By Diane Palmer, MSW, LCSW
Depression is very common in our senior population. Depression affects about six million Americans age 65 and older. Unfortunately, only 10 percent receive treatment. Below are answers to some of the most frequently asked questions about depression in the older adults.
No. It is not a â€˜normal’ part of getting older. Depression is a very serious problem among the older adults. Older individuals with significant symptoms of depression have roughly 50 percent higher health care costs than seniors who are not depressed.
Getting older is often accompanied by loss of key social support systems, such as the death of a spouse, siblings or significant others, retirement, or a change of residence. Financial concerns can also contribute to depression.
Depression can also be triggered by long-term illnesses that are common in later life, such as:
|diabetes||chronic lung disease|
|heart disease||Parkinson’s disease|
Symptoms of depression include:
- sleeping either too much or having trouble sleeping
- change in appetite — weight gain or loss
- feeling sad or hopeless
- loss of interest or pleasure in things previously enjoyed
- trouble concentrating or memory loss
- lack of energy not attributed to a medical problem, and other possible symptoms.
Everyone has their “down” days that may resolve on their own. However, if the symptoms of depression continue most of the day for 2 weeks or more, the person may be suffering from a depression that needs treatment. A person can not just will themselves to “snap out of it.”
It is important to realize that depression is very treatable. No one should have to suffer without trying to take advantage of the help that is available.
Unfortunately, doctors and family often miss the diagnosis of depression in older adults. This may result in no treatment or delays in treatment. Sometimes, symptoms of depression — such as decreases in mood, interest, energy, sleep, and concentration — are attributed to age-related medical conditions or to aging itself.
It has been consistently shown that a combination of antidepressant medication and counseling (also called “talk therapy”) work better than either option alone. Talk therapy is a process in which a trained professional enters a relationship with a client to help the client address his or her issues. For instance, meeting with a clinical social worker may provide an opportunity to receive emotional support and to express feelings in a safe environment with a person who is objective. Often people prefer not to share their personal feelings and thoughts with family or friends.
Exercise has also shown to be helpful as has support groups and other ways to decrease the isolation that sometimes accompanies depression.
Some people do not have any side effects from antidepressant medications. Other people do experience side effects initially and may find the side effects diminish as their body gets used to the new medication. If, after talking to your doctor you decide you’d rather avoid medications totally, you can try seeing a clinical social worker for counseling. This can give you the opportunity to talk about the changes and/or stressors in your life and other factors that may be contributing to your depression.
Many primary care physicians and nurse practitioners will prescribe antidepressants. Unfortunately, if the initial prescription does not work, the medication is often discontinued rather than being adjusted as needed. If this is the case, seeing a psychiatrist may be helpful. Psychiatrists are medical doctors who specialize prescribing in these types of medications. They can start you on a suitable dosage and monitor you for any side effects. They can then adjust the medications accordingly to give maximum benefits.
Q: How long does it take to feel better with antidepressant medication?
Results of treatment using antidepressant medications vary depending on the individual. Treatment works gradually over several weeks. It is important to realize that you will not feel better 30 minutes after taking a pill for depression like you might with medications for other things. It may take a month before you and your doctor can begin to see the benefits of medication and how they are working for you. Ongoing monitoring is recommended.
Q: I am receiving a â€˜happy pill’ from my primary care doctor. Do you think I have to worry about it?
It is a good idea to keep your physician informed of how you are doing on this medication. Often the dosage may need to be adjusted in order to receive maximum benefit. Sometimes several medications need to be tried to find the best one for you.
Q: I’ve been taking an antidepressant medication for a few months now and don’t want to take it anymore. Can I quit taking them on my own?
As with most medications, you should consult the prescribing doctor before stopping the medications.
Let them know you are concerned about them and what changes you have noticed. Help them realize that it is not a sign of weakness to accept the assistance of others. Tell them that help is available.
There are several sources of help in the area. It may be a good idea to discuss how you feel with your primary physician who can check to see if there are any underlying medical issues.
Clinical social workers experienced in counseling are available to meet with seniors either in an office or in their own homes. Many accept Medicare assignment. Some people also find support from their clergy. If you decide to try medications, seeing a psychiatrist specifically experienced in working with the older adults is suggested.
The National Institute of Mental Health considers depression in people age 65 and older to be a major public health problem.