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Golden Years

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Depression Not Uncommon Among Elderly

Depression in older adults on the rise By Deborah Jeanne Sergeant

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ecoming a "grumpy old man" or a "crabby old lady" isn't a natural part of the aging process. Aging increases the likelihood for certain risk factors for depression; however, older people can reduce their chances of depression. And those with depression can find relief. The majority of older adults do not suffer from depression, according to Ann Cornell, a psychologist at Behavioral Health Partners at URMC who has a specialty in geriatrics. "Statistics show that the rates of depression in older adults are lower than those in younger adults; however, older Cornell adults are at an increased risk for depression due to increased rates of chronic health conditions," she said. Among older adults who require home health care or hospitalization, the rates also increase. Depression in older adults is often misdiagnosed or undertreated due to the assumption that depression is a normal part of aging or failure to recognize the signs and symptoms of depression in older adults. "The percentage of older adults that experience depression appears to be increasing with each subsequent generation," Cornell said. Other factors that can increase the risk for depression include functional decline, personal loss, untreated pain conditions, social isolation and difficulty engaging in activities of daily living. They may also experience loss of hobbies and employment. These factors would negatively affect people of any age, but are likelier in older adulthood. Older people also may experience more directly age-related complications from health conditions such as thyroid disease and from medication. "Medically, they're more complicated," said Chris Pulleyn, licensed marriage and family therapist practicing in Rochester. "In prescribing anything, you have to look at what they're already taking." Prescription medication can cause a greater risk of depression if the patient takes two medications Pulleyn contraindicated for each other or at a dose exceeding an elderly person's ability to metabolize it effectively.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2016

Pulleyn said that older individuals in good health who are taking care of another family member or stressed about finances may be at higher risk for depression. "It takes a lot to cope in a positive way," Pulleyn said. "Generally, the most effective treatment for depression for most is a combination of anti-depressants and talk therapy. A lot of older people resist medication because they feel they're already taking enough medication. "There's also a generational resistance to 'happy pills' but sometimes combined with talk therapy have statistically shown to be the most powerful treatment for depression, depending upon the degree." She added that people who are mildly depressed may find relief through lifestyle modification, such as more aerobic exercise, eating better and finding positive ways to spend time. Many derive pleasure from volunteering, Audrey Berger, a psychologist in practice in Rochester, said that depression differs from a bout of the blues in that the feelings run deeper, include hopelessness and possibly physical manifestations, and last longer. Berger For mild to moderate depression, "getting good sleep and nutrition is important," Berger said. Seeking unhealthy coping mechanisms such as alcohol only temporarily blunts emotional pain, "but it's not helpful in the long run," Berger said. Don't count on a primary care physician to spot depression, especially if the visit is about a different malaise. Berger said that many primary care physicians miss it or "attribute the symptoms to other factors, like reaction to loss or 'just getting older,'" she said. Look for signs such as persistent sadness, unexplained fatigue, losing interest in activities previously enjoyed, isolation, low self worth, contemplating death or suicide, lack of mental focus, feeling hopeless, anxiety, unexplained body aches, irritability, unexplained changes in weight, sleeping, grooming and eating patterns. If you see these signs in yourself, bringing it up during a medical visit, talking with a minister trained in mental health counseling or seeking help from a mental health therapist may be the only way to obtain professional help. If someone you care about exhibits signs of depression, talk about what you're observing.

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