While everyone feels sad or down from time to time, these feelings usually resolve after a while. Clinical depression, however, involves feeling persistently unhappy and hopeless for at least two weeks. Depression is a mental illness that will not go away on its own. Individuals with clinical depression require professional treatment, such as counseling, medication, or a combination of both to alleviate symptoms.
Everyone’s personal experiences and brain chemistry are unique, so it can take some trial and error to find an effective treatment plan for depression. Detecting and treating this condition in older individuals can be especially tricky. But, the first step is to make an appointment with a medical or mental health professional to begin piecing together a personalized plan of action.
Diagnosing Depression in Seniors
For many people, the hardest step is deciding to seek medical help for depression. It can be easier to start by making an appointment with one’s family doctor or primary care physician (PCP). Most people have a PCP and have been with the same one for many years. This rapport can make it a little easier for patients to broach the subject and easier for doctors to make initial recommendations based on a patient’s medical history and personality.
During the initial appointment, the doctor will ask about the patient’s symptoms, the medications they are taking and how their moods are impacting their day-to-day life. They should then perform a physical exam to see if the new or worsening depression could be caused by a health problem (such as hypothyroidism or a vitamin deficiency) or a medication the patient is taking.
After a complete exam, the doctor may provide a referral to a mental health worker, such as a social worker, mental health counselor, psychologist or psychiatrist. For many seniors, seeing a doctor who specializes in diagnosing and treating mental health issues in older people can be very beneficial. These physicians are called geriatric psychiatrists.
Everyone needs someone trustworthy to talk to. While antidepressant medications are often thought of as the go-to treatment for depression, anxiety and some other mental health issues, therapy can be a very beneficial nonpharmaceutical treatment option. There are many different types of therapy, and certain methods seem to work better for different people. For instance, support groups can provide new coping skills and social support for someone who is struggling with a major life change, such as a serious medical diagnosis or the loss of a loved one.
Several kinds of talk therapy are useful as well. One method, called cognitive behavioral therapy (CBT), aims to help patients end destructive patterns of behavior and modify their thoughts to be more positive. Another method, called interpersonal therapy, helps patients work to improve their relationships with others and strengthen and expand their support systems.
Most mental health professionals tend to combine different methods and approaches in the therapy they provide. The best way to find the right therapist is to be honest about your goals for these sessions and find a therapist you are comfortable talking to. Referrals can come from physicians, family, friends or even online directories.
Antidepressant drugs can also help to improve mood, sleep, appetite and concentration. There are several types of these medications available. Many doctors start by prescribing a type of drug called a selective serotonin reuptake inhibitor (SSRI), such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil) or sertraline (Zoloft). SSRIs cause fewer side effects compared to other types of antidepressants, and they help regulate serotonin, a neurotransmitter in the brain that controls emotion.
Another class of antidepressants is serotonin and norepinephrine reuptake inhibitors (SNRIs). SNRIs include venlafaxine (Effexor), desvenlafaxine (Pristiq) and duloxetine (Cymbalta). This type of antidepressant is similar to SSRIs but it also regulates another neurotransmitter in the brain called norepinephrine, which is responsible for controlling responses to stressors. Other classes include tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). In some cases, doctors prescribe atypical antidepressants that affect one’s brain chemistry but do not fit into the aforementioned categories.
Some of these medications can take up to 12 weeks to reach their full effectiveness. In addition, some older antidepressants (TCAs) can cause unwanted side effects, but newer medicines like SSRIs tend to have fewer drawbacks. To avoid this problem, the prescribing doctor must know about all prescription and over-the-counter medications, vitamins, and herbal supplements a patient is taking. The same goes for any physical and additional mental health issues. These factors are vital because they influence which antidepressant the doctor believes will be the most effective and yield the least serious side effects.
People who suffer from depression can greatly benefit both mentally and physically from a regular exercise regimen. Even mild exercise like walking outdoors or in a shopping mall, gardening, dancing, and swimming are excellent options. Regular physical activity releases endorphins and increases blood flow to the brain, resulting in improved mood and lower anxiety levels. Exercise may not be wholly effective for every person experiencing depression, but being physically fit and eating a balanced diet can help.
It can be difficult to be social and active when you’re depressed. Two of the hallmark symptoms of depression are a lack of energy and a loss of interest in activities. If your aging loved one is disengaged as well as depressed, it is important to encourage them to continue pursuing hobbies and activities they once loved. Whether it’s golf, a game of cards with friends, or watching a video with grandkids, having things to do can help keep negative thoughts at bay. Be sure to stay in touch with your loved one throughout the treatment process so they know they have someone who cares and is willing to listen and lend a helping hand. Social isolation often results when depressed individuals withdraw, but this lack of connection can also cause their condition to worsen.
With treatment, most people will find that positive thoughts will gradually replace the negative thoughts that resulted from depression. Usually, a combination of the above factors is the most effective. Feeling better takes time, but it can happen.