Depression is highly treatable in many cases. The earlier the diagnosis is made and treatment is started, the more likely a person is able to experience full recovery.

Treatments used in the elderly with depression

Medication, counseling and therapy are some modes of treatment used for treating elder depression. Although response to treatment varies from person to person, it usually takes months before substantial improvements can be seen.

Medical Treatment

Antidepressant medication can help reduce the symptoms associated with depression. Although effective, antidepressants have been associated with some side effects, depending from person to person. Informing a doctor about any side effects is important, as a more suitable medication could be prescribed. To prevent complications, medication should not be stopped or changed without first informing a doctor.

Common side effects associated with antidepressant medication

• Dry mouth
• Blurred vision
• Nausea
• Increased appetite
• Weight gain
• Fatigue
• Drowsiness
• Sexual Problems
• Anxiety

Counseling and Therapy

PSYCHOTHERAPY OR “TALK THERAPY”

Psychotherapy has been shown to help depressed people cope with the illness by coaching them on how to approach situations using new ways of thinking. It could help them change negative ways of thinking that may otherwise worsen their state of depression.

COGNITIVE BEHAVIORAL THERAPY (CBT)

CBT alone or in addition to medical treatment has been found to be effective in treating the elderly with depression in many cases. CBT helps depressed people overcome their depression by helping them recognize that certain ways of thinking could lead to emotional distress. With CBT, a problem is often broken down into small essential parts: situation, thoughts, feelings and actions (see fig 1). For the depressed, these parts connect with each other such that a problematic situation often leads to unpleasant thoughts and feelings. When a person is not aware of this, it usually becomes a vicious cycle. It is hoped that CBT helps them recognize negative reinforcing patterns and assists in taking action by breaking the cycle of depression.

What happens during CBT?

• CBT is conducted over several sessions each lasting about an hour with a therapist.

• Sessions may be conducted in a group or individually.

• During CBT, the therapist would ask questions.

• The patient is encouraged to talk about his life focusing on present feelings, thoughts and actions.

• Homework and tasks are given during sessions.

• Progress is followed in each session.

A depressed elderly may take time to adjust to medical treatment and psychotherapy. A good treatment plan, accompanied by close follow-up sessions is key to improvement. Depression may recur if treatment is given inadequately or if there is poor compliance to medical treatment and psychotherapy.

During Treatment: healthy lifestyle benefits elderly people with depression

In addition to adequate medical treatment and psychotherapy, a healthy lifestyle and having a good support system of family and friends, are vital to recovery from depression and in preventing depression from setting in again.

Lifestyle tips to combat depression

Eat Healthily & Exercise

• Limit your intake of food rich in refined sugar. Not doing so may lead to sudden changes in your blood sugar levels. High blood sugar can contribute to feelings of anxiety, fatigue and irritability.

• Decrease alcohol and coffee in your diet. Both these substances may influence moods directly by altering the levels of chemicals found in the brain.

• Stock up on your nuts, seeds, salmon and sardines. These are rich in omega-3 oils which keeps your brain healthy.

• Take more green leafy vegetables. Green leafy vegetables are rich in vitamins and minerals. Vitamins B6, B12, iron and folic acid are necessary for brain function.

• Exercise! Regular exercise increases blood flow to the brain and releases natural chemicals that help improve your mood.

• Keep Busy.Find productive things to do and start a personal project today! Direct your attention to doing things that make you happy. Dig for those old recipes and prepare a nutritious and delicious meal, watch a funny DVD movie with relatives or borrow an entertaining novel or magazine form the library.

• Socialize. Meet people to lift your mood. Getting old friends together for breakfast to reminisce about the old days at a nearby kopitiam and watching a weekend movie with family and friends can be enjoyable.

• Plan and live within your means. Unmet medical bills and unpaid debts can lead to sleepless nights and emotional distress. This type of persistent stress may contribute to depression setting in.

Make time for building relationships. Sharing some jokes, watching funny movies and playing mahjong or board games can be fun and entertaining. Setting aside some quality time for bonding with relatives and friends can help you keep your mind active and avoid internalising negative thoughts and feelings which could otherwise lead to you feeling depressed.

Join support groups. In support groups, depressed-proned individuals may realise that other people share similar experiences. By interacting with other members of the support group, they may find better ways to cope with negative thoughts, feelings and poor relations with friends and relatives, for instance.

Don’t be afraid to learn. Learning more about depression and knowing where to go, when experiencing five or more symptoms of depression over two weeks or more can help with early diagnosis and treatment.