Geriatric depression is a mental health condition that affects the elderly. As with depression in young adults, depression in the elderly has various causes and treatment options. Elderly depression is the most common of all mental health conditions in adults over the age of 65, but medical experts do not consider this a typical part of aging. Common symptoms include persistent sadness, lack of energy, and a decrease in interest in activities once enjoyed, and can be treated with drugs, psychotherapy, or alternative therapy. This article describes depression in the elderly.
What is geriatric depression?
According to the World Health Organization (WHO), most older people have good mental health, but many people are at risk of developing mental health conditions such as depression. Geriatric depression is a mood disorder of the elderly with constant loss of interest and sadness. In the United States, it is reported that 7 million adults aged 65 or older suffer from depression every year. Of course, there are slight differences between countries, but in developed countries, it has been reported that about one in five elderly people suffer from depression.
Why does it happen?
Medical experts have not been able to clarify the cause of depression in the elderly. However, several possible factors can be identified. The combination of these factors causes depressive symptoms in the elderly. According to the National Health Service in the United Kingdom, the following are included.
1. Genetics
People with a family history of depression are more likely to develop senile depression. Studies have also shown that depression occurs in 30-50% due to genetic factors.
2. Brain Chemistry
An imbalance in neurotransmitters responsible for mood control can cause depression. Neurotransmitters are chemical messengers that control the body's biological processes. Studies have shown that changes in neurotransmitter levels in the brain can contribute to depression.
3. Brain Structure
Studies conducted in 2018 showed that people with depression may have problems with the frontal lobe of the brain.
4. Specific diseases
People with diseases such as diabetes, arthritis, cancer, heart disease and chronic pain are more likely to develop depression. Depression can also occur with aging-related health conditions.
5. Stress
Stressful life events such as losing loved ones, divorcing, and lack of support systems in old age can increase the risk.
6. Female sex hormones
People with female sex hormones are twice as likely to develop depression as biological men. This may be due to changes in estrogen and progesterone levels during various life stages that can cause episodes of depression.
7. Use of substances
People with a history of alcohol use disorder (AUD) or substance use disorder (SUD) may have a higher risk of developing depression. This may be because substance abuse can deepen the sadness and loneliness often associated with depression. In addition, studies have shown that certain drugs such as anticonvulsants, beta-blockers, benzodiazepines, statins, stimulants, and corticosteroids are associated with depression.
What are the symptoms?
Symptoms of depression in the elderly can vary from person to person. The most common early symptoms of depression in the elderly include severe fatigue and sad moods.
· energy loss
· lack of interest in activities once enjoyed
· guilt, despair, worthlessness for no reason
· Difficulty in thinking, focusing, or making decisions
· Too much sleep or too little sleep
· a digestive problem
· a change in appetite
· restless feelings
· Annoyed
· a feeling of wanting to stay away from friends and family
Treatments
Medical professionals may prescribe one of the following antidepressants:
1. Selective serotonin reuptake inhibitor (SSRI)
SSRIs treat depression by increasing serotonin levels in the brain. Sertraline is an effective SSRI for treating depression in the elderly. Other drugs include Escitalopram and Citalopram.
2. Serotonine and norepinephrine reabsorption inhibitors (SNRI)
SNRI works by producing more serotonin and norepinephrine in the brain. If SSRI is not successful, the doctor may suggest it. Benrafaxin and Duloxetin are examples of SNRI. Health experts consider SNRI drugs safe and effective in treating depression in the elderly because they have fewer side effects.
3. Monoamine oxidase inhibitor (MAOI)
Your doctor can prescribe MAOI when all other antidepressants are ineffective. MAOI prevents monoamine oxidase from removing dopamine, serotonin, and norepinephrine from the brain. These drugs include isocarboxazid and phenelzine. Some people may experience high blood pressure due to elevated levels of tyramine in MAOI. Health experts stress that people taking MAOI should monitor their blood pressure and pay attention to their food intake.
4. Tricyclic antidepressant (TCA)
TCA can treat depression by increasing the amount of serotonin and norepinephrine in the brain. Doctors rarely administer TCA as the primary treatment for senile depression. This is because it can cause irregular heart rates and falls in the elderly. These drugs include amitriptyline and amoxapine.
5. Atypical antidepressants
These drugs work differently than other antidepressants. Atypical antidepressants change the chemical properties of the brain to help relieve depression. These drugs include bupropion and nephazodone. You should take and complete these medications as prescribed by the doctor until the doctor says it is safe to stop even after the symptoms improve.