Treatment Options for the Depressed Elderly Patient

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.

What to Expect When Seeking Help For Elderly Depression

Whether you realize yourself that something is amiss or you are visiting your physician at the urging of a trusted friend, family member or perhaps caregiver, what to expect when seeking help for elderly depression is most likely on the forefront of your mind. Perhaps no other medical condition is so fraught with stigma and lore as that of depression and thus it is not at all surprising to have been exposed to a plethora of urban legends and other less than believable statements about potential treatment options.

Fortunately, seeking help for elderly depression is much like seeking help for any other ailment that is not readily visible to the naked eye. For example, when you have a wound or broken bone, the damage is usually visible to even the most novice of treating interns and thus very little background information is required. Yet an illness such as Lupus or type 2 diabetes requires a bit more background and will require the doctor to investigate a number of possible avenues prior to successfully and assuredly diagnosing the illness.

The same holds true for depression. It cannot be readily seen with the naked eye and thus it needs to be ferreted out by something akin to a process of elimination. Consider the fact that fatigue which you are experiencing may also be a secondary symptom for other illnesses, and thus your physician wants to make sure that she or he does not treat you for one problem when in truth you are actually suffering from another!

Your doctor's appointment will most likely start with a full physical examination that includes blood work. The doctor will sit down with you and ask you about your symptoms, when they began, for how long you have noticed them, whether or not they appear to change in severity, and if you have ever experienced something like them before in your life. If you have a history of bouts with depression, your doctor will also ask you what treatments have helped you in the past, and which did not seem to do the trick.

Furthermore, your physician will ask about your family's medical history, and may also begin a rudimentary assessment with respect to your memory, any loss thereof, your current frame of mind, and also what your goals are. She or he will answer any and all questions you may have with respect to elderly depression and you will be surprised to learn just how much this information differs from that which you may have overheard at the church social.

Your primary care physician will then most likely refer you to a psychiatrist or perhaps a psychologist. Even though your doctor does have the power to prescribe medication and monitor its effectiveness, there is little reason to not have a specialist do so. Just like you would not take your cherry red Corvette convertible to a Volvo mechanic for a tune up, you should also not consider it odd to have your depression treated by someone who has undergone special training in the field! Instead, if your physician appears unsure how to proceed, ask for the referral yourself. You may be pleasantly surprised to have a psychiatrist refer you to a psychologist for talking therapy rather than prescribe any antidepressants!