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Depression treatment guidelines for older adults

Old age brings with it a significant reduction in mental and physical abilities. This translates into an inability to fight disease and handle difficult situations. This sudden reduction in capabilities causes depression due to low self-esteem.  Strength of character and previous achievements are no guarantee against depression as it can occur even without any visible precipitating factor. Certain drugs and medication can be used to treat depression. However, over-prescription of these very drugs can cause further depression if not ingested carefully.

Apart from the conventional medications, there are other methods of treating depression naturally like psychotherapy or ‘talk therapy’. There are also natural remedies for depression like herbs, homeopathy meditation, hot baths and other relaxation techniques.

For older people doctors normally choose antidepressants that work upon brain chemicals called neurotransmitters responsible for moods, thought and behaviors. One such category of antidepressants that is in use nowadays is SSRIs (selective serotonin reuptake inhibitors). For psychotic depression that is accompanied by hallucinations and delusions, an antipsychotic drug is prescribed along with an antidepressant.

Factors that should be kept in mind once you start taking antidepressants include:

* Management of side effects.
* Interaction of other drugs that you might be taking.
* Dosage.
* Withdrawal symptoms on discontinuation.

SSRIs have fewer and more manageable side effects but they can interact with other drugs and cause serious damage. You should ensure that you indicate all medication that you are taking to the physician before you actually start the medication. Your alcohol intake, including wine and beer, is another matter that should be discussed with your doctor as hard drinks can interfere with antidepressants. Once on the medication, it is important to disclose all changes that may occur.

Psychotherapy is of little or no use in cases where older people are suffering from dementia, which is a mental deterioration of organic or functional origin. In most other cases, psychotherapy is a safe way of treating depression. Depending upon the condition of the patient, different types of psychotherapy are used to treat mild depression as a standalone therapy or in conjunction with medication.

* Cognitive behavioral therapy – to identify and correct pessimistic thoughts and beliefs.
* Interpersonal therapy – to improve relationship issues that might be the cause behind depression.
* Supportive therapy – to provide emotional support.
* Problem solving therapy – to help in managing problems.

Psychotherapy involves visiting a psychiatrist who ‘talks’ to the patient – alone or in a group. Psychologists may even ask older people to do some ‘home work’ in order to put the therapy to practical use. It is a slow but effective procedure and requires a concerted effort before it can show significant results.

Family support goes a long way in treating depression in older people. Older people need help and specific guidance as they are less likely to take care of the condition themselves. Late life depression can be a source of problem not only for the person suffering from it but also for the family and care givers. The family needs to adjust to the abnormal behavior of a loved one lest symptoms are aggravated. Depression in older people needs to be managed with a great amount of patience and perseverance. Untreated depression is the most common cause of suicide in America and older people are at double the risk of suicide than the national average.

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