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Depression in older adults: treatment works

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February 22nd, 2010
ERC_0310_depression_happy
ERC_0310_depression_happy
With age comes an ability to adapt that is borne of experience, says William Uffner, M.D., medical director for the older adults program at Friends Hospital in Philadelphia, Pa. Older adults are very resilient many sustain personal losses like the loss of a spouse or physical problems that an average 25 year old would completely buckle under, and they still don t become depressed. But some do suffer from depression, and it may be hard to recognize because signs of the disease are more varied in older individuals than in younger ones. Depression is a serious medical illness involving the brain marked by sadness, fatigue, changes in sleep patterns, difficulty thinking and concentrating, changes in appetite, feelings of dejection and hopelessness, and sometimes suicidal thoughts. Depression in older adults might appear as increased tiredness, or it can be seen as grumpiness or irritability. Older adults will often have a lot of physical symptoms like aches and pains, Uffner says.

What causes depression?

Compared to younger adults, older individuals are more likely to get depressed because of a significant illness, Uffner says. Depression can be a complication of major medical conditions like heart disease, stroke, osteoporosis, chronic lung disease, Parkinson s disease, Alzheimer s disease,and many others. Not only can a disease process itself contribute to depression, but the struggle of dealing with the associated loss of independence and function can also contribute, says Roberta Feldhausen, A.P.R.N.-M.H., director of mental health services atRiderwood. Mood changes and signs of depression (see sidebar) can also be caused by medicines taken for many health conditions like arthritis, high blood pressure, heart disease, and Parkinson s disease.

Is it depression or dementia?

Depression and dementia can sometimes have similar symptoms. Depression can manifest itself as dementia, a condition called pseudodementia, Feldhausen says. A person may have difficulty with memory and functioning they may lose interest in their usual activities, become more forgetful, or lose track of time. Someone with dementia may forget that you re coming over to visit, but someone with depression may tell you not to bother to come at all, Uffner says. Depression-related dementia is usually reversible, once you treat the underlying depression, Feldhausen says.

Treatment works

If you suspect a loved one is depressed, do not hesitate to ask if they ve considered hurting or killing themselves, Uffner says. It s important because depressed older adults are at a very high risk of suicide, especially men who live alone. Depression is very treatable with therapy and medication you don t have to suffer, Feldhausen says. If you have any symptoms of depression, talk to your doctor.

What to look for

If you (or a loved one) have several of these symptoms and they last for more than two weeks, see your doctor:
  • An empty feeling, ongoing sadness, or anxiety
  • Tiredness, lack of energy
  • Loss of interest or pleasure in everyday activities
  • Sleep problems, including sleeping too much
  • Eating more or less than usual
  • Crying often
  • Aches and pains that don t go away when treated
  • Increased use of alcohol
  • A ' hard time focusing, remembering, or making decisions
  • Feeling guilty, helpless, worthless, or hopeless
  • Being irritable
  • Thoughts of death or suicide or a suicide attempt

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