Depression in later life is usually diagnosed on the basis of two clusters of symptoms: feelings and physical changes. In a 3-page paper, written in APA format using proper spelling/grammar, research the topic of depression in the elderly and address the following:
How would one know if an elderly relative had clinical depression or was sad because of specific life changes and losses?

What are the consequences of depression in the elderly?

Which behaviors would indicate a person going through depression needs therapy?

What kind of therapy would a professional recommend and why?
Be sure to include APA citations for any resources you used as references.

Human Growth and Development- Depression in the Elderly

Introduction

Depression is common in the elderly population. according to the WHO, the prevalence of depression among older adults is 10 to 20% (Avasthi & Grover, 2018). However, depression in older adults is under-recognized and under-diagnosed because it is commonly viewed as part and parcel of life. Depression in older adults is associated with negative effects such as poor quality of life, physical comorbidities, difficulties in performing activities of daily living, cognitive impairments, and premature mortality. Depression in older adults is also allied to a higher risk of suicide, function impairments, and increased frequency of hospitalization, and family burden. Therefore, optimal recognition and effective management of depression among older adults is necessary to improve their quality of life, maintain optimal functionality, lower the mortality arising from suicide, reduce morbidity, and also reduce treatment costs ((Avasthi & Grover, 2018).  Human Growth and Development Depression in the Elderly Essay

Distinguishing Clinical Depression from Sadness due to Life Changes/Losses

Depression in the elderly is characterized by poor sleep, neglecting personal care such as not showering or forgetting to take the medications, loss of interest in life and activities that were once enjoyable, psychomotor retardation, apprehension about the future, poor concentration, memory impairment, recurrent thoughts about death, social withdrawal, appetite changes, irritability, and persistent unexplained pain. Additionally, the older adults with depression manifest apathy and somatic symptoms such as fatigue, lack of appetite, and loss of weight (Avasthi & Grover, 2018).

Even though sadness in the elderly may manifest in symptoms comparable to depression, in most cases depression in the elderly is not characterized by sadness. Depression in older adults is often characterized by the aforementioned symptoms and specifically physical complaints like unexplained pain, worsening headache or worsening arthritis, etc. (Avasthi & Grover, 2018). However, sadness because of the life changes and losses in older adults is characterized by erratic emotions and a mixture of good and bad days where an individual may experience some moments of happiness or pleasure even while sad due to life losses and changes. In depression, the negative moods and the feeling of despair and emptiness are constant, severe, and prolonged (Jeong et al., 2015).

Consequences of Depression in the Elderly

Depression in geriatric population is allied to an elevated rate of suicide mostly because of loss of interest in living. Evidence has demonstrated that the rate of suicide is very high in the geriatric population. Depression is also associated with harmful effects in the geriatric population such as where the loss of appetite can result in geriatric anorexia (Dao et al., 2018). Poor eating habits due to depression can weaken their immunity and thus make the old adults susceptible to infections. Depression in older adults also leads to reduced energy levels and this interferes with their ability to perform activities of daily levels. Depressed older adults have a higher rate of memory loss and cognitive impairments and this may increase the risks associated with self-medication, driving, cooking, and other activities that need full attention (Stark et al., 2018). Depression in older adults is also allied to an increased risk of heart diseases and an elevated risk of dying from an illness (Stark et al., 2018).

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Behaviors Indicating a Person with Depression needs Therapy

Depression needs therapy, when an individual manifests depressive symptom like anhedonia, irritability, appetite changes, anxiety, problems in thinking and concentration difficulties, slowed thinking, unexplained physical problems like headaches or back pain, as well as suicidal thoughts. This is because a timely treatment of depression facilitates a speedy remission of depressive symptoms (Stark et al., 2018). Human Growth and Development Depression in the Elderly Essay

Moreover, when an individual has suicidal talks such as talking about harming or killing oneself and preoccupation with death it is important to ensure the person gets therapy. Finally, when the depressive symptoms interfere with the individual’s ability to perform their usual activities, it is important to ensure they get therapy (Stark et al., 2018).

Therapy for Older Adults with Depression

SSRIs such as sertraline, citalopram, paroxetine, and escitalopram, SNRIs such as venlafaxine and mirtazapine, moclobemide, and bupropion are the most commonly used treatment options in treating depression in older adults. The medications are well tolerated in older adults although the SSRIs and SNRIs are associated with gastrointestinal side effects. These medications should be started at a half dose the usual adult dose, and if the older adult tolerates the dose, it can be increased within one week. This means that the dose is supposed to be titrated upwards into there is evident clinical response, the maximum dose is achieved, or side effects restrict more dose increase (Avasthi & Grover, 2018).

The recommended psychotherapies to treat depression in older adults include reminiscence therapy, CBT, interpersonal psychotherapy (IPT), and brief dynamic therapy. Psychoeducation to the older adults with depression and their family members and caregivers should be integrated into the treatment regimen. The psychoeducation should cover issues such as symptoms and effects of the depression, available treatment options, side effects of the treatments, timely response to treatment, and the importance of adhering to treatment. The patient is also educated about life stressors and effective coping skills (Avasthi & Grover, 2018).

Conclusion

Depression among the geriatric population is very common although mostly it goes unrecognized. Symptoms of depression include persistent, severe, and prolonged unlike the sadness associated with life changes. Older adults with depression are likely to commit suicide and adverse health effects. The appropriate treatment in depression for the elderly includes some SSRIs, SNRIs, and psychotherapies such as CBT, IPT, among others.

References

Avasthi, A., & Grover, S. (2018). Clinical Practice Guidelines for Management of Depression in the Elderly. Indian journal of psychiatry, 60(Suppl 3), S341–S362. https://doi.org/10.4103/0019-5545.224474.

Dao, A., Nguyen, V. T., Nguyen, H. V., & Nguyen, L. T. (2018). Factors associated with depression among the elderly living in urban Vietnam. BioMed research international, 2018(10), 1-9.

Jeong, H. G., Han, C., Park, M. H., Ryu, S. H., Pae, C. U., Lee, J. Y., Kim, S. H., & Steffens, D. C. (2015). Influence of the number and severity of somatic symptoms on the severity of depression and suicidality in community-dwelling elders. Asia-Pacific psychiatry: official journal of the Pacific Rim College of Psychiatrists, 6(3), 274–283. https://doi.org/10.1111/appy.12138.

Stark, A., Kaduszkiewicz, H., Stein, J., Maier, W., Heser, K., Weyerer, S., Werle, J., Wiese, B., Mamone, S., König, H. H., Bock, J. O., Riedel-Heller, S. G., & Scherer, M. (2018). A qualitative study on older primary care patients’ perspectives on depression and its treatments – potential barriers to and opportunities for managing depression. BMC family practice, 19(1), 2. https://doi.org/10.1186/s12875-017-0684-3.

Human Growth and Development Depression in the Elderly Essay