Late Life Depression
Most older persons are satisfied with their lives and are not psychologically predisposed to depression. Nevertheless, some experience a demoralization and despair resulting not only from incapacities due to aging but also from a sense of not having fulfilled their life expectations (e.g., leading up to and/or after retirement).
Geriatric depression can occur when older persons need to adapt to many adverse life experiences. They must adapt especially to the losses of relatives and friends. In these circumstances, they often appear to respond to these losses without difficulty compared to persons who are younger. This in part is because older persons, for example, expect that they will lose family and friends through death, and those family and friends whom they do lose often have suffered chronic illnesses for some time, thus allowing older persons to grieve the loss, in part, before the actual loss.
As a result, an adjustment disorder with depressed mood secondary to physical disability and/or chronic illness is among the most frequent causes of depressed mood among older individuals. Geriatric depression is often accompanied by anxiety symptoms and/or insomnia.
Source of late-life depression:
- Loss of a relationship
- Loss of body parts or function
- Loss of control or independence
- Chronic pain
Characteristics of older adults with depression
- Do not complain of depression spontaneously
- Lose weight but rarely gain weight
- Complain of insomnia but rarely of sleeping too much
- Complain of problems with concentration and memory loss
- Test positive for impairment on psychological testing
- Suffer from loss of interest in previously pleasurable activities
- May exhibit psychotic symptoms more than middle-aged adults
Consequences of depression
- Poor compliance, nutrition, hygiene, and giving up
- Passive or active suicidality
Interventions and how to treat depression
- Listen and understand
- Encourage expression of sadness/grief related to illness
- Offer specific and realistic reassurance
- Emphasize a constructive treatment plan
- Mobilize the patient’s support system
- Combat learned helplessness
- Elicit expression of preferences, encourage active steps
- Psychiatric consultation for medications or TMS
- Persistent and out of proportion symptoms or suicidality
Our geriatric psychiatrist, Dr. David Merrill, offers kind, compassionate, thorough clinical evaluations and follows depression treatment guidelines, helping the patient to stay connected with the activities and people who matter to them. Contact us at 310-582-7641 to schedule a consultation.
Depression and anxiety can affect everyone and may manifest in addiction disorders to alcohol, drugs or prescription medications. Dr. Keith Heinzerling is an addiction medicine specialist who treats adults of all ages. Patients with depression, anxiety, PTSD, end-of-life distress, chronic pain, drug/alcohol problems, and other conditions may be eligible for psychedelic-assisted therapy with ketamine.
If you or someone you know is in crisis, call the National Suicide Prevention Lifeline (Lifeline) at 1-800-273-TALK (8255), or text the Crisis Text Line (text HELLO to 741741). Both services are free and available 24 hours a day, seven days a week. The deaf and hard of hearing can contact the Lifeline via TTY at 1-800-799-4889. All calls are confidential. Contact social media outlets directly if you are concerned about a friend’s social media updates or dial 911 in an emergency. Learn more on the Lifeline’s website or the Crisis Text Line’s website.