Doctors may design a treatment plan that focuses on several key treatment options when addressing the needs of their elderly patients.
Treatments have been shown to be very effective for the older patient if the diagnosis is made early on in the depression. It must be noted that treatment does take longer to have an effect on the elderly and combating the potential increased risk for suicide must be addressed and headed off by any medical profession coming into contact with the elderly.
Treatment options are effective solo or in combination with each other. The various methods of treatment are as follows:
Antidepressants:
Medications in this category have been shown to be very effective in the treatment of depression in the elderly patient. The risk of potential side-effects or adverse reaction to other medications that they are taking is great and must be guarded against.
Caution must be exercised if prescribing any of the older antidepressants such as amitriptyline or imipramine as they can have a sedating effect that will cause a sudden drop in blood pressure. This sudden drop in blood pressure can lead to fainting and the risk for falls and fractures. A sudden drop in blood pressure is also not desired in the individual with a history of cardiac disease.
Psychotherapy:
Self-help or group therapy has been shown to be very effective in the older individual suffering from depression. Support from family and friends are also critical to the well-being of the depressed elderly individual. Psychotherapy is indicated when medications are refused or counterindicated. Drug therapy in combination with psychotherapy increases the effectiveness of the psychotherapy.
Electroconvulsive Therapy (ECT):
This treatment option can play an important role in the recovery process for those who are elderly and depressed. It is especially useful when an elderly individual is unable to take medications due to reactions with other drug therapy they are undergoing.
ECT involves sending electronic current through a portion of the brain for a brief period of time. This treatment option is usually utilized when the patient is faced with a life threatening depression or when the patient has no other options such as medications to turn to for relief or when medications have not been effective in bringing adequate relief.
The electrical stimulation from ECT causes an approximate 30 second seizure withing the brain. Several sessions of ECT are required to receive the desired benefit from the treatment.
ECT may cause some memory impairment following the treatments.
Difficulties Encountered With Treatment:
The generations of elderly patients that are currently being seen are those for whom the stigma of mental illness had the greatest impact. Mental illness among family members was hushed and ignored even to the point of shunning the depressed member. Mental illness was seen as a sign of weakness of character and not a disease. This stigma creates a hesitancy to report symptoms of depression or to seek medical attention. This puts pressure on the medical professional to recognize the signs and symptoms and then to initiate the conversation about the possibility of depression in a manner that will elicit the greatest possibility of success.
The lack of understanding regarding depression in the elderly and the successful cure rate also keeps people ignorant of the possibilities.
The elderly individual may also hesitate to contact a doctor regarding depression in fear of the potential medication cost. Many of our elderly citizens are already faced with an overwhelming prescription cost crisis and adding to it will be an understandable fear.
It should also be realized that any alcohol or other chemical substance abuse can severely hinder the effectiveness of depression medications.
