Geriatric Depression and Alternative Therapies

People of different ages suffer from psychological and physiological issues throughout various stages of their lives. Depression is one of those problems, and it can have severe effects on one’s life and health. According to LeVine (2010), depression is “a transitory mood or emotion experiences at various times by all individuals” (p.112). People who are over 65 can suffer from depressive moods, which are caused by possible disabilities, increased mortality rates within the elders’ communities, or by the results of severe illnesses (Cahoon, 2012).

Consequently, depression has different implications and can have a substantial impact on the present and future life of people. The purpose of this paper is to analyze the issue of depression in older adults, to observe the traditional ways of its treatment, and investigate alternative therapies that can positively contribute to overcoming depression.

Although different age groups are subjected to depression, among older adults, this psychological state is widespread and can influence individuals living in diverse settings. The statistics demonstrate that around 15% to 19% of Americans in the ages over 65 suffer from various symptoms of this condition (Cahoon, 2012).

The curious point is that for the elders who live in nursing homes or other care facilities, the rate goes higher and can reach up to 44% (Cahoon, 2012). Also, the depression rates tend to grow with the increase of the geriatric age. The researchers found that almost 25% of people who are older than 85 can get depression, while for those who are older than 90, the rate can go up to 50% (Aziz & Steffens, 2013). Therefore, one can see that the likelihood of depressive conditions increases with age.

Moreover, the level of depression implies high suicide and mortality rates. The numbers show that for the older adults, the death rate was 14 deaths in 100,000 people, while for the general population, this number was 11 (Cahoon, 2012). The studies have also discovered that older people suffering from depression who started to receive home care are more likely to be hospitalized than those who do not have this condition (Cahoon, 2012). Consequently, older adults have high risks of experiencing depression symptoms, which can decrease their lifespan and have a negative influence on their life perception.

Various factors can influence the increase in the possibility of being subjected to depression for older adults. Among them, there are losses, social isolation, depression tendencies among other family members, sleep disturbance, chronic medical illnesses, a decline in functionality, dependence, and others (Cahoon, 2012). Older people experience many losses in different areas of their lives.

It can be friends passing away, losing relatives, losing physical abilities, and losing houses and habitual daily rituals, which have a direct influence on the mood and psychological state of an individual. Among the elders, depression can be present in different forms, such as continuous depressive moods from earlier life, new depression, or mood disorders because of medical conditions or medication use (Aziz & Steffens, 2013). Thus, various reasons lie behind the depression rates among older people, and it is essential to be able to identify them and provide necessary treatment.

At this point, it is crucial to look at the possible symptoms that can help to recognize depressive states among older adults and take necessary measures to treat them. The signs include insomnia or excessive sleep, weight loss or gain, loss of energy, indecisiveness, depressed mood, lower interest in pleasant activities, feelings of guilt or worthlessness, and suicidal thoughts (Cahoon, 2012). The combination of some of those symptoms signals the development of depression among the elders, and tracking them is integral. According to Cahoon (2012), “it is essential to assess the patient’s mood regardless of presenting symptomatology” (p. 25).

Today, many tools that are useful in determining the presence of depression exist, and clinicians start actively using them. For instance, the Geriatric Depression Scale Form, the Hamilton Rating Scale for Depression, and the Patient Health questionnaire are valuable techniques for the elders’ evaluation (Cahoon, 2012). Thus, careful screening and assessment are required to minimize the adverse effects of prolonged depressive conditions among older adults.

Different pharmacological and traditional approaches aim to treat depression in the elders. According to Gould, Coulson, and Howard (2012), some of the common ways of managing depressive disorder are pharmacotherapy and psychotherapy. Pharmacological approaches to fighting depression imply the prescription of antidepressant drugs. Nevertheless, the statistics show that the drugs’ efficiency is lower for older people, and around 40% of the patients do not have the desired outcomes from the prescribed medication (Bottino, Barcelos-Ferreira, and Ribeiz, 2012).

Besides, the patients’ surveys have discovered that pharmacological treatment often is not appropriate because the elders do not always get the right dose of medicine (Bottino et al., 2012). Besides, some patients can be resistant to medication effects, which creates a treatment-resistant depression (Shelton, Osuntokun, Heinloth, and Corya, 2010). Consequently, the pharmacological approach through antidepressants and other related drugs is one of the ways that helps to treat depression in older adults in many cases but is not always successful.

Another traditional way of handling depressive disorder is psychological therapy. Personal attitude and individual interaction are the essential components for the holistic approach to depression treatment. Psychotherapy implies those aspects and focuses on the patient, which makes the treatment process more distinctive and has a high chance of success. One of the most common psychotherapy methods is cognitive-behavioral therapy (CBT), and it has proved itself to be very effective.

However, the studies have revealed that CBT produces better results when professionals combine it with pharmacotherapy (Gould et al., 2012). The National Institute for Health and Clinical Excellence states that cognitive-behavioral therapy and interpersonal therapy, in combination with proper medications, are likely to lead to remission (Bottino et al., 2012). Therefore, integrating both pharmacological and physiological therapies into the depression treatment process in older adults can produce positive results.

Hence, the weaknesses of separate use of pharmacotherapy or psychotherapy create a need to investigate other practices that can help the professionals fight depression. Besides the approaches discussed above, different alternative and complementary strategies to fight depression take their place within the healthcare industry. One of the complementary therapies is a yoga practice that helps to balance body and mind.

The studies have shown that implementing different yoga exercises, including meditation and breathing techniques, can have a favorable impact on the reduction of depressive moods (Mehta & Sharma, 2010). Breathing exercises or meditation practices are useful measures for older adults to implement in their daily lives, which can improve mental health.

Another interesting finding for the alternative approach to depression management is electroconvulsive therapy (ECT). The studies that have examined ECT’s influence on depression reveal that in response to this therapy, “redistribution of the cerebral blood flow” occurs (Shelton et al., 2010). It leads to the decrease of such hormones as dopamine and noradrenalin, which can reduce the levels of depression among the elders (Shelton et al., 2010).

However, the disadvantage of this approach lies in the fact that the working mechanism of ECT is not fully discovered. Besides, there are possible side effects, including nausea, vomiting, and migraines (Shelton et al., 2010). Consequently, electroconvulsive therapy can be an alternative way of handling depressive conditions. Still, the patient must be suitable for this treatment and get the necessary care and support afterward.

One more technique that is used in the healthcare industry as a treatment measure for treatment-resistant depressions is vagus nerve stimulation (VNS). VNS has proved its effectiveness in lowering depression symptoms and improving mental health among older adults. However, several studies concluded that better results come with an extended treatment process. Thus, using VNS for up to one year with a patient can be effective (Shelton et al., 2010).

One can claim that a prolonged period of treatment might create obstacles in specific instances. Also, the negative impacts of VNS can include voice alterations, pain in the neck, and coughing (Shelton et al., 2010). Consequently, vagus nerve stimulation is another alternative approach that has both positive and negative sides.

In conclusion, depression is a serious illness, and many older adults are subjected to it. Numerous individualistic and external factors can cause depressive moods in individuals. Depression disorder has different symptoms, and the professional need to carefully assess the patients to recognize the condition at the early stages. Besides the traditional use of psychotherapy and pharmacotherapy, various complementary and alternative approaches for depression treatment integrate the industry. Among them, there are yoga practices and meditation, electroconvulsive therapy, vagus nerve stimulation. A thorough evaluation of the existing methods and their careful application into practice to manage depression in older adults can have a positive influence on the outcomes.

References

Aziz, R., & Steffens, D. C. (2013). What are the causes of late-life depression? Psychiatric Clinics, 36(4), 497-516.

Cahoon, C. G. (2012). Depression in older adults. The American Journal of Nursing, 112(11), 22-30.

Bottino, C. M., Barcelos-Ferreira, R., & Ribeiz, S. R. (2012). Treatment of depression in older adults. Current Psychiatry Reports, 14(4), 289-297.

Gould, R. L., Coulson, M. C., & Howard, R. J. (2012). Cognitive-behavioral therapy for depression in older people: A meta‐analysis and meta‐regression of randomized controlled trials. Journal of the American Geriatrics Society, 60(10), 1817-1830.

LeVine, R. A. (2010). Psychological anthropology: A reader on self in culture. Malden, MA: Wiley-Blackwell.

Mehta, P., & Sharma, M. (2010). Yoga as a complementary therapy for clinical depression. Complementary Health Practice Review, 15(3), 156-170.

Shelton, R. C., Osuntokun, O., Heinloth, A. N., & Corya, S. A. (2010). Therapeutic options for treatment-resistant depression. CNS Drugs, 24(2), 131-161.