A Promising New Treatment for Senior Depression

Eric Lenze MD from Washington University School of Medicine with senior depression patient Daniel Viehmann

Good news for seniors with depression: A study conducted by Washington University School of Medicine and published in The Lancet this fall found that 44% of depressed adults over 60 who took anti-psychotic medication along with antidepressants felt better than patients on antidepressants alone. That gives doctors another treatment option for the 5% to 18% of seniors who suffer from depression. Right now, experts say, as many as 90% of depressed seniors don’t receive proper treatment—even though there are many effective treatment options.

Part of the problem in spotting depression is that most seniors today came of age when mental illness was stigmatized, mistakenly viewed as a character flaw, or simply not discussed. Another obstacle to getting help is that depression in seniors is often mistaken for normal aging or another disorder like Alzheimer’s, thyroid disease, or even cancer. An existing illness can contribute to depression while also making depression harder to identify.

According to the National Alliance for the Mentally Ill (NAMI), the rates of depression are highest for seniors who are seriously ill or disabled and those who feel socially isolated or dependent on others. Left untreated, depression can worsen other illnesses and lead to suicide—a particular risk for older Caucasian men. Even if you or your parent has always had robust mental health, it’s a good idea to know what depression can look like in seniors and how it can be treated.

Depression in older adults may look different

The best-known symptoms of depression are a persistently low mood, lack of energy, irritability, and thoughts of hopelessness or self-harm. But among seniors, experts say, depression can show itself in other ways. NAMI recommends watching for changes in behavior like making more demands, constantly asking for help, moving more slowly than usual, or complaining more often.

Other symptoms of depression include:

• Insomnia or sleeping excessively
• Loss of appetite and weight loss or overeating and weight gain
• Chronic pain
• Loss of interest in socializing and hobbies
• Memory and decision-making problems

Some older adults may not realize they are depressed or don’t want to admit it. That’s why people with any of these symptoms should ask their doctor if depression could be the cause or a contributing factor.

There are many effective treatments for depression

Modern therapies for depression work much better than the treatments of yesteryear. NAMI says up to 80% of depressed seniors feel better after proper diagnosis and treatment. Typical treatment options are antidepressant medications, talk therapy, and in some difficult-to-treat cases, carefully administered electroconvulsive therapy.

Antidepressants alone are effective only about half the time in older patients, according to the researchers who conducted the Lancet study. Researchers think age-related changes in the brain may reduce the effectiveness of standalone antidepressant therapy. Their next goal is to find a way to predict which seniors will need the 2-drug combination therapy so they can receive effective treatment faster.

Finding support and proper medical care

If you or your loved one may be in danger of self-harm or suicide, call 911 or go to the nearest emergency room. If you or your loved one has less severe signs of depression, see your physician. Bring a family member or friend to ask questions and take notes if you’re feeling confused or having memory problems.

Your doctor may be able to start treatment or refer you to a psychiatrist or a geriatrician with specialized knowledge of the medications that work best in seniors. You and your healthcare team may have to try a few treatments before you find the regimen that works best for you. This can take a few weeks or months, but it’s worth the time and effort, because your golden years shouldn’t be lived under a dark cloud.

Casey Kelly-Barton

Casey Kelly-Barton is an Austin-based freelance writer whose childhood was made awesome by her grandmothers, great-grandmother, great-aunts and -uncles, and their friends.