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Why is it important to treat depression in elderly people?

First and foremost, proper treatment can prevent suicide. Deteriorating health, a sense of isolation and hopelessness, and difficulty adjusting to new life circumstances can combine to push a person suffering from depression over the edge. For example, when depression is not treated in elderly white males, the suicide rate is six times the national average. Amazingly, 75% of such men were seen by a doctor within several months of their deaths. The National Institute of Mental Health considers depression in people age 65 and older to be a major public health problem. Depression also affects the quality of life for the elderly in other ways:

  • Depression substantially increases the likelihood of death from physical illnesses.
  • Depression can increase impairment from a medical disorder and impede its improvement.
  • Untreated depression can interfere with a patient's ability to follow the necessary treatment regimen or to participate in a rehabilitation program.
  • Healthcare costs of elderly people with significant symptoms of depression are roughly 50% higher than those of non-depressed elders.
  • Depressed elders are more likely to rate their health as fair or poor, to visit an emergency room, and have more doctor visits than non-depressed patients.
  • Depression tends to last longer in the elderly.
  • Treatment of depression can result in more effective treatment and better outcome for the commonly co-occurring anxiety disorders.
  • Treatment of depression can help resolve a substance abuse disorder (including alcohol and prescription drugs) that is the result of self-medication for symptoms.

How is depression in seniors or the elderly treated?

Depression is a treatable psychological problem. Even the most seriously depressed person who feels hopeless and helpless can be treated successfully, often in a matter of weeks, and return to a happier and more fulfilling life. Treatment depends on the cause and severity of the depression. In mild or moderate depression, psychotherapy is often the most appropriate treatment. Incapacitating depression may require medication along with psychotherapy. In combined treatment, medication can relieve physical symptoms quickly, while psychotherapy enables the patient to learn more effective ways of handling his problems. ECT (electro convulsive therapy) is sometimes used to "jump-start" the electrical activity in the brain. Hormone replacement therapy is now under investigation for the treatment of elderly depression.

Some cautionary notes regarding the use of anti-depressant medications in the elderly include:

  • Read package information carefully and ask questions, as there is a risk of side effects or potential reactions with other medicines.
  • Antidepressants can be sedating and can cause a sudden drop in blood pressure when a person stands up, leading to falls and fractures.
  • SSRI drugs can create dependency and may cause self-destructive thoughts, which, in at least 3.5% of cases, have led to suicide.
  • In general, it takes longer to treat depression in the elderly than in younger patients.
  • Antidepressants may take longer to start working in the elderly than they do in a younger population.
  • Since seniors are more sensitive to medications, doctors may prescribe lower doses at first.
  • Seniors may forget to take their medicine.
  • Fear of side effects as well as cost increase the resistance of seniors to taking drugs.

Taking a pill does not cure depression or make problems go away. It is important to get counseling to assist in dealing with the issues themselves.

 

Content provided with permission from Helpguide

For more information or to discuss eldercare concerns please contact Partners Employee Assistance Program at 1-866-724-4EAP.

In case of emergency, please call 911 or your local hospital emergency service.


This content was last modified on: 06/30/2008

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