There are several types of depression that older adults may experience:
Major Depressive Disorder – includes symptoms lasting at least two weeks that interfere with a person’s ability to perform daily tasks
Persistent Depressive Disorder (Dysthymia) – a depressed mood that lasts more than two years, but the person may still be able to perform daily tasks, unlike someone with Major Depressive Disorder
Substance/Medication-Induced Depressive Disorder – depression related to the use of substances, like alcohol or pain medication
Depressive Disorder Due to A Medical Condition – depression related to a separate illness, like heart disease or multiple sclerosis.
For some older adults with depression, sadness is not their main symptom. They could instead be feeling more of a numbness or a lack of interest in activities. They may not be as willing to talk about their feelings.
The following is a list of common symptoms. Still, because people experience depression differently, there may be symptoms that are not on this list.
Persistent sad, anxious, or "empty" mood
Feelings of hopelessness, guilt, worthlessness, or helplessness
Irritability, restlessness, or having trouble sitting still
Loss of interest in once pleasurable activities, including sex
Decreased energy or fatigue
Moving or talking more slowly
Difficulty concentrating, remembering, or making decisions
Difficulty sleeping, waking up too early in the morning, or oversleeping
Eating more or less than usual, usually with unplanned weight gain or loss
Thoughts of death or suicide, or suicide attempts
What Are the Risk Factors for Depression in Older Adults?
Things that raise the risk of depression in older people include:
Being female
Being single, unmarried, divorced, or widowed
Lack of a supportive social network
Stressful life events
Physical conditions like stroke, hypertension, atrial fibrillation, diabetes, cancer, dementia, and chronic pain further increase the risk of depression. Additionally, these risk factors for depression are often seen in older adults:
Certain medicines or combination of medicines
Damage to body image (from amputation, cancer surgery, or heart attack)
Dependence, whether through being hospitalized or needing home health care
Disability
Family history of major depressive disorder
Fear of death
Living alone, social isolation
Other illnesses
Past suicide attempt(s)
Presence of chronic or severe pain
Previous history of depression
Recent loss of a loved one
Substance abuse
How is depression treated?
Depression, even severe depression, can be treated. It’s important to seek treatment as soon as you begin noticing signs. If you think you may have depression, start by making an appointment to see your doctor or health care provider.
Certain medications or medical conditions can sometimes cause the same symptoms as depression. A doctor can rule out these possibilities through a physical exam, learning about your health and personal history, and lab tests. If a doctor finds there is no medical condition that is causing the depression, he or she may suggest a psychological evaluation and refer you to a mental health professional such as a psychologist to perform this test. This evaluation will help determine a diagnosis and a treatment plan.
Common forms of treatment for depression include:
Psychotherapy, counseling, or “talk therapy” that can help a person identify and change troubling emotions, thoughts, and behavior. It may be done with a psychologist, licensed clinical social worker (LCSW), psychiatrist, or other licensed mental health care professional. Examples of approaches specific to the treatment of depression include cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT).
Medications for depression that may balance hormones that affect mood, such as serotonin. There are many different types of commonly used antidepressant medications. Selective serotonin reuptake inhibitors (SSRIs) are antidepressants commonly prescribed to older adults. A psychiatrist, mental health nurse practitioner, or primary care physician can prescribe and help monitor medications and potential side effects.
Electroconvulsive Therapy (ECT), during which electrodes are placed on a person’s head to enable a safe, mild electric current to pass through the brain. This type of therapy is usually considered only if a person’s illness has not improved with other treatments.
Repetitive transcranial magnetic stimulation (rTMS), which uses magnets to activate the brain. rTMS does not require anesthesia and targets only specific regions of the brain to help reduce side effects such as fatigue, nausea, or memory loss that could happen with ECT.
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