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February 10, 2012

Depression in the Elderly (cont.)

Who may benefit from electroconvulsive therapy (ECT)?

ECT can play an important role in the treatment of depression in older adults. When older patients are unable to take traditional antidepressant medicines because of side effects or interactions with other medications, ECT is an effective alternative.

What other problems affect treatment of depression in the elderly?

The stigma attached to mental illness and psychiatric treatment is even more powerful among the elderly than among younger people. That kind of thinking is also often shared by members of the patient's family, friends, and neighbors. This stigma can keep elderly patients from acknowledging they are depressed, even to themselves.

Depression may be expressed through physical complaints rather than traditional symptoms. That delays appropriate treatment. In addition, depressed older people may not report their depression because they believe there is no hope for help.

Elderly people may also be unwilling to take their medicines because of side effects or cost. In addition, having certain other illnesses at the same time as depression can interfere with the effectiveness of antidepressant medicines.

Alcoholism and abuse of other substances may interfere with effective treatment. And unhappy life events -- including the death of family or friends, poverty, and isolation -- may also affect the person's motivation to continue with treatment.

WebMD Medical Reference

Reviewed by Amal Chakraburtty, MD, on September 12, 2009

© 2010 WebMD, LLC. All rights reserved.

SOURCES:

National Institute of Mental Health: "What Is Depression?"

FDA: "The Lowdown on Depression."

American Psychiatric Association, Practice Guideline for the Treatment of Patients with Major Depression, 2000.

Medline Plus: "Depression - Elderly."

MedlinePlus: "Insomnia prolongs depression in the elderly."

SAMHSA: "Depression among adults."

National Institute of Mental Health: "Older Adults: Depression and Suicide Facts."

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR, American Psychiatric Pub, 2000.

Fieve, R. Bipolar II, Rodale Books, 2006.

Reviewed by Amal Chakraburtty, MD, on September 12, 2009

© 2010 WebMD, LLC. All rights reserved.


Last Editorial Review: 9/12/2009



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