Depression in the Elderly

depressed elderly photo
According to the National Alliance on Mental Illness (NAMI), 6.5 million of the 35 million Americans who are aged 65 or older are affected by depression.  Depression in the elderly is closely associated with feelings of dependency and disability, and can have a negative impact on both the individual, and the family.  Untreated depression in the elderly increases the risk of physical illnesses, and cognitive decline.What are the causes of depression in the elderly?

  • Retirement, and feeling a loss of purpose
  • Moving from home to a retirement facility
  • Death of a loved one or close friends
  • Increased isolation/lonliness
  • Medical problems
  • Fears about loss of independence

The most common symptoms of late-life depression include:

  • Fatigue/feeling slowed down
  • New physical complaints or increased/aggravated symptoms of current medical problems
  • A neglect in personal hygiene
  • Loss of motivation and lack of interest in hobbies
  • Withdrawing, social isolation
  • Sleep disturbances
  • Loss of appetite, weight loss
  • Low self esteem – feelings of being a burden on the family
  • Increased alcohol use
  • Suicidal thoughts

Fortunately, most depressed elderly people can improve markedly with treatment, which can include psychotherapy, antidepressant medications, or a combination of both. Psychotherapy is especially beneficial for those with mild depression, or those who cannot take antidepressant medications due to drug interactions, a medical illness, or substantial negative side effects. For instance, amitriptyline and imipramine can be sedating, and can cause a sudden drop in blood pressure when standing up, which can put an elderly person at risk for falls.  Most of the antidepressants available are effective in older adults, but the risks of side effects must be carefully considered.

Antidepressant medications called Selective Seratonin Reuptake Inhibitors (SSRIs) have proven effective and are generally well tolerated by elderly patients.  SSRIs are favored over tricyclic antidepressants, due to their cardiac safety, ease of use, tolerability, and low lethality in overdose.  Examples of SSRIs are Wellbutrin, Prozac, Zoloft, Lexapro, Paxil, and Celexa.

If you are the loved one of a senior suffering from depression, providing emotional support increases the chances of successfully treating the depression.  This means helping to schedule an appointment with a primary care physician or mental health practitioner.  It can be very helpful to go along with the senior to the first appointment.  It may be a good idea to have regular visits by a professional in home caregiver to make sure that the senior is doing alright and taking their medications as prescribed.

Depression is a serious illness, but fortunately, with the support of family, doctors, therapists, and possibly medications, it is treatable.

For more information:

Photo by Hamed Saber