Treating depression in seniors

Knowing life has meaning helps older adults maintain their will to live.

BY: Jacqueline Oshiver, LCSW Princeton HealthCare System
    American folk artist Grandma Moses was in her 70s when she first started painting, demonstrating that life can be well-lived long into “the golden years.”
    Yet many people struggle with depression as they grow older and believe, unfortuntely, that feeling sad is a normal part of aging. While we all experience feelings of sadness and unhappiness throughout our lives, depression and growing old do not go hand-in-hand.
    This week is Mental Illness Awareness Week, sponsored by the National Alliance on Mental Illness to raise awareness about mental health disorders and treatment.
    Mental illness and depression do not discriminate. In fact, depression is one of the most commonly diagnosed psychiatric disorders among all populations, regardless of age.
    However, depression affects 15 out of every 100 adults over the age of 65 in the United States. That equals an estimated 2 million individuals in this age group who have a diagnosable depressive illness, according to the Geriatric Mental Health Foundation.
    Moreover, depression affects approximately 25 percent of those with chronic illness and is particularly common in patients with ischemic heart disease, stroke, cancer, chronic lung disease, arthritis, Alzheimer’s disease and Parkinson’s disease.
    Perhaps most concerning is that depression affects almost 50 percent of nursing home patients, according to the foundation.
    The statistics are significant and an important reminder that in addition to physical health, older adults must take care of their mental health, too.
    Causes of depression in older adults vary greatly, but often center on loss:
    • Loss of friends and family either through relocation or death.
    • Retirement or loss of structure that working provided for many people.
    • Loss of physical abilities because of illness or injury.
    Additionally, women of all ages are more at risk for depression, and older adults without strong social support are also at higher risk than they would be otherwise.
    Too often depression goes undiagnosed because it is overshadowed by physical illness, and the focus on the physical symptoms can mask symptoms of mental illness. Yet it’s especially important to recognize mental illness in older adults because depression can worsen physical ailments and make it harder for people to recover.
    Symptoms of depression in older adults include:
    • Persistent sadness lasting two or more weeks.
    • Difficulty sleeping or concentrating.
    • Feeling slowed down.
    • Withdrawing from regular social activities.
    • Excessive worrying about finances and health problems.
    • Changes in weight or appearance.
    • Changes in eating habits.
    • Pacing and fidgeting.
    • Feeling worthless or helpless.
    • Thoughts of suicide or death. The rate of suicide among older adults is higher than that for any other age group, and the suicide rate for people over age 85 is the highest of all, twice the overall national rate, according to the Geriatric Mental Health Foundation.
    In addition to the help that physicians may offer, friends and family play a key role in preventing and recognizing depression in older adults. Showing interest in an older adult can go a long way in making them feel important and cared for. A simple “How are you feeling?” or “How was your day?” shows a loved one that you’re interested in his or her well being.
    Like all of us, older adults need human contact. A social environment and staying active — even if it’s just a short walk outside or exercises while sitting in a chair in the living room — benefits mental health.
    Yet many older adults may not have close friends or family. In those cases, it is even more important for a physician or other care provider close to the patient to refer them or help.
    If you suspect that an older loved one may be suffering from depression, you should consider seeking help from a professional counselor who can assess your loved one’s condition and make recommendations for treatment.
    Psychotherapy is a common treatment for older adults with depression and may include a variety of approaches — such as cognitive behavioral therapy, interpersonal therapy and family therapy — that will help the patient recognize and cope with the stressors in his or her life. These strategies should help the individual to develop positive solutions to problems and challenges.
    Additionally, reminiscence therapy, or a life review process, helps older adults remember the good times in their lives and assists them in recognizing that their lives have meaning. Knowing life has meaning helps older adults maintain their will to live.
    In some cases, treatment may require medication, partial hospitalization or inpatient hospitalization, in the most serious situations.
    Princeton HealthCare System through Princeton House Behavioral Health offers a variety of programs tailored to older adults, including a partial hospitalization program called Senior Link specifically for older adults suffering from depression, major anxiety and other mood disorders. Senior Link is an active treatment program staffed by trained and licensed professionals, including psychiatrists who specialize in geriatrics.
    Patients attend Senior Link four to five days a week. The day consists of group activities such as psychotherapy groups, psychoeducational groups and activity groups. Patients benefit from interactions with other older adults who have similar problems. Because Senior Link is a hospital-based program, patients have access to a variety of services, medical and psychiatric.
    For more information about Senior Link at Princeton House Behavioral Health in Princeton, call 609-497-3343.
Jacqueline Oshiver, LCSW, is the site director at the Mount Lucas Site of Princeton House Behavioral Health.