency room. You can also call the toll-free National Suicide Prevention Lifeline at any time of day: Call .
Learn The Signs And Find Treatment
Do you feel very tired, helpless, and hopeless?
Have you lost interest in many of the activities and interests you previously enjoyed?
Are you having trouble working, sleeping, eating, and functioning?
Have you felt this way day after day?
If you answered yes, you may be experiencing depression.
As you get older, you may go through a lot of changesdeath of loved ones, retirement, stressful life events, or medical problems. Its normal to feel uneasy, stressed, or sad about these changes. But after adjusting, many older adults feel well again.
Depression is different. It is a medical condition that interferes with daily life and normal functioning. It is not a normal part of aging, a sign of weakness, or a character flaw. Many older adults with depression need treatment to feel better.
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Signs And Symptoms Of Depression In Seniors
Depression in seniors may be easily missed and go untreated for many reasons. Other medical conditions or medication side effects may mimic symptoms of depression in elderly adults. Seniors may also be less willing to talk about their feelings to avoid the mental health stigma, or they may prioritize discussing depression symptoms that manifest as physical problems such as chronic pain or insomnia during a doctors visit.
In some cases, symptoms of depression in seniors may be different from typical depression symptoms in younger adults. While most people who are depressed experience sadness and anxiety for at least several weeks, other common signs and symptoms of depression in elderly adults may include:
- Apathy and fatigue
- Sleep problems, such as insomnia or sleeping excessively
- Anger, irritability, and sudden mood changes
- Loss of interest in hobbies and activities they used to enjoy
- Confusion and difficulty with attention and concentration
- Changes in eating patterns, such as decreased appetite or overeating
- Aches and pains that dont get better with treatment
- Thoughts of death or suicide
Its natural to experience grief in the face of major life changes. But if your aging parent has symptoms of depression for several weeks or months, a visit to the doctor is warranted.
Symptoms Of Depression In Older People
Depression affects how people think, feel and act. They may lose interest in the things they normally enjoy. They may lack energy, have difficulty sleeping or sleep more than usual. Some people feel irritable and some find it hard to concentrate. Depression makes life more difficult to manage from day to day.
An older person may be depressed if, for more than two weeks, they have:
- felt sad, down or miserable most of the time, or
- lost interest or pleasure in most of their usual activities, and
- experienced several of the signs and symptoms across at least three of the categories below.
Feelings may include:
- moodiness or irritability, which may present as anger or aggression
- sadness, hopelessness or emptiness
- loss or change of appetite
- significant weight loss .
Its important to note that everyone experiences some of these symptoms from time to time and it may not necessarily mean that the person is depressed. Equally, not every person who is experiencing depression will have all of these symptoms.
Additionally, older people may use different language to refer to their depression. Instead of describing sadness, for example, they may talk about their nerves.
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What Is Depression In Older People
Depression is a mental health condition that can affect people of all ages. While it is normal to feel down sometimes, if you feel this way for 2 weeks or more, or your mood is affecting your ability to cope with everyday life, you may be experiencing depression.
Sometimes older people can think that symptoms of depression occur because of their age, poor health or dementia. Some older people prefer not to talk about depression, feel a sense of shame, or dont like to admit that theyre not coping. Sadly, this can lead to their not seeking help, or delaying assessment and treatment for a long time.
People who develop depression when they are over 60 often have other medical conditions. It is unusual for someone in good health to develop depression for the first time when they are over 60 but this can happen for some people.
This page is about depression in older people however, many aspects and risk factors are not age-specific. Go here for more general information about depression.
When Should I Seek Help
If you or someone close to you shows signs of depression for 2 weeks or more, or you are concerned that you may have depression, you should speak to your doctor. They will assess you for depression and build a mental health treatment plan together with you. This is a plan that maps out your treatment goals and includes the services and resources available to you.
If your doctor thinks that other health professionals should be involved such as a psychologist or psychiatrist who specialises in treating older people they will be able to refer you to someone who can help.
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Why Is Depression A Concern In Older Adults
In older adults, untreated depression can last for years. It can lead to or make worse other problems in physical and mental health and in relationships with others. It also makes suicide more likely.
Treatment can help depression and help you enjoy your life more. It also makes suicide less likely and may help older adults deal better with long-term health problems.
Prevalence Of Depression Among Older Adults
According to the Centers for Disease Control and Prevention , depression affects about 1%-5% of the general elderly population, 13.5% in elderly who require home healthcare, and 11.5% in older hospital patients.1
Older adults are at risk of misdiagnosis and lack of treatment because some of their symptoms can mimic normal age-related issues. Symptoms can also be mistakenly attributed to other illnesses, medications, or life changes.2
Elderly patients might also be reluctant to talk about their feelings or fail to understand that physical symptoms can be a sign of depression. For elderly people living independently, isolation can make it difficult to reach out for help.
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Depression In Elderly Adults: Signs Symptoms And Treatment
Depression isnt a normal part of aging. This serious but treatable medical condition can affect how older adults think, feel, and live. Depression impairs cognitive and physical abilities in seniors, reduces quality of life, and affects overall health.
Depression in elderly adults isnt widespread, but seniors who have other medical conditions are more likely to have it. In fact, depression affects up to 12% of seniors who are hospitalized and up to 14% of seniors who receive home health care, according to the Centers for Disease Control and Prevention. However, studies show that depression in seniors often goes unnoticed and untreated.
Although occasional feelings of sadness are normal, if you suspect your aging loved one is depressed, its important to get help. There are many effective treatment options that can help elderly adults with depression.
Depression In Older Adults
- Guides & Publications
- Depression in Older Adults
If you have a sad, despairing mood that lasts for more than two weeks, it may be depression. Depression is not the same as sadness, though it can be triggered by the sadness caused by loss , stress or major life change . Depression can also be caused by some medical conditions, such as chronic pain, thyroid problems, stroke or Alzheimers disease. Certain medications and alcohol use can cause depression as well. Depression may also develop for no apparent reason.
People who are depressed cannot just get over it. Depression is a biological illness caused by a chemical imbalance in the brain. It affects thoughts, feelings, behaviour and physical health. Older adults who are depressed may have had episodes of depression throughout their lives, or they may have their first episode late in life. Depression can affect anyone at any age, but is often not recognized in older adults. This is because some signs of depression can be mistaken for signs of aging, and also because older adults who are depressed may not complain about feeling low. When left untreated, depression may continue for weeks, months or even years. Untreated depression is the main cause of suicide in older adults.
What are the signs of depression?
What can I do about depression?
Where can I get help or get more information?
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What Stops Some Depressed Seniors From Getting Help
In the 65 and older age bracket, only 38% of adults believe that depression is a medical problem, and only 42% say they would seek help from a medical professional, according to Mental Health America.
There are some myths that may inhibit older adults and their care providers from seeking help for depression. They include:
- Prolonged sadness is inevitable because aging is hard.
- Symptoms must be due to some other health problem, like dementia.
- I should be able to snap out of it.
Cultural background can also be a driving force in whether older adults will seek help for mental health issues.
Mental Health America suggests Black Americans may not report symptoms if they view mental illness as weakness and treatment as a luxury.
Meanwhile, the suicide rate among white men 85 years old and older is the highest of any other demographic nearly four times larger than that of the broader population. Some think this might be because older white males believe that reaching out for help is a sign of weakness.
Older adults who are religious may see depression as a lack of faith. This can prevent them from seeking mental health help for symptoms of depression.
Depression is not connected to a lack of willpower. Life situations, medical conditions, and medications can all contribute to depression in older adults.
Talking To Your Doctor
If you think you have depression, the first step is to talk to your doctor or health care provider. Your doctor will review your medical history and do a physical exam to rule out other conditions that may be causing or contributing to your depression symptoms. He or she may also ask you a series of questions about how youre feeling. It is important to be open and honest about your symptoms, even if you feel embarrassed or shy.
If other factors can be ruled out, the doctor may refer you to a mental health professional, such as a psychologist, counselor, social worker, or psychiatrist. Some providers are specially trained to treat depression and other emotional problems in older adults.
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The Family As Caregivers
The family of a person with mental illness must often weather problem situations and events that can be somewhat dramatic. The family needs to be directed and supported. This information will assist you in coping with mental illness and helping your ill relative, while maintaining as much normalcy as you can within your family.As part of the shift toward a more balanced healthcare system, there is growing recognition of the role of families as primary caregivers or partners in care in both the hospital and the community. This is a welcome change of attitude. Families are generally deeply involved with their ill relative, but their insights and particular needs have often been overlooked. At one time professionals tended to blame the family for the persons becoming ill. Today more and more professionals realize the importance of building a healthy link with family caregivers.
Relatives have the right to ask questions. It is important to build a partnership with at least one professional member of the team in order to have these questions answered. Learn all you can about the illness. The patient may refuse to allow professionals to disclose information due to his state of mind. Nevertheless the family may request general information on the illness. It may be helpful to ask the following questions:
Click HERE for more information on living with an individual suffering from a mental illness and advice on how you can help them.