Depression in the Elderly Essay

Depression in the Elderly Essay

Depression in the Elderly Essay

Depression is a mood disorder that inculpates persistent loss of interest and feelings of sadness. Depression is associated with significant morbidity and mortality. For instance, major depressive disorder is graded as the third cause of the burden of disease globally (Bains & Abdijadid, 2021). Furthermore, the condition considerably contributes to suicide, disruption of interpersonal relationships, substance abuse, and adverse health outcomes. The prevalence of depression among the elderly in the US is estimated at 5% to 10% (Cheruvu & Chiyaka, 2019). The purpose of this paper is to focus on depression in the elderly including its presentation, consequences, and therapy.

How Would You Know If An Elderly Relative Had Clinical Depression Or Was Sad Because Of Specific Life Changes And Losses?

Clinical depression can be detected by a combination of clinical manifestations on the background of risk factors for depression. According to Maier et al. (2021), risk factors for depression in the elderly include bereavement, unresolved grief, social isolation, physical impairment, somatic diseases, poor nutrition, chronic stress, history of trauma, female gender, and personality traits such as low self-directedness and high neuroticism. Subsequently, an elderly individual with the aforementioned risk factors is highly predisposed to depression. Clinically, an elderly relative with depression will manifest as depressed mood, loss of interest, fatigue, loss of energy, feeling of worthlessness, sleep disturbances, poor concentration, recurrent thoughts of death,  and psychomotor agitation(Cheruvu & Chiyaka, 2019). According to American Psychiatric Association (2013), at least 5 of the above symptomatology must be present for at least 2 weeks with at least one of the symptoms being depressed mood or diminished pleasure. However, it is consequential to note that elderly patients with depression may also present with somatic such as fatigue, abdominal distress, headache, or weight change, thus, a high index of suspicion must be maintained.

Consequences of Depression in the Elderly

Clinical depression is a major cause of morbidity and mortality in the elderly. If left unattended, clinical depression presents devastating consequences to the elderly. Firstly, clinical depression affects the physical health of the individual. It interferes with the decision-making ability of the individual with resultant difficulties in coping with illnesses and abiding by physician’s instructions. Secondly, depression impairs sleep which causes daytime fatigue and impairs the thinking and concentrating capacity of the individual. Additionally, clinical depression affects family and social relationships since depressed individuals are stressful and difficult for friends and family members which disrupts marital harmony. Depression also predisposes to maladaptive behaviors and substance abuse. For instance, depressed individuals have an increased risk of engaging in heavy alcohol intake as well as other illicit drugs. Besides, depression in the elderly carries a high risk of suicide. Bains and Abdijadid (2021) estimate a 20% lifetime risk of committing suicide as a result of depression. Finally, depression results in functional impairments in work, family, and social life. For instance, Bains and Abdijadid (2021) attribute an annual 200 million days lost from work to clinical depression. Consequently, clinical depression in the elderly impairs their physical, cognitive, and functional aspects of life as well as the general quality of life.

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Behaviors That Indicate A Person Going Through Depression Needs Therapy

Persons with clinical depression require treatment due to worse outcomes of untreated depression. Cheruvu and Chiyaka (2019) emphasize the significance of early recognition, intervention, and support of persons with clinical depression as this is associated with up to 80% treatment prosperity. Consequently, subtle behaviors indicating depression must be recognized early to avoid treatment delays. For instance, an individual who frequently exhibits the following behaviors should be evaluated for possible treatment of depression. Frequent lack of pleasure in doing activities, feeling of hopelessness, low mood, excessive sleepiness, trouble falling asleep, self-harm, suicidal thoughts, excessive drinking, anorexia or overeating, poor concentration, increasing difficulty meeting demands of work, home, school, or social life, and feeling of worthlessness(Avasthi & Grover, 2018).

Type of Therapy a Professional Would Recommend

Therapeutic management of clinical depression involves both pharmacological and nonpharmacological approaches. Pharmacological management is principally by antidepressants including selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, serotonin modulators, atypical antidepressants, monoamine oxidase inhibitors, and tricyclic antidepressants. It is important to note that all the antidepressants are equally effective but individual side effects differ(Avasthi & Grover, 2018). On the other hand, nonpharmacological approaches include psychotherapy and electroconvulsive therapy. Psychotherapy encompasses cognitive behavioral therapy and interpersonal therapy. A professional would recommend a  combination of both psychotherapy and pharmacological therapy. According to Avasthi and Grover (2018), combination therapy is more effective than monotherapies. Finally, in addition to the above measures, lifestyle modifications and social support must also be integrated into the treatment for superior outcomes.

Conclusion

Clinical depression is a common cause of morbidity in the elderly. The presentation of clinical depression is highly variable and a high index of suspicion must be maintained. Early recognition, intervention, and support for patients with clinical depression are associated with good outcomes. Finally, treatment of depression must integrate pharmacological, psychotherapy, social support, and lifestyle modifications.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5 (R)) (5th ed.). American Psychiatric Association Publishing. https://doi.org/10.1176/appi.books.9780890425596

Avasthi, A., & Grover, S. (2018). Clinical practice guidelines for the management of depression in elderly. Indian Journal of Psychiatry, 60(Suppl 3), S341–S362. https://doi.org/10.4103/0019-5545.224474

Bains, N., & Abdijadid, S. (2021). Major Depressive Disorder. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559078/

Cheruvu, V. K., & Chiyaka, E. T. (2019). Prevalence of depressive symptoms among older adults who reported medical cost as a barrier to seeking health care: findings from a nationally representative sample. BMC Geriatrics, 19(1). https://doi.org/10.1186/s12877-019-1203-2

Maier, A., Riedel-Heller, S. G., Pabst, A., & Luppa, M. (2021). Risk factors and protective factors of depression in older people 65+. A systematic review. PloS One, 16(5), e0251326. https://doi.org/10.1371/journal.pone.0251326

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How would one know if an elderly relative had clinical depression or was sad because of specific life changes and losses?
What are the consequences of depression in the elderly?
Which behaviors would indicate a person going through depression needs therapy?
What kind of therapy would a professional recommend and why?