How to Treat and Support Older Adults with Depression

Within the older adult community, depression is one of the most widespread disorders. Yet, it often goes undiagnosed and therefore untreated. In addition to symptoms and signs of depression that may hinder the normal functioning of daily life, individuals diagnosed with depression also experience a higher risk of developing other physical and mental illnesses. 

Risk Factors

Although depression is an indiscriminate mental condition—meaning that anyone could experience it during their lifetime—individuals with the following conditions have a higher chance of developing depression.

• Medical conditions, such as stroke, cancer, brain disease, etc.

• Use of certain medications, such as those that treat acne, high blood pressure, high cholesterol, and oral contraceptives

• Addiction and/or alcoholism, substance misuse

• Family members with a history of depression

• Sleep problems

• Lack of exercise and/or physical activity

• Functional limitations, such as locomotor disabilities, that make engaging in activities of daily living difficult

• Social isolation and loneliness

• High levels of stress or have experienced stressful events such as loss of a partner, divorce, or being responsible for caretaking someone with chronic illness

Treatment Methods

As it is a medical condition, depression can be treated regardless of severity. It is important for individuals and/or their caretakers to recognize the signs and seek help and treatment from mental health professionals as soon as possible. According to a survey conducted by Mental Health America, more than 55% of older adults seeking mental health services received care from primary care physicians, while less than 3% of individuals aged 65 and older received treatment from mental health professionals. This can be problematic as primary care physicians accurately recognize less than half of patients with depression, which may result in decreased function and prolonged length of hospitalization after diagnosis. Below are several common methods of treating depression in older adults.

• Psychotherapy — Often also called “talk therapy,” psychotherapy is the treatment of depression through verbal and psychological methods. There are distinctive branches of psychotherapy that target different areas of one’s daily functioning, such as cognitive behavioral therapy, psychodynamic therapy, problem-solving therapy, interpersonal psychotherapy, and more. This treatment method is often used for patients experiencing lengthier depressive episodes and often used in conjunction with medication.

• Pharmacotherapy — This is the use of prescription medication, mainly SSRIs and antidepressants, to treat depression by balancing hormones that may affect one’s mood. It is often effective and results in no complications when used for acute episodes, not only for primary depression but also depression associated with medical conditions like cancer or heart and pulmonary diseases. It is strongly recommended that individuals seek professional assistance when considering treatment through medications.

• Electroconvulsive therapy (ECT) — This is the first option when patients have not responded to psychotherapy and pharmacotherapy, during which electrodes are placed on either side of the patient’s head to pass a mild electric current through the brain. Often used with patients older than age 60, those with delusions, psychomotor retardation, early morning awakening, and a family history of depression are most likely to benefit from this form of treatment. ECT is an effective short-term treatment but has shown to have higher relapse rates after six to twelve months. Patients with higher medication resistance also experience higher relapse rates following ECT.

• Collaborative treatment — These are programs featuring the collaboration between trained psychiatrists, primary care physicians, mental health specialists, and patients, providing treatment methods incorporated into the patient’s daily caretaking routine. Studies have shown that these treatment methods yield higher rates of success because they are administered in the older adult’s primary care setting.

The support of family members and/or caretakers before and after diagnosis are equally important and impactful. While professional diagnosis and treatment are essential for complete recovery, remember to be aware of your loved one’s physical limitations and individual preferences. Older adults are more sensitive toward lifestyle changes and, on average, less open to interventions with their lifestyle. It is important to remain tactful, respectful, and supportive before and during the diagnosis and treatment process.

If you’ve been experiencing these symptoms yourself, or if you’ve noticed elderly family members and/or loved ones around you that have been exhibiting similar behavior, contact a mental health care professional and/or facility to ensure treatment and support is available to them as soon as possible.

— Ariel Shih