Did you know that people aged 60 and over are nearly twice as likely to be on anti-depressants than younger adults? At the same time, research does not show that depression is more common among seniors than other populations. In this article, we’ll explore why so many seniors are taking anti-depressants, and what the effects of these drugs can be.
What is Depression?
It’s not just a bad mood you can “snap out of.” Major depressive disorder, commonly called depression, is a serious medical illness that affects how you feel, think and act. It causes feelings of sadness, lack of interest in activities you used to enjoy, and can lead to a many different emotional and physical problems. Symptoms can range from mild to severe, and must last at least two weeks to be considered depression. Some signs of depression include:
- Feeling sad or negative
- Loss of interest or pleasure in activities once enjoyed
- Changes in appetite—weight loss or gain unrelated to dieting
- Trouble sleeping or sleeping too much
- Loss of energy or increased fatigue
- Increase in purposeless physical activity (hand-wringing or pacing)
- Slowed movements and speech
- Feelings of worthlessness or guilt
- Preoccupation with health problems
- Difficulty thinking, concentrating, or making decisions
- Thoughts of death or suicide
Grief, bereavement, or other trauma can trigger depression, but those feelings are not a problem on their own. Feeling intensely sad, and grieving after a loss is natural and healthy. For some people, the grieving process may look like depression. There are also medical conditions, such as thyroid problems, that mimic these symptoms. In any case where a person is exhibiting worrying signs for at least two weeks, they should see their doctor for a full medical workup.
Fortunately, depression can easily be treated with a combination of medication and psychotherapy.
Depression in the Elderly
Depression is common in the aging population, even for those who have no previous history of the disease. Seniors are more likely to encounter triggers like the loss of a loved one, a move to a long-term care facility, or the diagnosis of a terminal illness. Depression presents in seniors with the symptoms described above, but can sometimes be hard to spot in seniors dealing with health problems, sleep problems, and loss of energy.
Use of Antidepressants in the Elderly
While depression is not diagnosed more frequently in seniors, antidepressants are prescribed for them at a higher rate. Nearly 20% of adults over age 60 took an antidepressant in the past month. One reason for this prevalence is that doctors are prescribing antidepressants for other diagnoses as well. There is some indication that these drugs will help anxiety issues, sleep problems, or neuropathic pain.
The problem is that there is no solid evidence that antidepressants are effective for mood or sleep disorders. Over-treatment can be dangerous when the specific drug interacts poorly with existing medications. Certain antidepressants can put you at risk for falls, low sodium, and other problems. Here are some things to consider if you or your elderly loved one is battling depression:
- Risk vs. Benefit: The first thing to consider are the potential risks and benefits. Always pursue the treatments with the highest benefits or lowest risks first. Psychotherapy, for example, is a very low risk treatment for depression. Many antidepressant drugs, on the other hand, have a high risk of unpleasant side effects.
- Interactions: How will this drug interact with medications your loved one is already taking? In addition, some treatment options may not be compatible with chronic health conditions . Try to avoid treatments that are most likely to interact poorly with your medications or health.
- Side effects: Always look at the potential side effects on the senior with depression. This can be poor balance and coordination, cognitive function, fatigue, insomnia, nausea, etc.
- Quality of life: The goal in pursuing depression treatment is to maximize the seniors’ quality of life. We want them to function as well as possible, emotionally, physically, and mentally. To the extent that they can communicate their wishes, take the patient’s feedback and opinions into account when choosing a treatment option.