Depression can be treated successfully. Depending on the case, different therapies
seem to work. For instance, support groups help some people deal with major life changes
that require new coping skills or social support. A doctor might suggest that an older
person use a local senior center, volunteer service, or nutrition program. Several kinds
of "talk" therapies are useful as well.
One method helps people change negative thinking patterns that might have led to
depression. Another way works to improve a person's relationships with others in an effort
to lessen feelings of despair.
Antidepressant drugs can also help. These medications can improve mood, sleep, appetite,
and concentration. There are several types of antidepressants available. Some drugs can
take 6 to 12 weeks before there are real signs of progress. Drugs may need to be used for
6 months or more after symptoms disappear.
Antidepressant drugs should be used with great care. This can help avoid unwanted side
effects. Older people often take many drugs, and a doctor must know about all prescribed
and over-the-counter medications being taken. The doctor should also be aware of any other
physical problems. It is important to take antidepressant drugs in the proper dose and on
the right schedule.
Electroconvulsive therapy (ECT) can also help. It is most often recommended when drug
treatments can't be tolerated or there is an unacceptable delay in when drugs would become
effective. ECT, which works quickly in most people, is given as a series of treatments
over a few weeks. Like other antidepressant therapies, followup treatment with medication
or occasional ECT is often needed to help prevent a return of depression.
What can be done to lower the risk of depression? How can people cope? There are a
few practical steps you can take. One way to prepare for major changes in life, such as
retirement or the death of family or friends, is to keep and maintain friendships over the
years. Friends can help ease the loneliness of losing a spouse. You can also develop
interests or hobbies, keep the mind and body active, and stay in touch with family to help
limit the effects of depression.
Being physically fit and eating a balanced diet are ways to help avoid illnesses that can
bring on disability or depression. Follow the doctor's directions on using medicines to
lower the risk of depression as a drug side effect.
Getting Help
The first step to getting help is to accept that help is needed. The subject of mental illness still makes some people uncomfortable. Some feel that getting help is a sign of weakness. Many older people, their relatives, or friends may believe, mistakenly, that a depressed person can quickly "snap out of it" or that some people are too old to be helped.
Once the decision is made to get medical advice, start with the family doctor. The
doctor should check to see if there are medical or drug-related reasons for the
depression. After a complete exam, the doctor may suggest talking to a mental health
specialist. The special nature of depression in older people has led to a new medical
specialty--geriatric psychiatry.
Be aware that some family doctors may not understand about aging and depression. They may
not be interested in these complaints. Or, they may not know what to do. If your doctor is
unable or unwilling to take seriously your concerns about depression, you may want to
consult another health care provider who can help.
If a depressed older person won't go to a doctor for treatment, relatives or friends can
help. They can explain how treatment may help the person feel better. In some cases, when
an older person can't or won't go to the doctor's office, the doctor or mental health
specialist can start by making a phone call. The telephone can't take the place of the
personal contact needed for a complete medical checkup, but it can break the ice.
Sometimes a home visit can be set up.
Don't avoid getting help because you are afraid of how much treatment might cost.
Short-term psychotherapy, with or without medication, will work in many cases. It is often
covered by insurance. Also, community mental health centers offer treatment based on a
person's ability to pay.
