Geriatric Depression and its treatment: Diagnosis
Depression in the Elderly
Major depression is common in the population at all stages of life. Between 6-8% of adults will develop an episode of depression in a given year. But wait!- let’s be sure we are clear about what depression is.
Depression is not an isolated day of feeling blue, sad, or ‘bummed out.’ Depression is a clinical illness that has well defined symptoms, which are present every (or nearly every) day for a period of at least two weeks. Beyond sadness, people with major depression may manifest diminished interest in activities, or loss of pleasure derived from activities that historically caused pleasurable feelings. Other symptoms of depression include alterations in sleep and appetite (too much or too little), poor concentration, reduced energy, hopelessness, guilt feelings, and thoughts of death or suicide.
Seniors will often, when depressed, manifest more somatic preoccupation (overly focus on bodily concerns), and withdraw. They tend to cry less when depressed. Seniors, particularly white males, are at significantly higher risk to dying by suicide, with no warnings given before the act.
Risks factors for developing depression in the older population include:
· Social isolation
· Multiple medication problems
· Loss of spouse
· Certain medications for treating medical conditions, including insomnia and anxiety
· Pain
· Alcohol or substance abuse
· Family history of depression
· History of depression earlier in life
· Fear of death
· Female gender
· Being single, widowed, divorced
While major depression can be debilitating in the extreme, the good news is that there are multiple treatments available to alleviate symptoms. Next up, we discuss the various treatments for depression in the elderly.