Depression in Seniors: Causes, Symptoms and Treatments

Depression in seniors can be very difficult for those closest to the patient to spot. Often, the symptoms of depression are attributed to the natural aging process, and may be overlooked. Paul Duberstein PhD., said in a press release that older adults may not experience sadness as readily as younger people because of the stigmas attached to mental health disorders.

In my experiences at various long term care facilities, I have noticed that the depressed geriatric client will withdraw from daily or social activities, appear to be more tired than usual, exhibit a lack of appetite, and have difficulty concentrating. Of those patients diagnosed with depression, many express feelings of loneliness, worthlessness, hopelessness, and emptiness.

Depression often occurs in the elderly with retirement, the death of a spouse, or the death of a friend or family member. A relocation of residence, such as from the clients home to a skilled nursing facility can also bring on depression. The realization of physical limits, mortality, or the diagnosis of a disease, are frequent causes of depression in the geriatric population. In addition, many medications list depression as a typical side effect. Vascular depression, a condition that occurs late in life, due to small strokes, causes damage to parts of the brain that control mood regulation, thyroid disorders, diabetes, Parkinson's disease, strokes, tumors, viral infections an multiple sclerosis, have all been shown to cause symptomatic depression.

According to Donna Cohen, PhD., depression goes untreated in 80% of the elderly population. Elderly suicides account for 18% of all suicides in the United States. Depression, in conjunction with and illness, seriously impairs the clients ability to recover, and can lead to a higher risk of fatality from that illness. Depression reduces the elderly clients ability to heal and doubles the risk of cardiac diseases.

In order to diagnose depression, a physician needs to know about specific symptoms observed by family, friends, and other health care providers. It is very important to report all symptoms that you witness to the doctor, as the patient may be reluctant to discuss his/her feelings.

Anti-depressants are usually the first course of action used to combat depression. Tricyclic antidepressants like Elavil and Endep, are the most widely used form of anti-depressant medication. Monoamine oxidase inhibitors, or MAOI"s such as Marplan, are commonly prescribed for atypical depression. Selective Serotonin Reputake Inhibitors, or SSRI's like Paxil, Prozac, and Zoloft are becoming the most common prescriptions used to treat depression.

Psychotherapy may be a treatment option to examine, if the geriatric patient is able to express his or her feelings. Also known as talk therapy, it can help the client understand the reason for the depression, and identify ways to manage feelings of despair.

Electro convulsive therapy may be indicated if the client is suicidal, psychotically depressed, or the anti-depressants have been ineffectual. ECT is an electrical charge to the brain that causes a brief and controlled seizure. ECT has been associated with short term memory loss, arrhythmia's, and seizure activity, and should only be used in very severe cases of depression.

Some studies suggest that exercise may help to alleviate the symptoms of mild to moderate depression in the elderly. Dan Dwyer states that as we exercise, our bodies build up a resistance to serotonin, so the body is not as easily tired.

Trans-cranial Magnetic Stimulation is a form of therapy in which the electrical environment of the brain is altered by placing an electromagnet on the scalp to stimulate the cerebral cortex , thereby making areas of the brain more or less active, depending on indications from a physician. It has been shown in some studies to alleviate depression completely.

Depression Light Therapy, Meditation, Vitamins, and Vagus Nerve Stimulation are some of the other treatments used for depression. All options should be discussed with the clients physician to determine the safest and most effective course of action. All cases and symptoms of depression vary, as do the treatment options.