Depression in Elderly or Aged

My topic is depression in elderly

Depression in the elderly is a very common problem.  Often the elderly that are susceptible are the ones who have health problems.  The symptoms of depression affect  every aspect of their lives. 

Recognizing depression in the elderly starts with knowing the signs and symptoms. Depression red flags include (Depression in Older Adults and Elderly.  Helpguide.org.  http://www.helpguide.org/mental/depression_elderly.htm):

• Sadness


• Fatigue


• Abandoning or losing interest in hobbies or other pleasurable pastimes


• Social withdrawal and isolation (reluctance to be with friends, engage in activities, or leave home)

§  Weight loss or loss of appetite

• Sleep disturbances (difficulty falling asleep or staying asleep, oversleeping, or daytime sleepiness)


• Loss of self-worth (worries about being a burden, feelings of worthlessness, self-loathing)


• Increased use of alcohol or other drugs

§  Fixation on death; suicidal thoughts or attempts

It’s important to be aware that medical problems can cause depression in older adults and the elderly, either directly or as a psychological reaction to the illness.  Depression can be complicated by Alzheimer’s disease or other forms of dementia. It also can complicate other medical conditions in the elderly.  Suicide in the elderly is one of the leading causes of death related to injury. Men account for most of these suicides, and divorced or widowed men are at the highest risk. Families should pay special attention to elderly male relatives who are alone. In addition to finding psychiatric help for them, family members should remove anything from their homes (such as knives) that they could use to harm themselves (Depression-Elderly.  Possible Complications.  http://health.nytimes.com/health/guides/disease/depression-elderly/overview.html).
Physical illnesses that can cause depression include(Depression in Older Adults and Elderly.  (Helpguide.org.  http://www.helpguide.org/mental/depression_elderly.htm ):

§  Parkinson’s disease

§  stroke

§  heart disease

§  cancer

§  diabetes

§  thyroid disorders

§  Vitamin B12 deficiency

§  dementia and Alzheimer’s disease

§  lupus

§  multiple sclerosis

But any chronic medical condition, particularly if it is painful, disabling, or life-threatening, can lead to depression or make it worse.

Symptoms of depression are a side effect of many commonly prescribed drugs. You’re particularly at risk if you’re taking multiple medications. While the mood-related side effects of prescription medication can affect anyone, older adults are more sensitive because, as we age, our bodies become less efficient at metabolizing and processing drugs.

Medications that can cause or worsen depression include ((Depression in Older Adults and Elderly.  Helpguide.org.  http://www.helpguide.org/mental/depression_elderly.htm):

§  Blood pressure medication (clonidine)

§  Beta-blockers (e.g. Lopressor, Inderal)

§  Sleeping pills

§  Tranquilizers (e.g. Valium, Xanax, Halcion)

§  Calcium-channel blockers

§  Medication for Parkinson’s disease

§  Ulcer medication (e.g. Zantac, Tagamet)

§  Heart drugs containing reserpine

§  Steroids (e.g. cortisone and prednisone)

§  High-cholesterol drugs (e.g. Lipitor, Mevacor, Zocor)

§  Painkillers and arthritis drugs

§  Estrogens (e.g. Premarin, Prempro)

Proper support groups are treatment for depression.  One can reduce depression by staying active by joining volunteer work or having regular visitors, talking about problems with a psychologist, psychiatrist, or other therapists.   In cases of moderate-to-severe depression, people may get the best results by combining psychotherapy with antidepressant medications.

Short-term (about 12 weeks) group-based physical exercise programs involving walking or other forms of aerobic exercise can reduce depression in older adults.

Antidepressant drug therapy has been shown to increase the quality of life in depressed elderly people. These medications are carefully monitored for side effects. Doctors usually prescribe lower doses of antidepressants for older people, and increase the dose more slowly than in younger adults.

These medications include:

·         Selective serotonin-reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro) are used as first-line treatments.

·         Serotonin-norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine (Effexor) and Duloxetine (Cymbalta), as well as mirtazapine (Remeron) may also be tried.

·         Tricyclic antidepressants are not used as often because of side effects, particularly for the heart.

Neuroleptic medications can help treat agitation in some people. Electroconvulsive therapy (ECT) can be used in people who are severely depressed if other treatments don’t work.  (Depression-elderly-treatment.  University of Maryland Medical Center.  http://www.umm.edu/ency/article/001521trt.htm)

Staying healthy, fit and active are the answers to successful aging.  Dr. Judy Salerno, deputy director of NIH’s National Institute on Aging (NIA), says, “When I entered the aging field many years ago, we didn’t talk about disease prevention. We simply characterized normal aging. Now we are seeing that people can age successfully in good health well into old age. Disease and disability are not inevitable consequences of aging.” (Senior Health: Introduction to successful aging.  MedicineNet.com.  http://www.medicinenet.com/senior_health/article.htm.)

 

 

 

 

 

 

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