What to consider if you think an older adult is depressed . . .

by Suzanna Waters-Castillo

Many of us have parents, siblings, and friends that are reaching their older years, and we may be concerned about their mental health or mood. As people age, we all need to know that depression is not normal for this age group and can cause significant distress, especially if left untreated.

Older adults who are depressed may not feel sad about anything in particular, but rather may say things like, “It’s too much trouble,” “I don’t feel like getting up or going out,” or “I just don’t have the energy.” They may also neglect their grooming, cook and eat less, and not keep up normal routines.

Although depression can occur without any apparent reason and is often caused by biological changes in the brain, with older adults there can also be such contributing factors as the loss of a spouse; financial difficulties; or a serious medical condition, especially one that goes unrecognized because the individual assumes they’re simply feeling lethargic or uninterested in life. Here are the most common symptoms of geriatric depression:
* feelings of apathy
* withdrawal from social activities
* excessive worries about health and financial problems
* frequent tearfulness
* ongoing feelings of worthless or helplessness
* sudden weight change
* insomnia
* pacing and fidgeting, difficulty concentrating, and
* sadness that lasts two weeks or more.

Fortunately, the health community now has effective approaches for treating geriatric depression, including:
* psychotherapeutic approaches such as cognitive-behavioral therapy and behavioral activation;
* a class of medications called selective serotonin reuptake inhibitors (SSRI) which increase the level of neurotransmitters in the brain. Some of the trade names for these medications are Zoloft, Prozac and Asentra.

If you recognize symptoms or suspect clinical depression it is important that the older adult see their primary care physician for a complete physical checkup. If the person is apathetic, confused, or agitated it is best to have a caring person accompany them to the doctor. If an anti-depressant is prescribed, be sure to discuss instructions for the medication with the person and point out that continued use is necessary to achieve the maximum benefit.

One reason that anti-depressants don’t always work for this age group is that older adults may not take them long enough. It typically takes older adults longer to experience results, sometimes as long as 12 weeks. It is also important to remind your parent or friend that anti-depressant medications are not addictive.

Treating depression can lead to improved quality of life for the individual, their family, and the other people they see frequently.

Dr. Waters-Castillo directs Continuing Studies’ aging and long-term care programs, including the Mental Health and Older Adult Certificate, which train professionals in best practices for working in this growing area.