Depression

This week let’s deep dive into the topic of depression and aging. Maintenance of mental and emotional health is a huge component of aging well, and depression is very underdiagnosed and inadequately treated in older adults. There are life events that occur as we age that predispose a person toward depression such as loss of loved ones and loss of independence/function, but depression is not a normal part of aging.

As we age, the rate of depression can vary widely. About 1/10 older adults will meet criteria for depression, and this rate only increases for older adults suffering from significant medical illness, in some studies up to 4/10! The symptoms of depression can match symptoms of other chronic illnesses, which can make it difficult to sort out the cause. In fact, a common presenting symptom of depression in an older adult is memory difficulty which can be very concerning for something like dementia, but with a few questions we can get to the bottom of the symptoms.

In our office, we offer the GDS, which stands for the Geriatric Depression Scale. This is a short questionnaire of 15 items that let’s us know a person’s mood over the past week. There are a few other questionnaires, such as the PHQ-2 and PHQ-9, and whenever you go see your clinician you should have one of these questionnaires done at least one time per year. Recognition of depression is critical because it is the first step toward treatment and improved mental and emotional health.

Depression, although not always easily treatable, does have several medication options, which work best with counseling and therapy. I always highly recommend both, but I understand many people have reservations about both medications and therapy. Many older adults, particularly older men, were raised in a setting to not talk about feelings and it can be uncomfortable and invasive. This is actually one reason I like the depression questionnaires, they ask important questions that are administered in a non-threatening or triggering manner, and I have found some people are more honest on paper than in person (many people do not want to “bother” their doctor, which is very kind-hearted, but were are here to be “bothered”).

Recognition and treatment of depression is critical for healthy aging. There are many things that are natural parts of aging, wear-and-tear of joints, occasional memory trouble, vision and hearing trouble, but depression is not a normal part of aging. Those natural parts of aging can predispose us to depression, but I just want to repeat again, depression is not a normal part of aging. If you think you or a loved one is experiencing symptoms of depression, I would highly recommend visiting your primary care clinician to start a discussion.

Key Points:

• Up to 4/10 older adults will experience depression, this number is likely an underestimate

• Depression is not a normal part of aging

• There are medications and treatments available, but recognition and diagnosis is the key first step!