Depression in the Elderly (cont.)

When is electroconvulsive therapy (ECT) used?

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, or when depression is very severe and interferes with basic daily functioning (such as eating, bathing and grooming), ECT is often a safe and effective treatment alternative.

What 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. This stigma can keep elderly people from acknowledging that they are depressed, even to themselves. Elderly people and their families sometimes also may wrongly misidentify depression symptoms as "normal" reactions to life stresses, losses, or the aging process.

Also, depression may be expressed through physical complaints rather than traditional symptoms. This 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 cause or worsen depression and 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

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.

MedlinePlus: "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 Joseph Goldberg, MD on May 17, 2012


Medically Reviewed by a Doctor on 5/17/2012

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