Late patients. Many depressed patients will not
Late adulthood should be a time in a person’s life where they feel fulfilled. They can look back on their memories and be happy with the way they have lived their life. Now, too many elderly people are not satisfied and look at this stage as depressing. Most fear death of either a loved one or for themselves.
This topic is interesting to me because elderly people should make the best of their last stage of life. This topic discusses about getting older, the life changes that they go through physically, emotionally, and mentally. We should know more about it so that we can help our family and friends get through one of the best, yet toughest part of our mortal life.Depression is defined as “a state of despondency marked by feelings of powerlessness and hopelessness” (Coon, 2001). Some people can mix up depression with just having the blues because of a couple of bad days or even weeks. It is already said that depression affects about one sixth of the population or more (Doris, Ebmeier, Shajahan, 1999). Depression can happen in any age range from birth to death.
The cause of depression is still obscure and becoming clear that a number of diverse factors are likely to be implicated, both genetic and environmental. Some causes are leading stressful lives, genetic factors, a previous depressive episode, and the personality trait neuroticism (Doris, et al., 1999).
There are many common symptoms in which everybody looks for which is unhappiness and disappointment. Symptoms that are different, pervasive, or interfere with normal function are considered to be pathological. Some symptoms include loss of pleasure in almost all activities, loss of reactivity to usually pleasurable stimuli, significant loss of appetite or weight loss and excessive or inappropriate guilt (Doris, et al., 1999). There are many forms of treatment that can be used for this disease. There are always new research and medications that are being tested out on patients. Many depressed patients will not go and get help.
“Pharmacotherapy is the most common treatment in primary care response rates between 50% and 60%, and is often used in addition to supportive counseling.” (Doris, et al., 1999) More treatments that can be used are Electro-convulsive therapy (ECT), Repetitive trans-cranial magnetic stimulation (rTMS), and many alternative physical therapies. Electro-convulsive therapy is used in severe, life-threatening depressive illnesses. This is usually used after pharmacotherapy has failed. Repetitive trans-cranial magnetic stimulation is an experimental treatment for depression.
Although there are not many studies involving this treatment, patients either have treatment-resistant depression or have less severe disorders. (Doris, et al., 1999).The age of late adulthood rages from the age of sixty and above. For some elderly people, life after retirement can be great.
Yet for some, it can be the worse time of their life. “Work has always been a central concern in their lives, symbolizing their identities and providing them with self-esteem.” (Kavanaugh, 1997). The changes that occur to their body and mind can change how they choose to live the rest of their life. In Erick Erickson’s psychosocial dilemmas, late adulthood deals with integrity versus despair.
This is defined as “a conflict in old age between feelings of personal integrity and the despair that occurs when previous life events are viewed with regret” (Coon, 2001). When thinking back about their lives, they should feel good and when they start to think about the failure in their life is when they have feelings of depression because they know it is too late to change anything. “Old age deepens our understanding- not only of ourselves, but of aspects of life we may have avoided” ( Matousek, 1999).Depression can occur at any age, but usually increases among older people. One of the big causes of late adulthood depression is related to the loss of a loved one or spouse. In a study done by the American Family Physician, people were divided into five groups of newly bereaved, long-term widowed, sill-married, the divorced and the never-married.
“Data were collected on 5,449 persons, with 223 considered newly bereaved.” (Miller, 2000) These people had a higher rate of depressive symptoms compared with the other study groups. About one third reported depressive symptoms one month after their partner’s death. After two to three months, 12 percent still reported symptoms.
These people were nine times more likely to be depressed than their married counterparts, and some remained depressed up to two years after the loss (Miller, 2000). Men and women age differently whether it being physical health or psychological well-being. “In general, men live shorter lives and more often suffer from fatal conditions, such as heart disease, lung disease, liver disease and cancer, while women live longer lives and are more apt to have chronic, debilitating conditions, such as arthritis, and require more help with activities of daily living.
” (Kavanaugh, 1997)Men usually have a harder time adjusting to changes. They usually find it difficult to depend on others for things they used to be able to do. Men were brought up to be strong and independent when they grew up. They sometimes look at recreation activities as a waste of time and may feel that their lives lack purpose and meaning. “Studies of recent elderly widowers suggest that men may suffer more emotional problems after the loss of a spouse than women do.” (Kavanaugh, 1997).If you have a loved one that you may think have depression for any reason, you should consider these symptoms.
These include lack of energy and fatigue, sleeplessness, prolonged sadness, lack of interest in activities that formerly were pleasurable, and feeling hopeless, helpless, or worthless (Medical Update, 2000). If these symptoms occur, they should go to a family doctor immediately. The treatments used for depression are commonly used in any age bracket. It varies with the elderly because we do not know how much there body can take and most likely they are already taking a good amount of medications for other problems.“Even when physicians suspect depression, they may be hesitant to prescribe medication, knowing the greater sensitivity older people have to adverse drug effects” (Friedrich, 1999).With each person, varies how the treatment will affect them compared to others.
“The rewards of making diagnosis are high, as more than 80% of patients respond well to treatment.” (Butler, Cohen, Lewis, Simmons-Clemmons, Sunderland, 1997). There are two main drugs being used today, which are serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs). (Harvard Mental Health Letter, 1999). Examples of serotonin reuptake inhibitors are Paxil, Zoloft, and Celexa. These have fewer side effects and less risk of dry mouth, constipation, dizziness, and cognitive impairment.
Examples of tricyclic antidepressants are Pamelor, and Norpramin, which are usually used to treat severe depression or melancholia. Along with TCAs, an electrocardiogram may be used because these antidepressants can disturb heart rhythms. (Harvard Mental Health Letter, 1999). Another method of treatment is psychotherapy, especially in preventing the depression to occur again. This can be critical in maintaining a person’s confidence and motivation to stick with medications. “Studies show that psychotherapy is very effective.
Twenty visits, for example, can often make a very significant impact in turning things around.” (Butler, et al., 1997). Using psychotherapy and drugs, remission should take six to twelve weeks. To insure treatment, patients should continue even after they are better.
“But 20% of elderly depressed patients do not get well despite SSRIs or TCAs and psychotherapy.” (Harvard Mental Health Letter, 1999). Before SSRIs came about, there were two classes of antidepressants that were being used. These drugs were monoamine oxidase inhibitors and the tricyclics. Using these drugs as treatments is not going to cure anything over night. “With all these drugs, a minimum of 4 weeks has to pass before you start to see the effects.
” (Butler, et al., 1997). This is known with any treatment for any disease.A treatment that is very useful that can also rejuvenate the body is physical activity.
“Although sedentary living is only one of many possible causes for such negative emotional states, many researchers agree that physical activity can play a significant role in reversing them.” (JOPERD, 2001). After retirement, the elderly do not know what to do with themselves so they stay around the house and do work. Getting out and exercising can help make a person feel good about themselves and their body at any age group.Exercising can consist of anything from taking a walk or maybe even a jog to joining a health club.
There is confidence that a positive relationship exists between physical activity and psychological well being among the elderly (JOPERD, 2001).If you know someone going through this, the best thing to do is be there for him or her. Family can help a lot by reminding them how special they are, what they have to look forward to like watching there grandkids next birthday or seeing them graduate from either high school or college (Butler et al., 1997). Helping them also means letting them do things on there own. You do not want to make the person feel very helpless because that can only make them worse.
Depression is a serious disease that cannot be taken lightly. People ask themselves why we should even try to help the elderly with depression because they are going to die soon anyway. We want to try to prevent death as much as we can. Dying should not be someone’s resolution to a situation, no matter how old or young the person is. Late adulthood should be one of the best parts of your life. After all the long, hard work, it is time to relax, have fun, and do things that you have always wanted to do, but could never find the time to do it.
There should be more information and studies to the improving of depression in the elderly. There seems to be more information about depression in adolescence and childhood because they are so young, they have their whole life to look forward to. It seems that late adulthood depression is not overlooked, but not treated with the same seriousness because they are so old.
Psychologists should take into perspective when researching this topic that the person is trying to get better. If they did not want to, they would not have asked for help. People can only make the late part of their life as well as they want it to be.Bibliography:BibliographyIntroduction to Psychology: Gateways to Mind and Behavior 9th editionDennis Coon, 2001Chapters 5 & 16The Brown University Long-Term Care Quality Advisor“Psychosocial adjustment: male residents face challenges” by Kevin Kavanough September 29, 1997 Vol 9 n18 pl(3)Harvard Mental Health Letter“What Are the Best Treatments for Depression in Old Age?” June 1999 Vol 15 i12Medical Update“Mental Illness In the Elderly” September 2000 Vol 24 i3 p.2The Journal of Physical Eduction, Recreation & Dance (JOPERD)“Active Seniors Less Susceptible to Depression” January 2001 Vol 72 i1 p.
9The Lancet“Depressive Illness” by Alan Doris, Klaus Ebmeier, Polash ShajahanOctober 16, 1999 Vol 354 p 1369American Family Physician“Does Conjugal Loss Cause Depression in the Elderly?” by Karl E. MillerMarch 15, 2000 Vol 16 p.1852The Journal of American Medical Association (JAMA)“Recognizing and Treating Depression in the Elderly” by M.
J. FriedrichVol 282 No. 13 October 16, 1999Modern Maturity“Face the Music and Dance” by Mark Matousek Inverview with Psychologist James HillmanNov/Dec 1999 issueGeriatrics“Late-life depression: treatment strategies for primary care practice” by Robert N.
Butler, Gene Cohen, Myrna I. Lewis, Wanda Simmons-Clemmons, and Trey SunderlandApril 1997 Vol 52 No 4 pg 51