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Depression - elderly - Treatment

Treatment:

See: Depression - major for more information about medications and other therapies used to treat depression.

The first step is to address any physical illnesses and stop taking any medications that may be making your symptoms worse.

If these steps do not relieve the depression, antidepressant medications and talking through problems (psychotherapy) with a psychologist, psychiatrist, or other therapist is usually helpful.

Antidepressant drug therapy should be carefully monitored for side effects, which can be more common in the elderly. Doctors usually prescribe lower doses of antidepressants for older people, and increase the dose more slowly than in younger adults.

To better manage depression at home, elderly people should:

  • Exercise regularly, seek out pleasurable activities, and maintain good sleep habits.
  • Learn to watch for the early signs of depression, and know how to react if it gets worse.
  • Minimize alcohol use and avoid illegal drugs. These substances can make depression worse over time, and they may also impair judgment about suicide.
  • Surround themselves with people who are caring and positive.
  • Talk about their feelings to someone they trust.
  • Take medications correctly and learn how to manage side effects.

Expectations (prognosis):

Depression usually responds to treatment. If it is not detected, depression can lead to complications. The outcome is usually better for people who have access to social services, family, and friends who can help them stay active and engaged.

Complications:

The most worrisome complication of depression is suicide. Depression and older age are both risk factors for suicide. Men account for most suicides among the elderly, and divorced or widowed men are at the highest risk. Families should pay special attention to elderly relatives who live alone.

Other complications include reduced functioning at work and in social relationships.

Calling your health care provider:

Call your health care provider if you feel persistently sad, worthless, or hopeless, or if you cry often. Also call if you are having trouble coping with stresses in your life and want to be referred for talk therapy.

Go to the nearest emergency room or call your local emergency number (such as 911) if you are thinking about suicide (taking your own life).

If you are caring for an aging family member and think they may have depression, contact their health care provider.

  • Reviewed last on: 8/15/2010
  • David B. Merrill, MD, Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia Unviersity Medical Center, New York, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Cassano P, Fava M. Mood disorders: major depressive disorder and dysthymic disorder. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier;2008:chap 29.

Unutzer J. Clinical practice: late-life depression. N Engl J Med. 2007;357:2269-2276.

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