Uticopa Blog

Diagnosing depression in the elderly

Before being diagnosed with depression, elderly adults should be screened for common health issues that can affect mood. These include:

• Hormonal imbalances
• Thyroid problems
• Vitamin B12 deficiency
• Other nutritional deficiencies
• Electrolyte imbalances or dehydration

Getting professional help for depression

While support and self-care can help depressed older people, professional help should also be pursued. If you see the signs and symptoms of depression in yourself or an older relative, make an appointment with a doctor or mental health therapist for a thorough evaluation. This is particularly important since many medical conditions, medicines, and even certain physiological changes of ageing can cause depression or compound the problem.

Illness and depression

When undergoing evaluation for depression, long-term or severe health issues should also be taken into account. Chronic medical conditions, particularly those that are painful, disabling, or life-threatening, can understandably lead to depression. Illnesses that affect the brain can also cause depression through the disease process itself.

Some medical conditions that commonly affect older people can also trigger depression. These include:

• Heart attack + heart disease 
• Parkinson’s disease 
• Stroke 
• Alzheimer’s
• Multiple sclerosis 
• Cancer
• Diabetes

Depression caused by medicines

All medicines have side effects, but some can actually cause symptoms of depression or make a pre-existing depression worse. Harmful drug interactions or a failure to take a medicine as prescribed can also contribute to depression. For elderly individuals with multiple prescriptions, the risk of medication-induced depression is particularly high.

• Medications that can induce depression include:
• Steroids
• Painkillers
• Hormones
• Arthritis medicinesHigh blood pressure drugs
• Heart disease medicines
• Tranquilizers
• Cancer drugs

Your doctor can help you determine if any of your prescriptions are causing your depression symptoms.

Treatment options for the elderly

Depression treatment is just as effective for elderly adults as it is for younger people. Therapy, support groups and medicines can all help relieve symptoms. However, health issues should always be considered in an older adult’s treatment plan.

Any medical issues complicating the depression must be addressed and resolved. For example, many older people suffer from chronic pain. Pain that interferes with daily activities can prevent depression recovery, so it must be managed as part of the treatment plan.

Anti-depressant treatment

Anti-depressant medicines may help ease the symptoms of depression in the elderly. However, if the depression is due to loneliness, poor health, or other lifestyle issues, medicine may not be the best choice.

Anti-depressant use in older adults also comes with safety concerns. So, it’s important to be aware that older adults are more sensitive to drug side effects and vulnerable to interactions with other medicines they might be taking. Depressed older people may also forget to take their medicines. Furthermore, recent studies have found that drugs such as Prozac can cause rapid bone loss and a higher risk of fractures and falls. Because of these risks, elderly adults on anti-depressants should be carefully monitored.

Counselling and therapy

Studies have found that mental health therapy works just as well as medicine in relieving mild to moderate depression. And unlike anti-depressants, therapy also addresses the underlying causes of the depression.

• Supportive counselling can include religious and peer counselling. It can help ease loneliness and the hopelessness of depression.
• Psychotherapy can help older people work through stressful life changes, heal from losses, and process difficult emotions. 
• Cognitive behavioural therapy (CBT) can help older people change negative thinking patterns, deal with problems in healthy ways and develop better coping skills.
  
• Support groups for older people for depression, illness or bereavement can connect them with others who are going through the same challenges. They are a safe place to share experiences, advice, and encouragement.

Dementia vs. depression

Never assume that a loss of mental sharpness is just a normal sign of old age. It could be a sign of depression or dementia, both of which are common in the elderly. But since depression and dementia share many similar symptoms, including memory problems, sluggish speech and movements, and low motivation, it can be difficult to tell the two apart. There are, however, some differences that can help you distinguish between the two.

Symptoms of Depression:

• Mental decline is rapid
• Knows the correct time, date, and where he or she is
• Difficulty concentrating
• Language and motor skills are slow, but normal
• Notices or worries about memory problems

Symptoms of Dementia

• Mental decline is slower
• Confused and disoriented; becomes lost in familiar locations
• Difficulty with short-term   memory
• Writing, speaking, and motor skills are impaired

Whether the cognitive decline is caused by dementia or depression, prompt diagnosis and treatment are key. If it’s depression, memory, concentration, and energy will bounce back with treatment. Treatment for dementia will also improve your or your loved one’s quality of life. And in some types of dementia, symptoms can be reversed, halted, or slowed.