Although roadblocks to treatment exist for most individuals with depression an older adult's road to recovery
can seem especially difficult. For example, in older people, depression is sometimes mistaken for dementia. Or
it may occur in conjunction with dementia or other illnesses that mask the depressive symptoms. Health care
professionals may treat the medical illness and overlook the depression.
In addition, many in this older
generation mistakenly regard depression as a weakness or a shameful family secret. In fact, older people
are least likely to seek help for depression. Those who do seek help may need to pay for it out of pocket
or bridge a wide gap between the costs and what Medicare will cover.
Once an older person seeks treatment, other problems may arise. For example, older adults are sometimes more
sensitive to side effects of antidepressants. These drugs also may not mix well with medication they take for
other illnesses. For these reasons, as many as 40% of older people taking antidepressants quit or repeatedly
miss doses because of side effects, memory problems, or difficulty keeping track of complicated drug regimens.
Although older patients with severe depression appear to respond to antidepressant drugs about as well as
younger people, they sometimes improve more slowly and relapse sooner. However, a knowledgeable doctor can
help see you through these kinds of concerns.
Psychotherapy alone may help older patients with milder depression, while combining psychotherapy with medication
may be helpful for those with more severe depression. Older adults in good physical and cognitive health may
respond well to cognitive behavioral therapy or interpersonal therapy. Cognitive behavioral therapy has also
shown promise among the cognitively impaired and physically ill.
References (To view, roll mouse over the "References" heading; to hide, click on the heading)
Westoby CJ, Mallen CD, Thomas E. Cognitive complaints in a general population of older adults: Prevalence, association with pain and the influence of concurrent affective disorders.
Eur J Pain. 2008 Dec 23.
Mandal B, Roe B. Job loss, retirement and the mental health of older americans. J Ment Health Policy Econ. 2008 Dec;11(4):167-76.
McKinnon MC, Yucel K, Nazarov A, MacQueen GM. A meta-analysis examining clinical predictors of hippocampal volume in patients with major depressive disorder.
J Psychiatry Neurosci. 2009 Jan;34(1):41-54.
The recommendations on this website do not constitute professional advice, substitute for professional treatment, or establish a therapeutic
relationship. Dr. Randi Fredricks, Ph.D. of San Jose Counseling and San Jose Psychotherapy is a counselor and psychotherapist in San Jose, California
providing counseling, psychotherapy, and therapy for individuals and couples with relationship issues, anxiety, panic attacks, post-traumatic stress
disorder, depression, relationship issues, self-esteem, addiction, co-dependency, trauma, abuse, eating disorders, and managing grief and loss.
If you search for counseling San Jose, psychotherapy San Jose, psychotherapist San Jose, therapist San Jose, counselor San Jose, couples therapist
San Jose, couples counselor San Jose, marriage therapy San Jose, life coach San Jose, career coach San Jose, executive coach San Jose, you can find
San Jose Counseling and San Jose Psychotherapy and Dr. Fredricks in San Jose and the Silicon Valley as the leading provider of such services.
In addition to serving San Jose, Dr. Fredricks serves Campbell, Los Gatos, Saratoga, Milpitas, Mountain View, Monte Sereno, Cupertino, Scotts Valley,
Santa Cruz, Felton, Sunnyvale, Morgan Hill, Fremont, Los Altos, and Gilroy, California.
Author of Healing & Wholeness: Complementary
and Alternative Therapies for Mental Health
