Depression Treatment For Elderly People
Depression in older adults can deteriorate their health and increase the risk of dying. It is crucial that they see their doctor to ensure they receive the correct treatment.
There are a variety of factors that can make it difficult to diagnose depression in older adults. Some of these include misdiagnosing depression symptoms as part of aging or concealing them due to co-existing medical conditions, a lack of support from others and stigma.
Antidepressants
Antidepressants are often the initial step in treatment for many cases. These medications can increase neurotransmitters inside the brain and improve mood and also reduce symptoms of depression. These drugs are usually used in conjunction with psychotherapy. It could take several weeks before they start to work.
Elderly patients with depression must be evaluated for any other co-morbidities and be treated accordingly. Many times, medical conditions like stroke, heart disease and chronic pain cause depression in patients who are older. They may be more susceptible to adverse effects of certain medications.
The stigma of aging keeps people from seeking medical assistance for their emotional issues. Depression symptoms are often confused with other conditions such as eating or pain problems caused by dentures. These symptoms are made worse due to the lack of social support, and can be difficult to communicate with family members.
The vascular depression which occurs in older adults is more prevalent. This is due to a decrease of blood flow to the head. As compared to other types of depression, vascular depression is associated with more severe cognitive impairment and less responsiveness to treatment. This kind of depression is treatable with a variety of medications including SSRIs SNRIs TCAs.
The drugs used to treat depression among older patients must be tailored to the patient's needs, since they are more susceptible to adverse reactions. Doctors should begin with lower doses and build up gradually, taking into consideration the changes in pharmacokinetics that occur with age. They must also consider the impact other medications and supplements can have on the patient's response to antidepressants.
It is essential that doctors educate patients and their relatives about the symptoms of depression and treatment options. This will help patients comprehend their illness and adhere to their medication regimens. It is also important to let patients know about the time lag for the effects of antidepressants.
A thorough history is crucial for evaluating depression in the elderly. This should include information on the period of its onset, the relationship with other life stressors and previous episodes of depression. It is also essential to determine if the symptoms of depression are the result of medications or other health-related issues like menopausal or seasonal affective disorder.
Electroconvulsive Therapy
Electroconvulsive therapy, or ECT can help the brain perform a type of reset that helps reduce depression symptoms. It is typically prescribed to people who are not responding to medication or suffer from life-threatening and severe depression, such as those with suicidal thoughts or medical conditions that are dangerous. Medicare and most insurance companies cover ECT. It is typically administered in an hospital. You'll be given a general anesthetic while it's being performed and you'll not feel anything during the procedure. It may take six ECT treatments to treat your depression.
There is a possibility of experiencing confusion for several days or even hours after the treatment. It is possible to lose memory in the immediate aftermath of ECT. These issues are usually temporary. It could take a few weeks to start recalling. If you have a family history of cardiac disease, you could be at a higher risk of complications from ECT. People with preexisting cardiac ailments should stay away from ECT unless it's recommended by your doctor.
A recent study compared the risk of complications to the heart during ECT in patients with and without pre-existing heart disease. The researchers discovered that the rate of complications was significantly higher in the group with a pre-existing heart disease. The researchers suggested that a reduction in the use of ECT for elderly patients with heart disease may help lower the complication rate.
ECT is effective for a range of depressive disorders including unipolar, bipolar and mania. It can also be used to treat other mental disorders, including schizophrenia and psychosis caused by antiparkinsonian medications. It can also be used to treat severe dementia, especially when it is caused by a life-threatening condition.
If you're considering ECT or ECT, you and your doctor should complete a thorough psychiatric examination prior to having the procedure. Your doctor should review your medical records to determine if you suffer from any medical conditions that could impact your treatment. If you have a heart condition or other heart condition, your doctor may recommend an electrocardiogram (EKG) or chest X-ray prior to receiving ECT.
Psychotherapy
Depression in the elderly can be difficult to diagnose and manage. People who are older typically have a difficult time admitting to being depressed because of the stigma that comes with mental illness. They might be embarrassed to seek help, and may be afraid of being a burden to their families. Depression can also increase an older person's risk of developing heart disease and makes it harder to recover from other ailments. Psychotherapy is an effective treatment for depression in older adults.
Depression is a common disorder in the elderly, however the majority of patients aren't treated or diagnosed. This is due to a variety of reasons that include misdiagnosis, as well as inattention by healthcare professionals. Patients who are older may experience symptoms such as an apathy, lack of interest in their daily activities, sleep disturbances and frequent thoughts of death. These symptoms are often blamed on aging and dementia however, they are usually caused by depression.
A thorough examination should include an extensive history, a review of the response to previous treatments and laboratory investigations. A minimum number of tests should include a haemogram as well as liver function tests, kidney function tests and urine analysis. In the case of a possible nutritional deficit, various investigations like thyroid function tests, folate, and vitamin B12 levels, should be carried out.
The acute phase of treatment for depression must be focused on getting remission and must be adapted to the specific needs of the patient. A psychotherapy program must be utilized in conjunction with antidepressant medications. The therapy can be short-term or long-term. It could be aimed at addressing overt behavior and cognition or focused on understanding and changing deeply-rooted emotional and interpersonal issues.
The continuation and maintenance phase of treatment should consist of using the same antidepressant drug as in the acute phase. This should be done in conjunction with careful monitoring of the remission and relapse rates. It is important to monitor the relapse rates of elderly patients, as they are more likely to relapse.
Social support
Social support is a key element of mental wellbeing. Studies have shown that those with strong social networks are less likely to suffer from depression and are better able to handle stressors in their lives. It is also essential for maintaining an immune system that is strong. This is especially true for older adults who are more stressed and have less healthy coping methods. This is likely to be the reason that older adults require more social support than younger adults.
In depression treatment modalities , a lack of family and social support is linked to poor health outcomes for older adults. Social support can help lessen the negative effects of events in life, like the loss of a loved one or an illness that is serious. It can also have a positive effect on the hypothalamic-pituitary-adrenal cortex (HPA) and noradrenergic systems. Therefore, it is important to identify and address any issues that arise in this area to improve the patient's quality of life.
There are many ways that a healthcare provider can provide social support to an elderly person who is depressed. Psychotherapy, pharmacotherapy, and electroconvulsive treatment are just a few options. These treatments can improve mood and function, as well as increase independence. The quality of the care the patient receives will determine the extent of their recovery.
Social support is defined as emotional support and instrumental support, as well as a sense belonging and community. Support for emotions can be defined as the ability of an individual to express their feelings and issues to others. Instrumental support is receiving assistance with tasks. Informational support involves obtaining guidance from a trustworthy source.
In Vietnam there are a variety of types of social support available, including immediate family friends, neighbors, and professional helpers. In the case of mental health treatment social support has been shown to enhance the quality of life for geriatric patients, and also reduce mortality and morbidity from suicide and other medical conditions. This is also linked to lower costs for psychiatric treatment and health care. This is a major benefit for both the public and private health system.