Depression and the Elderly

Reviewed May 15, 2017

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Summary

When depression is missed, life is less enjoyable.
 

Depression can look different in an older person. The life stresses and health problems of older adults are not the same as for other age groups. For these reasons, family members and caregivers sometimes miss depression in the elderly. When depression is missed, life is less enjoyable. Daily tasks are harder. Being with people is less fun. The chance of sickness or death is greater. 

Depression and increasing age

At any time, about one in every 25 older adults living at home has a major depression. If milder depressions are counted too, then twice as many are depressed. In nursing homes, the number of depressed elders is much higher. More elderly women than elderly men are depressed. Both may become more depressed as they get older.

Some elderly depressed people do not think of themselves as sad or down. The way they act, though, should make you think they could be depressed. Depressed people may spend less time with others and less time on hobbies and interests. They often look more withdrawn and irritable. Older adults who are depressed can worry that others are trying to hurt them. Sometimes they worry that others are stealing from them. Some depressed older adults think more slowly and look forgetful and confused. They might complain more of aches and pains. Their sleep is often worse. They may lose or gain weight. Depression brings a greater risk of suicide, especially in white men in their 80s and older. The rate of suicide in this group is more than five times the usual rate.

Check medical health

Among older adults who are depressed, it is important to check medical health. Medical problems can cause or worsen depression. When medical causes of depression are found and treated, it might improve. Thyroid problems, diabetes, high blood pressure, cancer, and infections are some of the medical causes of depression in older adults. Other older people become depressed because their diet is missing important vitamins or because their sleep is not good. Still others can be depressed because of the stresses that affect many older adults. Losing people you love usually causes grief. Sometimes grief leads into depression. Worrying about money problems or not having a good place to live can worsen depression. Having bad health with low energy or pain, too, can increase worry and depression.

Getting help

When older adults are depressed, they often look for help from a primary care doctor. This can be a good decision if it leads to treatment. Sometimes, though, a primary care doctor offers a medicine when talking would help just as much. Talk therapy helps many depressed older adults. There are special therapy approaches to depression in the elderly. These include cognitive-behavioral therapy, interpersonal therapy, and problem-solving therapy. Finding a therapist who knows one or more of these and other special approaches can be difficult but worth the extra trouble.

Sometimes, it is necessary to use medication. When a depressed older adult is thinking about suicide, out of touch with reality, or unable to remember things normally because of dementia, medications can be very important. Almost every medication used to treat depression works for many older adults too. Age does not mean that a depressed person will not get better. Older adults can have more trouble with side effects of medications. In addition, older adults are often taking other medications already. Sometimes these do not mix well with an antidepressant. Be sure that your doctor knows all the medications you are taking before adding an antidepressant.

The best news about depression in older adults is that it usually gets better with treatment. Talking, medication, care of medical problems, good diet, getting enough exercise and sleep, reducing stress, and spending more time with family and friends are all ways to reduce depression in an older adult.

By James M. Ellison, MD, MPH
Source: Lawrence J, Davidoff DA, Kennedy JS, et al. Diagnosing depression in later life. In Ellison JM, Kyomen HH, Verma S. Mood Disorders in Later Life. Second Edition. Informa Healthcare. Informa Healthcare, 2007. pp 1-14; Gallo J, Rabins P. Depression without sadness: Alternative presentations of depression in late life. Am Fam Physician 1999; 60:820–826; Burkhart KS. Diagnosis of depression in the elderly patient. Lippincotts Prim Care Pract 2000; 4:149–162.
Reviewed by Mario Testani, MD, Physician Advisor, Beacon Health Options

Summary

When depression is missed, life is less enjoyable.
 

Depression can look different in an older person. The life stresses and health problems of older adults are not the same as for other age groups. For these reasons, family members and caregivers sometimes miss depression in the elderly. When depression is missed, life is less enjoyable. Daily tasks are harder. Being with people is less fun. The chance of sickness or death is greater. 

Depression and increasing age

At any time, about one in every 25 older adults living at home has a major depression. If milder depressions are counted too, then twice as many are depressed. In nursing homes, the number of depressed elders is much higher. More elderly women than elderly men are depressed. Both may become more depressed as they get older.

Some elderly depressed people do not think of themselves as sad or down. The way they act, though, should make you think they could be depressed. Depressed people may spend less time with others and less time on hobbies and interests. They often look more withdrawn and irritable. Older adults who are depressed can worry that others are trying to hurt them. Sometimes they worry that others are stealing from them. Some depressed older adults think more slowly and look forgetful and confused. They might complain more of aches and pains. Their sleep is often worse. They may lose or gain weight. Depression brings a greater risk of suicide, especially in white men in their 80s and older. The rate of suicide in this group is more than five times the usual rate.

Check medical health

Among older adults who are depressed, it is important to check medical health. Medical problems can cause or worsen depression. When medical causes of depression are found and treated, it might improve. Thyroid problems, diabetes, high blood pressure, cancer, and infections are some of the medical causes of depression in older adults. Other older people become depressed because their diet is missing important vitamins or because their sleep is not good. Still others can be depressed because of the stresses that affect many older adults. Losing people you love usually causes grief. Sometimes grief leads into depression. Worrying about money problems or not having a good place to live can worsen depression. Having bad health with low energy or pain, too, can increase worry and depression.

Getting help

When older adults are depressed, they often look for help from a primary care doctor. This can be a good decision if it leads to treatment. Sometimes, though, a primary care doctor offers a medicine when talking would help just as much. Talk therapy helps many depressed older adults. There are special therapy approaches to depression in the elderly. These include cognitive-behavioral therapy, interpersonal therapy, and problem-solving therapy. Finding a therapist who knows one or more of these and other special approaches can be difficult but worth the extra trouble.

Sometimes, it is necessary to use medication. When a depressed older adult is thinking about suicide, out of touch with reality, or unable to remember things normally because of dementia, medications can be very important. Almost every medication used to treat depression works for many older adults too. Age does not mean that a depressed person will not get better. Older adults can have more trouble with side effects of medications. In addition, older adults are often taking other medications already. Sometimes these do not mix well with an antidepressant. Be sure that your doctor knows all the medications you are taking before adding an antidepressant.

The best news about depression in older adults is that it usually gets better with treatment. Talking, medication, care of medical problems, good diet, getting enough exercise and sleep, reducing stress, and spending more time with family and friends are all ways to reduce depression in an older adult.

By James M. Ellison, MD, MPH
Source: Lawrence J, Davidoff DA, Kennedy JS, et al. Diagnosing depression in later life. In Ellison JM, Kyomen HH, Verma S. Mood Disorders in Later Life. Second Edition. Informa Healthcare. Informa Healthcare, 2007. pp 1-14; Gallo J, Rabins P. Depression without sadness: Alternative presentations of depression in late life. Am Fam Physician 1999; 60:820–826; Burkhart KS. Diagnosis of depression in the elderly patient. Lippincotts Prim Care Pract 2000; 4:149–162.
Reviewed by Mario Testani, MD, Physician Advisor, Beacon Health Options

Summary

When depression is missed, life is less enjoyable.
 

Depression can look different in an older person. The life stresses and health problems of older adults are not the same as for other age groups. For these reasons, family members and caregivers sometimes miss depression in the elderly. When depression is missed, life is less enjoyable. Daily tasks are harder. Being with people is less fun. The chance of sickness or death is greater. 

Depression and increasing age

At any time, about one in every 25 older adults living at home has a major depression. If milder depressions are counted too, then twice as many are depressed. In nursing homes, the number of depressed elders is much higher. More elderly women than elderly men are depressed. Both may become more depressed as they get older.

Some elderly depressed people do not think of themselves as sad or down. The way they act, though, should make you think they could be depressed. Depressed people may spend less time with others and less time on hobbies and interests. They often look more withdrawn and irritable. Older adults who are depressed can worry that others are trying to hurt them. Sometimes they worry that others are stealing from them. Some depressed older adults think more slowly and look forgetful and confused. They might complain more of aches and pains. Their sleep is often worse. They may lose or gain weight. Depression brings a greater risk of suicide, especially in white men in their 80s and older. The rate of suicide in this group is more than five times the usual rate.

Check medical health

Among older adults who are depressed, it is important to check medical health. Medical problems can cause or worsen depression. When medical causes of depression are found and treated, it might improve. Thyroid problems, diabetes, high blood pressure, cancer, and infections are some of the medical causes of depression in older adults. Other older people become depressed because their diet is missing important vitamins or because their sleep is not good. Still others can be depressed because of the stresses that affect many older adults. Losing people you love usually causes grief. Sometimes grief leads into depression. Worrying about money problems or not having a good place to live can worsen depression. Having bad health with low energy or pain, too, can increase worry and depression.

Getting help

When older adults are depressed, they often look for help from a primary care doctor. This can be a good decision if it leads to treatment. Sometimes, though, a primary care doctor offers a medicine when talking would help just as much. Talk therapy helps many depressed older adults. There are special therapy approaches to depression in the elderly. These include cognitive-behavioral therapy, interpersonal therapy, and problem-solving therapy. Finding a therapist who knows one or more of these and other special approaches can be difficult but worth the extra trouble.

Sometimes, it is necessary to use medication. When a depressed older adult is thinking about suicide, out of touch with reality, or unable to remember things normally because of dementia, medications can be very important. Almost every medication used to treat depression works for many older adults too. Age does not mean that a depressed person will not get better. Older adults can have more trouble with side effects of medications. In addition, older adults are often taking other medications already. Sometimes these do not mix well with an antidepressant. Be sure that your doctor knows all the medications you are taking before adding an antidepressant.

The best news about depression in older adults is that it usually gets better with treatment. Talking, medication, care of medical problems, good diet, getting enough exercise and sleep, reducing stress, and spending more time with family and friends are all ways to reduce depression in an older adult.

By James M. Ellison, MD, MPH
Source: Lawrence J, Davidoff DA, Kennedy JS, et al. Diagnosing depression in later life. In Ellison JM, Kyomen HH, Verma S. Mood Disorders in Later Life. Second Edition. Informa Healthcare. Informa Healthcare, 2007. pp 1-14; Gallo J, Rabins P. Depression without sadness: Alternative presentations of depression in late life. Am Fam Physician 1999; 60:820–826; Burkhart KS. Diagnosis of depression in the elderly patient. Lippincotts Prim Care Pract 2000; 4:149–162.
Reviewed by Mario Testani, MD, Physician Advisor, Beacon Health Options

The information provided on the Achieve Solutions site, including, but not limited to, articles, quizzes, and other general information, is for informational purposes only and should not be treated as medical, health care, psychiatric, psychological or behavioral health care advice. Nothing contained on the Achieve Solutions site is intended to be used for medical diagnosis or treatment or as a substitute for consultation with a qualified health care professional. Please direct questions regarding the operation of the Achieve Solutions site to Web Feedback. If you have concerns about your health, please contact your health care provider.  ©2017 Beacon Health Options, Inc.

 

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