Home » Misc » Treatment for depression in the elderly

Treatment for depression in the elderly


SAMHSA’s National Helpline | SAMHSA

Your browser is not supported

Switch to Chrome, Edge, Firefox or Safari

Main page content

  • SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

    Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

The service is open 24/7, 365 days a year.

English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.

In 2020, the Helpline received 833,598 calls. This is a 27 percent increase from 2019, when the Helpline received a total of 656,953 calls for the year.

The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.

The service is confidential. We will not ask you for any personal information. We may ask for your zip code or other pertinent geographic information in order to track calls being routed to other offices or to accurately identify the local resources appropriate to your needs.

No, we do not provide counseling. Trained information specialists answer calls, transfer callers to state services or other appropriate intake centers in their states, and connect them with local assistance and support.

  • Suggested Resources

    What Is Substance Abuse Treatment? A Booklet for Families
    Created for family members of people with alcohol abuse or drug abuse problems. Answers questions about substance abuse, its symptoms, different types of treatment, and recovery. Addresses concerns of children of parents with substance use/abuse problems.

    It's Not Your Fault (NACoA) (PDF | 12 KB)
    Assures teens with parents who abuse alcohol or drugs that, "It's not your fault!" and that they are not alone. Encourages teens to seek emotional support from other adults, school counselors, and youth support groups such as Alateen, and provides a resource list.

    After an Attempt: A Guide for Taking Care of Your Family Member After Treatment in the Emergency Department
    Aids family members in coping with the aftermath of a relative's suicide attempt. Describes the emergency department treatment process, lists questions to ask about follow-up treatment, and describes how to reduce risk and ensure safety at home.

    Family Therapy Can Help: For People in Recovery From Mental Illness or Addiction
    Explores the role of family therapy in recovery from mental illness or substance abuse. Explains how family therapy sessions are run and who conducts them, describes a typical session, and provides information on its effectiveness in recovery.

    For additional resources, please visit the SAMHSA Store.

Last Updated: 08/30/2022

SAMHSA Behavioral Health Treatment Services Locator

Home

Welcome to the Behavioral Health Treatment Services Locator, a confidential and anonymous source of information for persons seeking treatment facilities in the United States or U.S. Territories for substance use/addiction and/or mental health problems.

PLEASE NOTE: Your personal information and the search criteria you enter into the Locator is secure and anonymous. SAMHSA does not collect or maintain any information you provide.

Please enter a valid location.

please type your address

  • FindTreatment.

    gov

    Millions of Americans have a substance use disorder. Find a treatment facility near you.

  • 988 Suicide & Crisis Lifeline

    Call or text 988

    Free and confidential support for people in distress, 24/7.

  • National Helpline

    1-800-662-HELP (4357)

    Treatment referral and information, 24/7.

  • Disaster Distress Helpline

    1-800-985-5990

    Immediate crisis counseling related to disasters, 24/7.

  • Overview
  • Locator OverviewLocator Overview
  • Locator OverviewLocator Overview
  • Finding Treatment
  • Find Facilities for VeteransFind Facilities for Veterans
  • Find Facilities for VeteransFind Facilities for Veterans
  • Facility Directors
  • Register a New FacilityRegister a New Facility
  • Register a New FacilityRegister a New Facility
  • Other Locator Functionalities
  • Download Search ResultsDownload Search Results
  • Use Google MapsUse Google Maps
  • Print Search ResultsPrint Search Results
  • Use Google MapsUse Google Maps
  • Icon from Find practitioners and treatment programs providing buprenorphine for opioid addiction (heroin or pain relievers). Find practitioners and treatment programs providing buprenorphine for opioid addiction (heroin or pain relievers).
  • Icon from Find practitioners and treatment programs providing buprenorphine for opioid addiction (heroin or pain relievers). Find programs providing methadone for the treatment of opioid addiction (heroin or pain relievers).

The Locator is authorized by the 21st Century Cures Act (Public Law 114-255, Section 9006; 42 U.S.C. 290bb-36d). SAMHSA endeavors to keep the Locator current. All information in the Locator is updated annually from facility responses to SAMHSA’s National Substance Use and Mental Health Services Survey (N-SUMHSS). New facilities that have completed an abbreviated survey and met all the qualifications are added monthly. Updates to facility names, addresses, telephone numbers, and services are made weekly for facilities informing SAMHSA of changes. Facilities may request additions or changes to their information by sending an e-mail to [email protected], by calling the BHSIS Project Office at 1-833-888-1553 (Mon-Fri 8-6 ET), or by electronic form submission using the Locator online application form (intended for additions of new facilities).

Depression in the elderly: causes, symptoms, prevention, treatment

Many of us, perhaps, often encountered such manifestations from elderly relatives as: bad mood, discontent and other negative things. At such moments, communication with older people becomes extremely difficult, but at the same time, such a state of an elderly person must be treated with understanding and sympathy. Elderly people are extremely often faced with such a disease as senile depression, and in fact it is a mental disorder of the neurotic sphere against the background of a change in the functioning of the processes of the autonomic and, accordingly, the nervous systems.

However, even depression in the elderly is treatable and can and should be addressed. Treatment is possible! Moreover, in most cases it brings tangible results. What are the symptoms of depression and the causes of depressive conditions in the elderly, as well as what methods of prevention and treatment exist, we will describe in this article.

Causes of depression in old age.

According to the statistics of the global psychiatric community, from 15% to 30% of older people (65 years of age and older) experience symptoms of depression. The spectrum of causes can be extremely diverse. In an active period of life, when each of us has millions of worries and tasks, including favorite work, opportunities to take care of children and loved ones, physical activity, there is simply no time to think about experiences. A person feels himself needed by the family and society, is aware of his life goals and objectives. From the moment of retirement and completion of labor activity, especially if the children have grown up and moved away, a huge amount of free time appears, and it becomes very difficult for an elderly person to use it, feeling self-realization. The level of social significance and the number of contacts are sharply reduced, which leads to the manifestation of decadent moods and depressive states. Another significant reason is a decrease in physical activity and limited opportunities to spend time in the usual way.

All of the above causes lead to the development of neurotic symptoms, such as feelings of fear and anxiety, panic attacks, decreased appetite and autonomic symptoms, which we will discuss below.

Depression in the elderly: Who is at risk first?

The gender factor should also be taken into account. Women over 80, for example, experience senile depression more frequently than men of the same age. And in middle-aged people, the symptoms may be more pronounced than in the very elderly. Also, as noted earlier, the presence of a family and a caring environment, people who can support, create the appearance of significance and distract the elderly from gloomy thoughts, plays a significant role.

Thus, relatively speaking, the causes and prerequisites for the development of depression in the elderly may depend on the factors listed below.

  • social
  • gender
  • vegetative

But at the same time, one should not underestimate the general mental component of the personality. In addition to such psychological reasons, in many older people, depression is caused by the initial psychotype (gene predisposition), previous experience and tendency to neurotic diseases, alcohol or medication abuse, as well as the environment in which the person is located, physical health.

Symptoms of depression

With regard to symptoms of depression, the main and most common symptoms are:

  • frequent mood swings,
  • general energetic mental decline,
  • as well as decreased interest in life.

At the same time, many elderly people, who previously had a docile nature and cheerfulness, suddenly become aggressive for no apparent reason, or vice versa fall into indifference and apathy, completely losing interest in life and any motivation.

In medical practice, the most common symptoms include: An older person's overestimation of their current physical condition. Complaints about health that are not true. Increased anxiety, apathy, unwillingness to communicate with anyone, physical stagnation, negative vision of reality, including thoughts of death, anhedonia, the potential for panic attacks, loss of interest in social responsibilities (unwillingness to solve even simple everyday tasks), memory impairment, hysteria and demanding increased attention to oneself, unreasonable nitpicking of relatives and strangers.

Thus, more structured symptoms of depression can be manifested as:

  • decreased activity and increased anxiety about the slightest activities outside the home
  • sharp and constant mood swings, manifestations of aggression,
  • increased level of anxiety and unreasonable fear,
  • increased lack of attention from loved ones,
  • increased lack of attention from loved ones.

It is logical to assume that the listed symptoms worsen not only the mental state, but also directly affect the physical health of an elderly person. Due to constant gloomy thoughts, anxiety, fear and discontent, chronic diseases and age-related ailments develop.

According to WHO statistics, the physical consequences of depressive disorders in the elderly can lead to diseases such as circulatory disorders in the vessels of the brain, including atherosclerosis, which increases the risk of ischemia, heart attacks and strokes, and can also provoke the development of diabetes or even cancer.

It should be understood that the development of chronic and dangerous diseases requires constant drug therapy, and taking drugs, as we know, can aggravate the mental state, in this regard, elderly people should be careful when taking drugs.

Prevention of depression in the elderly

The most effective method that can prevent the development of depressive disorders in elderly relatives is participation and care, as well as an understanding of the emotions and feelings that a person experiences with the advent of old age.

Absolutely any person in old age needs help and participation, even if he does not openly declare it and does not demand attention to himself. To help an elderly person and prevent the development of a depressive syndrome, it is worth showing him that he is significant and still in demand. Ideally, delegate important powers to grandparents: caring for grandchildren, finding important information, cooking, and so on. It’s great if an elderly relative can do something with his hands: knitting, minor repairs, sewing, construction - any work with his hands can not only distract the elderly from gloomy thoughts, but once again remind him of his significance and role in the family. Unfortunately, in a state of depression, older people often begin to limit themselves in communicating with other people, so the task of loved ones is to gently and tactfully provoke an aged person to action. Another powerful trigger for the development of a depressive disorder in old age is the loss of a spouse or friend. As well as the development and exacerbation of chronic diseases, the loss of former activity and efficiency. To avoid the consequences of these factors, it is very important not to give up physical activity: it’s great if the family has a dacha where old people could mess with the garden, build something or take care of flowers. Regular walks, hydrotherapy, therapeutic exercises - all these simple methods are an excellent prevention of the development of neurotic conditions. Drug therapy is another effective method in some cases. A well-designed course by a specialist will help eliminate the aggravation of many symptoms.

How to get an older person out of depression at home

The first thing to do if you suspect a mood disorder is to talk softly and carefully with your relative, try to identify the specific reasons that cause him anxiety. Particular attention should be paid to the physical condition. Further in the conversation, it is necessary to explain to an elderly person the need to go to a psychologist or even a psychiatrist, since the treatment of depressive disorders is possible only under the supervision of a specialist. Also, as noted, it is very important to organize the proper level of physical activity: water procedures, fresh air, sunbathing, communication with nature and animals. And finally, try to organize your leisure time in such a way as to improve your mood. Any insignificant, but pleasant fact for a close elderly person can distract him from his worries and direct his thoughts in the right direction. According to statistics, bouts of bad mood and spleen overtake people in the evening before night. To smooth out these periods, you can resort to traditional medicine methods: chamomile tea or rosehip infusion, a warm bath, body-oriented practices if possible (massage sessions, for example) - all these simple methods will help an elderly person fall asleep easier and reduce anxiety levels.

But the most important thing is, of course, attention and care, sincere participation and friendly communication from relatives.

How depression is diagnosed in the elderly

The diagnosis of age-related depression is a time-consuming and complex process, depending on many factors, since, first of all, the symptoms of depression can be lost against the background of other general symptoms that accompany physical spectrum disorders in older people. Moreover, the patient is likely to be more concerned about somatic manifestations (lack of appetite, poor sleep, blood pressure), and yet all of the above somatics may be a direct manifestation of a depressive mental disorder.

Another important factor is the reduced interest on the part of relatives in the depressive manifestations of the elderly. Grunts and complaints about health are taken by others as a matter of course in old age and are associated with the natural state of aging of the body. It is also worth noting that the elderly themselves are not willing to seek help from a specialist because of the fear of falling into a madhouse or a nursing home, which also significantly complicates the process of diagnosing a pathological condition.

Features of the treatment of depression in the elderly

Due to the fact that in our modern society the diagnosis of "senile depression" is not common, the treatment itself is presented in a rather limited range, however, it exists and can bring very positive results.

In fact, complex therapy is represented by two areas of treatment: medication and psychotherapy.

Unfortunately, most older people, agreeing to drug therapy, completely refuse psychotherapy and communication with a specialist. In this aspect, it is very important that relatives can explain the need and effectiveness of this treatment and convince the elderly person to undergo therapy with a professional. In most cases, complex treatment shows excellent results and can bring the patient to the level of stable remission.

So, let's look at each of the areas of treatment in more detail.

Treatment of depression in the elderly, as we mentioned above, the complex consists of two stages: medication and psychotherapy.

Drug therapy

It is logical to note that drug therapy involves the use of drugs.

Experts recommend the following medications for depression in the elderly:

  • Melipramine . Listed as a stimulant antidepressant. It has a sedative effect that affects the calming of the nervous system and improves the mood of the patient. In fact, it is suitable for the treatment of any kind of depression, normalizes sleep, stimulates motor function.
  • Attarax . It has a strong and fast action, effectively relieves anxiety, dulls the feeling of fear. Recommended to relieve irritability and aggression on the part of the patient.
  • Leviron . It is also used for all types of depressive disorders. It has a strong sedative effect, aimed at general calming of the nervous system. It is recommended for the treatment of just the same elderly people, as it has a reduced range of side effects.
  • Cipramil . Perfectly treats psychosomatic manifestations, Recommended for course admission. The main spectrum of influence is calming.

Psychotherapy

Be that as it may, but psychotherapeutic treatment, even for an elderly person, is still the most effective method in the fight against any kind of depressive disorders. Moreover, in the case of mild and moderate depressive forms, a psychotherapeutic approach is sufficient, that is, it allows you to do without medication. Medicines can only be used to consolidate the effect and long-term stabilization of the condition.

As we know, the psychotherapeutic method is the safest, besides, even in the case of taking medications, one cannot do without the intervention of a specialist. Neutralization of depressive states and its consequences is possible only through personal psycho-emotional contact with the patient. Medications themselves have an impact only on the work of the central nervous system and the brain, and a change in lifestyle and thoughts occurs precisely in work with a psychotherapist.

As noted above, very important aspects in therapy are such aspects as adherence to the daily routine, the establishment of a proper lifestyle, including walks, activities, proper nutrition, proper timely sleep, etc. The patient can be enrolled in a special club for the elderly. It is worth noting that even in Russia, especially at psychotherapeutic centers, there are special clubs for the elderly, where they can not only receive qualified assistance. But also find like-minded people.

Depression in the elderly and its types

In accordance with the causes that provoke the development of a depressive disorder at a later age, this neurotic disease can be divided into types:

  • Organic depression . It is the most common disease, based on the destruction of the nervous system, which can be genetic (congenital) or acquired during life.
  • Psychogenic depression . The trigger for its development is most often a traumatic factor. Any acute negative event that happened to the patient. For example, the departure of a loved one, problems in the family, difficulties in society, and even a change of residence.
  • Somatogenic depression . This variety is especially characteristic of the elderly, as well as patients who are in a medical institution for a long time. This type is basically based on physical health problems that in most cases accompany people of age (diseases of the heart, brain, musculoskeletal system, respiratory organs and the vegetative-vascular system). In other words, physical suffering and disability are a powerful trigger for the development of neurotic disorders.
  • Bipolar \ Monopolar depression is expressed in endogenous and affective diseases: sudden attacks of aggression or irritability, sudden and frequent mood swings, provoked by internal destructive aspects in combination with a genetic factor.
  • Iatrogenic depression . The predominant trigger is long-term use of drugs of any spectrum.

As for the depression of the elderly, as such, the main motive for its pathogenesis is the negative emotions that an elderly person most often experiences. They are associated with many factors, including physical abnormalities. In second place is the social environment: disappointment in life and people, loneliness, lack of support from loved ones.

Effective removal of an elderly person from depression

As we have repeatedly noted, the first possible help for an elderly person who is faced with depression can and should be provided by the next of kin. If there are none, then friends or acquaintances, even neighbors on the landing. Drug therapy is, of course, the lot of specialists, but the main thing to do is to sincerely, attentively and heart to heart talk. To listen, to cheer, to do something pleasant, even just to walk down the street together.

How to treat depression in an elderly relative at home

Here are some simple but powerful tips on what to do in this case.

  • Listen carefully and patiently . Allow the elderly to feel nostalgic, remember the past and loved ones, and, if necessary, let them cry.
  • Contact the attending physician , even with the local therapist and tell in detail about all the symptoms, it is quite possible that some of them will serve as prerequisites for aggravating the condition.
  • Come up with different tasks and encourage their implementation . Tasks can be absolutely simple, the main thing is for the relative to feel his importance: to participate in cooking or setting the table, to advise on new interiors.
  • Do not skimp on praise and encouragement . Notice any, even in your opinion, and an insignificant trifle. Independent walk, good mood, housework.
  • Find out and help to realize the strengths of your relative. If grandfather is good at crafts, involve him in building crafts for his grandson or in creating a birdhouse. Grandma loves to bake pies - ask her to cook something for friends.
  • It is very important for to monitor the serviceability and availability of additional sensory accessories for the elderly, whether it be glasses or a hearing aid. These things should always be in a constant reach, because it is thanks to them that an elderly person does not lose touch with the outside world.
  • If a relative has a musculoskeletal problem, show empathy, demonstrate full understanding of their disease state . See if there's anything you can do to help.

I would not like to think about sad things, but a person's suicidal tendencies are often absolutely not noticeable. Carry out a number of preventive measures to protect the environment, such as: thorough cleaning of sharp objects, providing timely and regular warm meals, monitoring the intake of medicines prescribed by a doctor.

We understand that when an elderly person in a family is in a state of apathy and irritation, it is very difficult for a relative. Many lack patience and acceptance, which is understandable in principle, since the ability to empathize and sympathize, especially against the backdrop of the worries of the modern world, is a great art. Do not forget that we are all people, and if someone needs our help, we are obliged to provide it. And the experts are always there.

causes, symptoms, diagnosis and treatment

Depression is the most common mental disorder among the elderly. Every seventh person in old age suffers from depression. According to medical statistics, symptoms of depression occur in 13% of older people. The main factors in the development of depressive disorder in the elderly are traumatic life events, lifestyle and chronic diseases. Symptoms of depression are often hidden under general poor health, health complaints, chronic fatigue and bad mood, so relatives may not realize for a long time that a loved one has a serious problem and they need to see a specialist.

Depression in the elderly is very different from depression at a young age. Older people avoid the demonstrative manifestation of "suffering", do not complain and, for the most part, are not able to recognize the presence of a depressive state themselves. Often the symptoms of depression are disguised as manifestations of other diseases - a person may have a heart or intestines ache, he begins to complain of weather sensitivity or headaches. It is rather difficult for a non-specialist to diagnose signs of a mental disorder in these symptoms.

Causes of depression

The most common problems of older people that can cause depression are the loss of a spouse or other close person, health problems, primarily diseases that limit physical activity and the ability to self-care, diseases of the nervous system, loss of social contacts , financial difficulties.

Long-term use of certain drugs can lead to iatrogenic (pharmacogenic) depression.

Almost half of the elderly population is diagnosed with cerebral ischemia, which in most cases is accompanied by depression. Often, relatives perceive such diseases and the accompanying depressed mental state of an elderly person as inevitable, a normal process of aging and extinction. But gerontologists are convinced that brain diseases should be treated at any, even the most advanced age.

Often the impetus for the development of depression is a stroke or heart attack, as well as the development of diseases associated with the degradation of cognitive functions - dementia and Alzheimer's disease.

Women are more susceptible to depression than men. Also at risk for developing depression in older age are lonely people, the elderly, those who abuse alcohol, or those who have been diagnosed with mental disorders and suicide attempts in the past.

Symptoms of depression in old age

  • Changes in mood - despondency, irritation, lack of vitality, apathy and general negative mood.
  • Decreased physical and social activity - an elderly person begins to move little, rarely leaves the house. Any simple task or the need to go somewhere turns into a problem, makes him nervous and causes anxiety. A person closes in on himself, his circle of interests narrows, he stops communicating with friends. Often all activity is limited to trips to the clinic and the store. Inactivity and loss of social contacts cause deterioration of physical and mental health, which provokes a worsening of the depressive state.
  • Increased anxiety - an elderly person begins to worry excessively about himself and his loved ones, and his fears and anxieties are disproportionate to the occasion and situation.
  • Sleep disturbance - depression always causes problems with sleep. In old age, these are most often sleep disturbances, insomnia, anxious and superficial sleep.
  • Appetite disturbance - in the elderly with depression, there is often a sharp decrease in appetite and, as a result, weight loss.
  • Impairment of memory and concentration.
  • Deterioration of health. In old age, depression can manifest itself exclusively with physical symptoms - these are constant complaints of deterioration in well-being, constant pain, problems with the intestines, blood pressure, and so on. It is with such complaints that up to 90% of all age-related patients suffering from depression treat. Since people of advanced age always have several diseases at once, acquired at different periods of life, they begin to be actively treated. But with clinical depression in the elderly, no treatment for somatic diseases will help improve well-being and mood.
  • Feeling of own uselessness, uselessness, blaming relatives for misunderstanding and lack of attention.

Diagnosis of depression

Senile depression is difficult to diagnose. This is due to the peculiarities of the psychology of older people and the widespread attitude towards old age as a period of life associated with illness, infirmity and constant complaints. Symptoms of depression are often mistaken for manifestations of somatic diseases or age-related changes. Therefore, very often depression in the elderly remains undiagnosed and untreated.

Older people go to the doctor all the time for various illnesses, and they only focus on the physical symptoms of the illness. An older person may not be aware that the physical symptoms are associated with a mental state. In addition, people at this age often find it embarrassing and embarrassing to complain about mental problems, so even the most professional doctors can miss the development of depression. Traditional tests also do not reveal the presence of this disease. A special role should be played by caring relatives and the attending physician - those people who are well acquainted with a person and can assess changes in his physical, emotional and mental state and notice the symptoms of a depressive disorder in time. In this case, it is necessary to seek the advice of a specialist - a psychiatrist, clinical psychotherapist, neurologist, geriatrician or gerontologist. Older people rarely admit that they have mental problems and agree to visit a doctor, so you should try to bring an elderly relative to a frank conversation and convince him of the need for treatment.

Treating depression

Not treating depression in the elderly is contributing to a deterioration in their quality of life and a decrease in its duration. Depression in an elderly person can lead to a heart attack, coronary heart disease and other cardiovascular diseases, provoke the onset of type II diabetes and suicidal thoughts. Such patients do not follow the recommendations of doctors for the treatment of underlying diseases, which leads to their exacerbation.

Depression in the elderly is treated with a combination of medication and psychological therapy. Psychological counseling can be obtained in public institutions under the CHI program (limited number of consultations) and for a fee. Experienced geriatricians know that not all drugs are suitable for the elderly, that there are dosage features that depend on age, concomitant diseases and other medications taken. Treatment methods for older and younger patients can differ significantly. The sooner treatment is started, the more likely it is to normalize the biochemical processes in the brain.

Pain syndrome is one of the main triggers of depression in the elderly. Many elderly people live with constant pain in the joints, back, headaches. Doctors say that you can’t endure pain, so you need to contact your doctor with this problem and find an effective drug. By eliminating the pain syndrome, you can cope with a depressed state.

Restoring social contacts and physical activity is also important in mild depression. The support and help of the family is very much needed here. It is necessary to involve an elderly relative in common family affairs, find him an interesting activity or hobby, help him solve everyday problems, and not leave him alone.

Learn more