Posted: November 16th, 2022

Geriatric depression

Geriatric depression is a mental health condition that affects elderly people. Depression in older people, like depression in younger adults, can have a variety of causes and treatment options.

Although geriatric depression is the most common of all mental health conditions in adults 65 and older, health experts do not consider it a normal part of the aging process.

Depression symptoms in older adults may include persistent feelings of sadness, loss of energy, and decreased interest in activities that a person once enjoyed.

Medication, psychotherapy, or alternative therapies may be used in treatment.

This article gives an overview of geriatric depression, including symptoms, causes, and treatment options.

A word about gender and sex
Gender and sex exist on a spectrum. To refer to sex assigned at birth, this article will use the terms “male,” “female,” or both. More information can be found by clicking here.

What exactly is geriatric depression?
Getty Images/Arman Zhenikeyev
While most older adults have good mental health, many are at risk of developing mental health conditions such as depression, according to the World Health Organization (WHO)Trusted Source.

Geriatric depression is a mood disorder characterized by a persistent loss of interest and feelings of sadness in older adults.

According to the Centers for Disease Control and Prevention (CDC)Trusted Source, 7 million adults aged 65 and older in the United States suffer from depression each year.

However, according to the Royal College of Psychiatrists in the United Kingdom, depression can affect one in every five older adults living in the community or two out of every five living in a care home.

Symptoms
Depression symptoms differ from person to person.

Some of the most common signs and symptoms of depression in older people are:

a depressed or sad mood
fatigue or lack of energy loss of interest in previously enjoyed activities feeling guilty, hopeless, or worthless for no apparent reason difficulty thinking, concentrating, or making decisions
Aches and pains caused by too much or too little sleep
digestive problems
alterations in appetite
restlessness
irritability
separation from friends and family
suicidal ideation or attempt
A healthcare provider can Help a person in ruling out underlying causes of geriatric depression. They can also provide useful treatments and self-care advice.

Geriatric depression can cause people to consider self-harm, including suicide. If an older adult has these thoughts, they or someone else should seek immediate help by dialing 800-273-8255 or the local emergency number.

Suicide avoidance
If you know someone who is in imminent danger of self-harm, suicide, or harming another person:

“Are you thinking about committing suicide?”
Listen to the other person without passing judgment.
To contact a trained crisis counselor, dial 911 or the local emergency number, or text TALK to 741741.
Stay with the individual until professional Helpance arrives.
Remove any weapons, medications, or potentially dangerous objects.
If you or someone you know is contemplating suicide, a suicide prevention hotline can help. The 988 Suicide and Crisis Lifeline is open 24 hours a day, 7 days a week. People who are deaf or hard of hearing can use their preferred relay service or dial 711 then 988 during a crisis.

More links and local resources can be found by clicking here.

Causes
Healthcare professionals do not know what causes geriatric depression, but they have identified some possible causes. Depressive symptoms in older adults can be triggered by a combination of these factors.

These are, according to the National Health Service (NHS) of the United Kingdom:

Genetics: People who have a family history of depression are two to three times more likely to suffer from geriatric depression. Furthermore, research suggests that depression is caused by genetics in 30-50% of cases.
Imbalances in the neurotransmitters responsible for mood regulation can lead to depression. Neurotransmitters are chemical messengers in the body that regulate biological processes. According to research, changes in neurotransmitter levels in the brain may contribute to depression.
Brain structure: According to a 2018 studyTrusted Source, people who develop depression may have a frontal lobe abnormality.
Certain medical conditions: People who have diabetes, arthritis, cancer, heart disease, or chronic pain have a higher risk of developing depression. Furthermore, depression may coexist with aging-related health problems.
Loss of a loved one, divorce, and a lack of a support system in old age can all increase a person’s chances of developing geriatric depression.
Female sex hormones: People with female sex hormones are twice as likely as biological males to be depressed. This could be due to changes in estrogen and progesterone levels throughout life, which can trigger depressive episodes.
Substance abuse: People who have a history of alcohol use disorder (AUD) or substance use disorder (SUD) are more likely to develop depression. This could be because substance abuse can exacerbate the feelings of sadness and loneliness that are commonly associated with depression. Furthermore, researchTrusted Source has linked anticonvulsants, beta-blockers, benzodiazepines, statins, stimulants, and corticosteroids to depression.

Geriatric depression diagnosis
A doctor may diagnose geriatric depression if an older adult has signs and symptoms of depression for at least two weeksTrusted Source.

A doctor will take a person’s medical history and use a geriatric depression scale when asking about depression symptoms to determine how long they have been present before making a diagnosis.

Before beginning treatment, the doctor will conduct a physical examination and order a blood test to rule out any underlying causes.

Treatment
Geriatric depression is treatable, with options including medication, psychotherapy, and other complementary therapies.

Medication
Any of the following antidepressants may be prescribed by a healthcare professional:

SSRIs are selective serotonin reuptake inhibitors that treat depression by increasing serotonin levels in the brain. Sertraline is a well-known and effective SSRI for treating depression in older adults. Escitalopram and citalopram are two other medications.
SNRIs (serotonin and norepinephrine reuptake inhibitors): SNRIs work by increasing serotonin and norepinephrine levels in the brain. If SSRIs have failed, doctors may recommend them. SNRIs include venlafaxine and duloxetine. Because SNRI medications have fewer side effects, health experts Trusted Source believe they are safe and effective in treating depression in older people.
Monoamine oxidase inhibitors (MAOIs): When all other antidepressants have failed, doctors can prescribe MAOIs. MAOIs inhibit the removal of dopamine, serotonin, and norepinephrine from the brain by monoamine oxidase. Isocarboxazid and phenelzine are two examples. Some people may develop high blood pressure as a result of increased tyramine levels caused by MAOIs. Health experts advise MAOI users to monitor their blood pressure and avoid tyramine-rich foods such as dried sausage, fermented soy products, and improperly stored foods.
Tricyclic antidepressants (TCAs): TCAs can treat depression by increasing serotonin and norepinephrine levels in the brain. TCAs are rarely used as a first-line treatment for geriatric depression because they can cause irregular heart rates and falls in the elderly. Amitriptyline and amoxapine are two examples.
Atypical antidepressants: These antidepressants work differently than other antidepressants. Atypical antidepressants alter brain chemistry to alleviate depression. Bupropion and nefazodone are two examples.
Even if symptoms improve, a person should continue to take and finish these medications as prescribed by their doctor until their doctor says it is safe to stop.

If a person has any concerns about their antidepressants, they should talk to their doctor.

2017 Psychotherapy Research

According to a reliable source, psychotherapy can help people with geriatric depression improve their symptoms.

Interpersonal and cognitive behavioral therapy are examples of psychotherapy, also known as talk therapy (CBT). By encouraging positivity, CBT teaches a person new ways to think and behave, as well as changing habits that can lead to depression.

Interpersonal therapy may also be beneficial. Its goal is to Help people in identifying and changing emotional challenges that affect their mood.

Electroconvulsive therapy (ECT) (ECT)
A doctor may recommend ECT if geriatric depression is severe and does not respond to medication or psychotherapy.

ECT is a type of brain stimulation in which electrical current is used to activate the brain and treat depression.

According to a 2016 reviewTrusted Source, electroconvulsive therapy (ECT) is a safe and effective treatment option for older adults suffering from depression.

Depression in the elderly versus depression in younger people
Depression affects younger and older people differently.

According to the National Institute of Mental Health (NIMH)Trusted Source, while younger people are more likely to be diagnosed with depression, depression can occur at any age, including in older adults. This could be due to health issues, the loss of loved ones, or other complications associated with aging.

Furthermore, unlike in younger people, sadness is frequently overlooked as a significant symptom of depression in older adults. Other signs of depression in older people may be difficult to detect by a doctor. This can make diagnosing geriatric depression difficult.

As a result, if they notice signs of depression, older adults should consult with a doctor and discuss their feelings.

Insomnia and depression in the elderly
Insomnia is a sleep disorder in which people struggle to fall or stay asleep.

Sleep problems in older adults can predict the onset of geriatric depression. Insomnia can increase the risk of depression in older people, according to a 2017 reviewTrusted Source.

According to the National Sleep Foundation (NSF), insomnia affects a person’s energy levels and mood and can lead to conditions such as depression and anxiety. According to the NSF, 57% of older adults experience a decline in overall health and quality of life as a result of insomnia.

If a person experiences symptoms of insomnia, they should consult their doctor. A doctor will evaluate a patient’s symptoms and recommend the best medications to treat sleep disorders.

Outlook
While most cases of geriatric depression cannot be prevented, treatment can provide significant long-term benefits and alleviate worsening symptoms.

A medical professional will evaluate a person’s symptoms and recommend the best combination of medications and therapies.

According to the NIMH, if a person begins treatment soon, they may see improvementsTrusted Source 2 weeks after treatment begins and may be able to prevent future episodes.

Without treatment, episodes can last several weeks or longer. This can affectTrusted Source a person’s quality of life and increase the risk of suicide in older adults.

Summary

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