Depression In Elderly

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Depression In Elderly

Mental disorders are becoming more prevalent in today’s society as people add
stress and pressure to their daily lives. The elderly population is not
eliminated as a candidate for a disorder just because they may be retired. In
fact, mental disorders affect 1 in 5 elderly people. One would think that with
disorders being rather prevalent in this age group that there would be an
abundance of treatment programs, but this is not the case. Because the diagnosis
of an individual’s mental state is subjective in nature, many troubled people
go untreated regularly (summer 1998). Depression in the elderly population is a
common occurrence, yet the diagnosis and treatment seem to slip through the
cracks. Depression is an example of a metal condition that may slip through the
cracks when it comes to detection. The health care industry contributes to the
overlooking of depression in the elderly because of the overwhelming desire to
keep costs down. The factors of depression are open for interpretation, which
results in different doctors looking for different things. In addition to that,
elderly people may not exhibit the traditional symptoms of depression either.

Aged individuals may have symptoms of depression that go unnoticed due the fact
that those symptoms are being attributed to a different ailment. "One half of
all depressed patients seen by general physicians are not identified as
depressed (August 1995)." Also, some of the things people look for in
detecting depression are things that society seems to think are the norm for our
elders (October 1999). In addition, there appear to be a few fundamental
differences between depression in the young and old. Elderly people tend to have
more ideational symptoms, which are related to thoughts, ideas, and guilt.

Elderly depressed individuals are also more likely to have psychotic depressive
and melancholic symptoms such as anorexia and weight loss. Finally, older people
tend to have more anxiety present in their depression than younger patients do
(winter 1996). In the natural order of things, bodies tend to wear down somewhat
and people become higher risk candidates for various health problems. It is the
increase in health problems that allows for some symptoms of depression to be
overlooked. Doctors begin to attribute all problems and ailments to the primary
problem, neglecting the possibility of depression. The prevalence of low blood
pressure is one of those items that do increase as an individual ages. The
correlation of depression with low blood pressure also increases as time passes,
particularly among men. A study by Barrett-Connor and Palinkas indicated "men
with low blood pressure scored significantly higher on both the emotional and
physical items of a depression test (February 1994)." These same individuals
also scored higher on measures of pessimism, sadness, loss of appetite, weight
loss, and preoccupation with health than did people with normal blood pressure.

Some believe that because low blood pressure can cause fatigue, anyone with
these two symptoms could possibly be diagnosed with depression. This is a
snowball effect where the low blood pressure causes the fatigue, which in turn
causes someone to feel useless, which further develops into other possible
depressed symptoms. An interesting side note to this study was that the low
blood pressure found in the patients was not directly related to any chronic
health condition (February 1994). Low blood pressure is not the only risk factor
for the development of depression. Some other factors include losses dealing
with jobs, status, finances, physical ability, or relocation. Family problems
dealing with divorce, siblings, children, or a death can also send one on a
downward spiral. Changes in the brain such as decreased adaptive capacity,
neurotransmitter and receptor changes, cognitive impairment, and dementia
increase the risk of depression (winter 1996). As more factors enter the
equation and the patient becomes more depressed, the likelihood of a suicide
attempts increases. As previously mentioned, diagnosing depression in the
elderly can be a challenging task due to all of the factors involved. When
considering if an individual is depressed, one must examine the individual’s
background, cognition, medical history, etc. In order to diagnose depression,
there are written and oral inventories of a person’s mind that need to be
performed. Symptoms of severe depression include: diminished interest in usual
activities, significant weight loss or gain, insomnia or hypersomnia,
psychomotor agitation or retardation, fatigue or loss of energy, feelings of
worthlessness or guilt, diminished ability to concentrate, and recurrent
thoughts of death or suicide. Depression does not always have to be severe. To
be diagnosed with mild depression or dysphoria, the mood of the patient would
first need to

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