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Who is Affected by Depression?
Why Elderly Depression is Overlooked
Statistics
Treatment Options
The Top Signs/Symptoms of Depression
Consequences of Not Seeking Help
References
Depression
is more than just feeling “blue”, “down”, or “hopeless”, it’s a serious
medical
illness that interferes with daily life and normal functioning for
weeks at a
time (NIMH 2009). There is no certain cause of
depression but research
suggests
that it is a combination of genetic, biochemical, environment, and
psychological factors (NIMH 2009). Depression is a
disorder of the
brain in
which the neurotransmitters (chemicals that the brain uses to
communicate with)
are out of balance affecting the regulation of mood, thinking, sleep,
appetite
and behavior (MHA 2009). (Back to
Top)
Who
is affected by
depression?
There
are over 35 million Americans
who are 65 or older and of them 7 million suffer from some form of
depression.
About 2 million suffer from full-blown depression and the other 5
suffer from
less severe forms of the illness. Within the United States one third of
nursing
home residents suffer from depression. The disorder can occur at any
time
during a resident’s placement in a nursing home. Research suggests that
newly
admitted nursing home residents have greater functional impairment and
are 1.5
times more likely to die within 12 months of admissions (Deborah
W., Christopher C., Michelle K., etal
2003.). In a large nursing home study, only 14 percent of
patients
identified by psychiatric evaluation as having clinical depression were
documented, and only 20 percent of patients with depression receive
antidepressant treatment. Depression in the elderly is severely
under-recognized and under-treated. (Back
to Top)
Why elderly depression
is
overlooked
Depression
is not a normal part of
aging, and studies have shown that most elderly seniors are satisfied
with
their lives (CDC 2005). Depression in the elderly is
often overlooked
because
most seniors show different less noticeable symptoms that are often
associated
with other illnesses. Illnesses that increase an elderly persons chance
of
depression include and are not limited to heart disease, stroke,
cancer,
dementia, Parkinson and even Alzheimer’s disease (NIMH
2009). Drug
treatments
for these illnesses and others show side effects of causing depression.
Only 42
percent of adults over 65 years of age seek help from professionals
while most
elderly try to “handle it themselves” (NMHA 2009).(Back to Top)
The elderly (people 65 and older), account for 12
percent of the U.S.
population and in 2004 this age group accounted for 16 percent of total
suicides (CDC 2005). Dominantly of this age
group men 80 years
or older
have the highest suicide rates (APA
2009). Depressive symptoms occur in about 15 percent of
seniors
living
within the community and 25 percent of seniors within a nursing home
also show
symptoms associated with depression (healthyworks
special 1999). A
majority of
elderly adults with depression can improve when they receive treatment
with a
combination of methods usually containing antidepressant medication and
psychotherapy. Research has revealed that medication and a combination
treatment plan with therapy is effective in reducing the reoccurrence
of
depression in the elderly (Little
JT, Reynolds
CF III, Dew MA, etal 1998 and
1999). (Back to Top)
Antidepressant
medications affect
the release of neurotransmitters in the brain. Some of the medications
are
known as selective serotonin reuptake inhibitors (SSRIs). They control
the
neurotransmitter serotonin in the brain. Other antidepressant
medications can
be used to effect different neurotransmitters (APA
2009). It is important for the elderly to be aware that
there
are several medications for depression and that different medications
may work
for one person and not for another. If this is the case then the
elderly person
should contact their doctor to try another medication. Another
important fact
for the elderly to keep in mind is that sometimes antidepressant
medications
can take weeks to kick in. After 4 to 8 weeks if no change has occurred
then a
new medication should be attempted (Rubinow
DR, Schmidt PJ, Roca CA 1998.). As
stated earlier
medication alone is not the key to battling depression.
When
seeking help the elderly
should also consider psychotherapy in addition to medication. Research
has
shown that certain type of psychotherapy along with medication have
reduced the
number of incidents of depression in later-life (Tsuang & Faraone, 1990). The elderly
interact
with health care
professionals trained to dealing with depression, suicidal thoughts,
and other
problems. Studies have shown that elderly in good physical health with
this
combination treatment succeeded in overcoming their depression (Cochran SV &
Rabinowitz FE 2000). Other studies however have shown that
elderly with
depression on top of physical illnesses and problems with memory and
thinking
did not benefit from the combination of medication and psychotherapy
treatments
(Pollack W.
Mourning 1998). (Back to Top)
The
Top Signs/Symptoms of Depression
- depressed mood
(feelings of sadness or emptiness)
- lack of interest.
- significant
decrease or increase in appetite
- insomnia or
hypersomnia
- psycho-motor
agitation or slow down (observable by others)
- fatigue or loss
of energy
- feelings of
worthlessness or inappropriate guilt
- diminished
ability to concentrate or make decisions
- recurrent
thoughts of death or suicidal ideation
Short term
- Fatigue or loss of energy
- The capacity for enjoyment decreases and sometimes may become negligible.
- You might become less energetic for a short period of time.
- Less interest in social activities (Back to Top)
Long term
- Unrelenting sadness, anxiety and other mood problems such as empty mood etc.
- Long term feelings of hopelessness and negative thoughts that may last for years, in few cases might last for entire life as well.
- Long term affects result in persistent feelings of helplessness and worthlessness so that sufferers often do not realize their skills. They underestimate their selves and may choose a wrong direction for their future.
- Patients suffering from long term affects of depression are often found facing sleeping problems such as, Insomnia and hypomania disorders. These two disorders cause sleeplessness and excessive amount of sleep; patients might sleep for more than 20 hours a day.
- Causes less amount of Interest in those enjoyable activities that a person suffering from depression loved to cherish in the past.
-
Problems in concentrating
- Physical problems such as headache, abdominal pain etc may become part of your daily life that may cause inability to perform daily duties as effectively as a normal person.
- Fatigue. Long lasting affect of fatigue may cost you inability to perform various tasks efficiently and energetically.
- The long-term affects of depression
may also result in suicide as well; many cases of suicides have been
noticed due to depression. (Back to Top)
Centers for Disease
Control and Prevention, National Center for Injury Prevention and
Control.
Web-based Injury Statistics Query and Reporting System (WISQARS)
[online].
(2005) [accessed January 31 2007]. Available from URL:
www.cdc.gov/ncipc/wisqars.
Cochran SV, Rabinowitz FE. Men
and Depression:
clinical and empirical perspectives. San Diego: Academic Press,
2000.
Deborah
Wagenaar, DO; Christopher C. Colenda, MD, MPH; Michelle Kreft, BS;
Julie
Sawade, BS; Joseph Gardiner, PhD; Elena Poverejan, PhD. Treating Depression in Nursing Homes:
Practice Guidelines in the Real World. JAOA •
Vol 103 • No 10 •pgs. 465-469 October 2003
Little JT, Reynolds CF III, Dew MA,
Frank E, Begley
AE, Miller MD, Cornes C, Mazumdar S, Perel JM, Kupfer DJ. How common is
resistance to treatment in recurrent, nonpsychotic geriatric
depression? American
Journal of Psychiatry, 1998; 155(8): 1035-1038.
Mental Health America. Factsheet
Depression. © 2009 Mental Health America.<
http://www.mentalhealthamerica.net/go/depression>
Reynolds CF III, Frank E, Perel JM,
Imber SD,
Cornes C, Miller MD, Mazumdar S, Houck PR, Dew MA, Stack JA, Pollock
BG, Kupfer
DJ. Nortriptyline and interpersonal psychotherapy as maintenance
therapies for
recurrent major depression: a randomized controlled trial in patients
older
than 59 years. Journal of the American Medical Association,
1999;
281(1): 39-45.
Rubinow DR, Schmidt PJ, Roca CA.
Estrogen-serotonin
interactions: implications for affective regulation. Biological
Psychiatry,
1998; 44(9): 839-850.
Science
Daily. Elderly
in Long-Term Care Setting Suffer Depression More Than Those Cared for
at Home.May
2008. © 1995-2009
Science Daily LLC <
http://www.sciencedaily.com/releases/2008/05/080508181557.htm>
About Me/Contact the Author
© Copyright 2010, Katrina Greenhalgh, University of Massachusetts Lowell - Lowell, MA