Many people, when thinking about major and minor depression, have a mental image of younger adults or teens. However, aging itself is a major life change, and seniors may be subject to depression as they lose friends, family, and certain levels of independence. Like other forms of major depression, geriatric depression can be damaging to daily life, health, and relationships, and even dangerous in extreme cases. In this article we'll take a closer look at how depression manifests in geriatric patients, its connections to physical illness, and how it can be treated.
Geriatric depression, also known as late-life depression, is a mental and emotional disorder affecting older adults, distinct from normal sadness or “blue” moods. It is a condition impacting older adults, characterized by mood changes, lack of pleasure, and somatic symptoms.
It is important to note that geriatric depression is not a normal part of aging and can be treated with proper diagnosis and treatment.
Depressive symptoms in older adults can be subtle and different than those in younger people. These symptoms may include somatic complaints, sleep disturbances, and cognitive decline. Some signs to look for include:
Major depression in older adults can cause significant distress and impairment in daily life, while minor depression is also common in older adults and can increase the risk of developing major depression. Depressive symptoms can be masked by coexisting medical conditions, making diagnosis challenging.
While depressed mood can be common across all forms of depression in older adults, all depression disorders are not the same. The following are different types of depressive disorders that can be found in the elderly.
Major depression is a severe form of depression that can occur in older adults, characterized by depressed mood, loss of interest, and changes in appetite and sleep.
Minor depression is a less severe form of depression that can still cause significant distress and impairment.
Psychotic depression is a type of depression that involves psychotic symptoms, such as hallucinations and delusions.
Late-onset depression is a type of severe depression that occurs in older adults with no previous history of depression.
As with most mental health conditions, researchers have not found a single cause for geriatric depression; rather, it's the result of a combination of potential risk factors. Risk factors for geriatric depression include a family history of mental disorders, chronic illness, substance abuse, a personal history of mental illness, and cognitive impairment.
Medical conditions, such as cardiovascular disease and chronic diseases, can increase the risk of developing depressive disorders in elderly patients.
Personality traits may also play a role in late-life depression. Individuals with anxious-avoidant and dependent personality traits have an increased risk of developing depression.
For older adults, social isolation and lack of social support can contribute to the development of depression. A change in living situation, loss of friends and family, or leaving employment can trigger a major depressive episode and cause a senior to further withdraw from social contacts, creating a negative cycle.
The Diagnostic and Statistical Manual (DSM-5) provides criteria for diagnosing depression in older adults. Mental health professionals use tools like the geriatric depression screening scale for assessing depressive symptoms in older adults. The Geriatric depression scale uses a series of questions that
A comprehensive diagnostic evaluation should include a physical exam, laboratory tests, and a review of medical history, and is used in addition to the geriatric depression scale to pinpoint symptoms of late-life depression. When diagnosing geriatric depression, cognitive impairment and comorbid medical illnesses should also be considered.
Proper treatment of depression in elderly patients should be individualized and based on the severity of symptoms and medical comorbidities. Psychotherapy, such as cognitive behavior therapy and interpersonal therapy, is an effective, evidence-based treatment for depression in older adults.
Selective serotonin reuptake inhibitors (SSRIs) are commonly used to treat depression in older adults, especially with more severe depression, but can have side effects such as weight gain and sleep disturbance. It can be a safe and effective treatment if drug dosage is overseen by a psychiatrist or other medical professional.
Tricyclic antidepressants and monoamine oxidase inhibitors can also be used to treat mood disorders but may have more side effects and interactions. In cases of psychotic depression, antipsychotic medications are often prescribed as well. For more severe and treatment-resistant depression, electroconvulsive therapy (ECT) may be considered.
Non-pharmacological interventions, such as exercise and social support, can be effective in reducing depressive symptoms. Maintaining a well-balanced diet and regular sleep habits can also help reduce depressive symptoms.
Talk therapy can help older adults develop coping skills and improve mental health, while support groups and counseling can provide emotional support and reduce social isolation.
Managing depression in older adults requires a comprehensive approach that includes medical, psychological, and social interventions. Adequate treatment and follow-up care are essential to prevent relapse and improve outcomes. Drug interactions and side effects should be carefully monitored, and dosage adjustments made as needed, while substance abuse and medical comorbidities should be addressed in the treatment plan.
Geriatric depression can have a significant impact on daily life, including functional decline, social isolation, and decreased quality of life. Older adults with depression may experience difficulty sleeping, changes in appetite, and physical pain.
Depression can lead to an increased risk of suicidal ideation and behavior in elderly patients, and early detection as well as finding the right tools to treat depression can help reduce the impact of depression on daily life.
Late-life depression can co-occur with other mental disorders, such as anxiety disorders and substance abuse. Medical comorbidities, such as cardiovascular disease and chronic diseases, can increase the risk of developing major depression.
In elderly patients, cognitive impairment and dementia can also increase the risk of developing depression, while depression can worsen medical illnesses and increase the risk of mortality. Medical conditions and depression in older adults often go hand in hand, causing a cycle of dysfunction. The good news is that most people who receive adequate treatment will notice an improvement in symptoms and quality of life.
Barriers to diagnosis and treatment include lack of awareness, stigma, and limited access to healthcare services. Healthcare providers may not always recognize depressive symptoms in older adults, leading to delayed diagnosis and treatment. Medical comorbidities and cognitive impairment can also make diagnosis and treatment challenging.
Patient education and awareness are essential for recognizing depressive symptoms and seeking treatment. Older adults and their caregivers should be educated about the signs and symptoms of depression. The importance of seeking medical attention if symptoms persist or worsen should be emphasized. Effective treatment is available and can make a world of difference.
If you notice signs of depression in a loved one, proper treatment can make a difference. A therapist or medical professional can do a comprehensive screening that includes tools like the geriatric depression scale, patient interview, and medical tests to decide what treatment would be most effective. Resources and support services should be provided to help elderly adults manage depression.
If you or someone in your life seems to be experiencing late-life depression, working with a therapist can not only treat the condition itself, but a therapist can also offer coping skills and interventions that may be helpful in managing symptoms in day-to-day life.
At Williamsburg Therapy Group, our team of doctoral-level psychotherapists in North Brooklyn allows you to work with a trained professional that can create a treatment plan and offers a variety of practical strategies, healthy coping skills to improve mental health, and techniques that can help manage symptoms of geriatric depression.
If you have a family history of major depression or you are worried about a loved one's symptoms, reach out to our customer service coordinator to get matched with a mental health care professional who works with late-life depression and can offer tools and strategies to manage symptoms, boost self-esteem, and help them feel an interest in life again.