Depression in Older Adults

The purpose of this article is to address selected aspects of depression in older adults. Specifically, symptoms, risk factors, diagnosis, and interventions for depression in older adults are reviewed. ********** Ageism can influence the diagnosis of depression in older adults because of a tendency of society to dismiss the "old person" as just being "grumpy." However, some older adults do experience depression that needs to be diagnosed and treated (Boyd & Bee, 2006). One needs only to review the cases in nursing and convalescent homes, hospitals, and senior citizen centers to recognize that crises arise for older adults as frequently and are experienced as intensely for these individuals as for people at any other age. The nature of the crises of older adults is similar to that of crises of individuals at other ages, but there is a special quality that derives from age itself. Most often this lies in the combined impacts of loneliness from losses of family members and friends, the need to adapt to deteriorating physical capacities, and the lack of treatment and diagnosis of depression in older persons (Serby & Yu, 2003). Among other factors, the high rate of suicide among older people in the United States urges mental health professionals and families to take depression and related symptoms among older adults seriously (Erber, 2005). In fact, the National Institute of Mental Health (NIMH; 2003) reported that compared with 13% of the total U.S. population, 18% of individuals 65 years and older commit suicide. Furthermore, White men who are 85 years old or older are among the individuals with the highest suicide rates. Despite these alarming rates, Duberstein and Conwell (2000) suggested that with proper and more vigilant attention to the signs and symptoms of depression, some of these suicides could be prevented. Persons who are 65 years and older tend to be vulnerable to chronic or episodic depression (Boyd & Bee, 2006). Depression among older adults can be the consequence of many factors including stress and impairment, medical conditions, relational problems, and loss of family and friends (Kraaij & Garnefski, 2002; Lynch, Compton, Mendelson, Robins, & Krishnan, 2000). Depression among older persons can also occur in response to chronic physical impairments. LaRue (1992) reported that about 80% of older persons have at least one chronic condition. These chronic conditions can consequently add to one's emotional distress or depression. For example, Serby and Yu (2003) noted in their study that 40% of adults with Parkinson's disease, 20%-25% of those who have had a stroke, 15%-20% of those who have Alzheimer's disease, and 50% of patients with dementia have significant levels of depression. Other comorbid medical conditions include cancer, neurological disorders, various metabolic disturbances, arthritis, cardiovascular disease, and sensory loss (NIMH, 2003). The overlapping of such negative symptoms with depression makes assessing and, thus, treating depression a challenging task. Descriptions of older adults as anxious, sad, disabled and frail represent a common misconception within society (Knight, 2004). Associated with these notions is the belief that aging and frailty are associated with multiple physical and emotional problems. Also, it is expected that older adults should be happy and stay active. These societal attitudes may affect the way older adults feel about themselves and express their emotions and thoughts, and they may even influence the disturbing rates of depression and suicide among this demographic. These stereotypes about aging do not necessarily represent the reality of the aging process. Being constantly depressed and mentally debilitated is not normal or natural at any age. Hence, it is crucial for all helping professionals to understand and possibly reconstruct their own perceptions about the mental health of older adults. In addition, helping professionals need to consider and have a deeper knowledge about the symptoms, risks, diagnosis, treatment, and interventions of depression in older adults. …