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Depression in the Elderly
Some people have the mistaken idea that it is normal for the elderly to feel
depressed. On the contrary, most older people feel satisfied with their lives.
Sometimes, though, when depression develops, it may be dismissed as a normal
part of aging. Depression in the elderly, undiagnosed and untreated, causes
needless suffering for the family and for the individual who could otherwise
live a fruitful life. When he or she does go to the doctor, the symptoms described
are usually physical, for the older person is often reluctant to discuss feelings
of hopelessness, sadness, loss of interest in normally pleasurable activities,
or extremely prolonged grief after a loss.
Recognizing how depressive symptoms in older people are often missed, many
health care professionals are learning to identify and treat the underlying
depression. They recognize that some symptoms may be side effects of medication
the older person is taking for a physical problem, or they may be caused by
a co-occurring illness. If a diagnosis of depression is made, treatment with
medication and/or psychotherapy will help the depressed person return to a happier,
more fulfilling life. Recent research suggests that brief psychotherapy (talk
therapies that help a person in day-to-day relationships or in learning to solve
problems of everyday life) is effective in reducing symptoms in short-term depression
in older persons who are medically ill. Psychotherapy is also useful in older
patients who cannot or will not take medication. Efficacy studies show that
late-life depression can be treated with psychotherapy. Improved recognition
and treatment of depression in late life will make those years more enjoyable
and fulfilling for the depressed elderly person, the family, and caretakers.
In a given year, between one and two percent of people over age 65 living in
the community, i.e., not living in nursing homes or other institutions, suffer
from major depression and about two percent have dysthymia. Depression, however,
is not a normal part of aging. Research has clearly demonstrated the importance
of diagnosing and treating depression in older persons. Because major depression
is typically a recurrent disorder, relapse prevention is a high priority for
Suicide is more common among the elderly than in any other age group. Research
has shown that nearly all people who commit suicide have a diagnosable mental
or substance abuse disorder. In studies of older adults who committed suicide,
nearly all had major depression, typically a first episode, though very few
had a substance abuse disorder.
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