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Depression in Old People

Depression in Old People


Everything you need to know about
Depression in Old People

Clinical depression is widespread in the elderly. Depression is the most frequent mental health problem in older persons, affecting 22% of men and 28% of women aged 65 and up, followed by anxiety. Mental health disorders are more common in some categories of older adults. The most plausible cause is that elderly people’s depression symptoms are often different. The consequences of various ailments and the medications used to treat them are commonly confused with depression in elderly persons.

What Is the Difference Between
Depression in Old People and
Depression in Younger Adults?

Older people are affected differently by depression than younger people. Depression commonly coexists with other medical conditions and limitations in elderly individuals and often lasts longer.

Depression is linked to an increased risk of heart disease and death from illness in older persons. Depression, on the other hand, limits an older person’s ability to rehabilitate. The prevalence of depression significantly increases the chance of death from physical ailments among nursing home patients, according to studies. Depression has also been related to a higher risk of death following a heart attack. As a result, even if the depression is moderate, it’s critical to have an older adult you’re concerned about examined and treated.

Depressive symptoms may not be visible in older adults. They could instead:

  • Exhausted
  • Sleeping problems
  • Impatient or grumpy
  • Feeling perplexed
  • Struggling to concentrate
  • No longer appreciates the hobbies they used to
  • Slow down in pace
  • Have weight or appetite change
  • Feeling forlorn, insignificant, or guilty
  • Suffer from aches and pains
  • Have suicidal thoughts

A primary care doctor can check for depression using a series of standard questions, allowing for improved diagnosis and treatment. Doctors are encouraged to check for depression on a regular basis. This can happen during a chronic illness appointment or during a wellness visit.

Suicide risk is significantly increased by depression, particularly among older white men. People aged 80 to 84 have a suicide rate that is more than twice that of the overall population. Depression in adults 65 and older is considered a major public health problem by AGE UK.

Furthermore, as people get older, they often lose social support systems as a result of the death of a spouse or sibling, retirement, or relocation. Doctors and family members may miss indicators of depression in older persons due to changes in their circumstances and the expectation that they will slow down. As a result, proper therapy is frequently delayed, causing many elderly people to suffer from depression unnecessarily.

How Does Insomnia Affect
Depression in old people?

Insomnia is commonly associated with depression in old people. In addition, sleeplessness has been linked to new or recurrent depression, particularly in older persons, according to research.

Experts occasionally advise against using benzodiazepines or newer “hypnotic” medicines to treat insomnia since they might cause reduced alertness, respiratory depression, and falls.

Experts recommend using the hormone melatonin or a low-dose formulation of the tricyclic antidepressant doxepin to treat sleeplessness in the elderly. Other antidepressants with sedative properties, such as Remeron or trazodone, are occasionally given for both purposes. In older adults, the sleep aid Belsomra has also been demonstrated to be effective and safe. A psychiatrist or psychopharmacologist may recommend different drugs, psychotherapy, or both if the sleep disturbance or depression does not improve.

What Are the Risk Factors for
Depression in old people?

The following factors increase the likelihood of depression in old people:

  • Being a woman
  • Being single, divorced, widowed, or unmarried
  • A social network that isn’t supportive
  • Life’s stressful events

Stroke, hypertension, atrial fibrillation, diabetes, cancer, dementia, and chronic pain are among physical disorders that raise the risk of depression. These depression risk factors are also commonly encountered in older adults:

  • Certain medications or drug combinations
  • Body image problems (from amputation, cancer surgery, or heart attack)
  • Dependence, whether due to hospitalisation or the necessity for home health care
  • Disability
  • Major depressive disorder runs in the family
  • Death phobia
  • Isolation due to living alone
  • Other diseases
  • Previous attempts at suicide(s)
  • Pain that is continuous or severe
  • Previous depression history
  • A loved one has recently died
  • Abuse of substances

Brain scans of persons who acquire their first depression in their senior years frequently indicate areas of the brain that aren’t getting adequate blood flow, which is thought to be the result of years of high blood pressure. Separate from any life stress, chemical alterations in these brain cells may increase the probability of depression in old people.

What Depression Treatments
Are Available for Older People?

Medicine, psychotherapy or counselling, electroconvulsive treatment or other newer forms of brain stimulation are all options for treating depression in old people (such as repetitive transcranial magnetic stimulation, or rTMS). A combination of these treatments may be employed in some cases. A doctor’s recommendation is based on several criteria, including the kind and degree of depressive symptoms, previous therapies, and overall health.

How Do Antidepressants Ease
Depression in Old People?

Antidepressants may be helpful in older adults, but they may not be as effective as in younger patients, according to studies. In addition, the risk of side effects or potential drug interactions must be carefully examined. Certain older antidepressants, such as amitriptyline and imipramine, might produce sedation, confusion, or an abrupt drop in blood pressure when a person gets up. This can result in fractures and falls.

You may be prescribed the following medications:

  • SSRIs such as citalopram, escitalopram, fluoxetine, paroxetine, and sertraline are selective serotonin reuptake inhibitors.
  • Desvenlafaxine, duloxetine, and venlafaxine are SNRIs – serotonin and norepinephrine reuptake inhibitors
  • Vilazodone and vortioxetine are two serotonin modulators and stimulators -SMS
  • Bupropion, mirtazapine, and trazodone are examples of atypical antidepressants
  • Isocarboxazid, phenelzine, selegiline, and tranylcypromine are monoamine oxidase inhibitors -MAOIs

Antidepressants may take longer for older persons to start working than they do for younger ones. Doctors may recommend smaller doses initially since elderly people are more sensitive to medications. In general, older persons require more time to recover from depression than younger patients.

Is Psychotherapy Effective in Treating
Depression in Old People?

Support from family and friends, participation in self-help and support groups, and counselling are all beneficial to most depressed individuals. Psychotherapy is particularly effective for those who have had substantial life difficulties, such as the death of friends and family, house relocations, and health issues, or who prefer not to take medication and only have mild to moderate symptoms. It’s also beneficial for people who can’t take pharmaceuticals due to side effects, drug combinations, or other medical conditions.

In older individuals, psychotherapy can help with a variety of functional and social repercussions of depression. Many doctors prescribe psychotherapy in addition to antidepressants.

When should you use
electroconvulsive treatment (ECT)?

In the treatment of depression in older persons, ECT can be very effective. When older people are unable to take traditional antidepressants due to side effects or interactions with other medications, when depression is severe and interferes with basic daily functions (such as eating, bathing, and grooming), or when the risk of suicide is particularly high, ECT is a safe and effective treatment option.

What Issues Affect the Treatment
of Depression in Old People?

The stigma associated with mental illness and psychiatric therapy is especially strong among the elderly. This stigma can prevent older people from even admitting to themselves that they are depressed. Depression symptoms are commonly misdiagnosed by older persons and their families as “natural” reactions to life stresses, losses, or the ageing process.

Depression can also manifest itself physically rather than through standard symptoms. This causes treatment to be delayed. Furthermore, depressed elderly persons may not seek treatment because they incorrectly assume there is no hope.

Because of adverse effects or costs, older persons may be hesitant to take their medications. Furthermore, having some additional disorders at the same time as depression can make antidepressant medications less effective. Alcoholism and other substance abuse can exacerbate or cause depression, making therapy more difficult. Unhappy life circumstances, such as the death of a family member or friend, poverty, or solitude, can all impair a person’s willingness to continue treatment.