“I’m growing old
And I don’t wanna know
I’m growing old
And I wanna go home.”
– Nick Drake “Black Eyed Dog”

Geriatric Depression

Is depression a foregone conclusion as you get older?

No, according to the National Institute on Aging.

“Depression is a common problem among older adults, but it is NOT a normal part of aging. In fact, studies show that most older adults feel satisfied with their lives, despite having more illnesses or physical problems,” the NIH wrote on its website. “However, important life changes that happen as we get older may cause feelings of uneasiness, stress, and sadness.”

If you are an older adult and are experiencing depressive symptoms, you aren’t alone. As many as 7 million Americans 65 years of age and older suffer from geriatric depression, according to research from the Centers for Disease Control.

It’s important to get help to address depression. Left untreated, the CDC says depression in the elderly can “complicate chronic conditions such as heart disease, diabetes, and stroke; increases health care costs; and often accompanies functional impairment and disability.” Further, depression can lead to “higher mortality from suicide and cardiac disease.”

Understanding the symptoms of depression and how you may be at risk is the first step in getting help.

Symptoms & Risk Factors

Geriatric depression presents similarly to major depressive disorder. Sami, an older adult, describes her battle this way:

“…an emotional bankruptcy. My depression, anxiety and post-traumatic stress syndrome were all-consuming. The only way to describe it is that I felt hungover – exhausted, dehydrated, and had the worst headache. Most days, I couldn’t get out of bed.”

While geriatric depression is a form of major depressive disorder that presents similar symptoms (e.g., sadness, tiredness, and/or feeling overwhelmed), the Cleveland Clinic reports that older adults will often report different symptoms to their doctors, including:

• “Cognitive problems
• Loss of interest in activities
• Loss of concentration
• Nagging aches and pains
• Digestive problems”

Older adults face risk factors that can increase the likeliness of depression. From the Cleveland Clinic’s website, the following conditions can prompt a mood disorder:

• Heart disease
• Chronic obstructive pulmonary disease
• High blood pressure
• A disability
• A new medical illness
• Poor self-perceived health

Polypharmacy & Depression Treatment

A complicating factor for geriatric depression treatment is that many people take multiple medications to manage diseases that come with advancing age.

“Many of the patients who come in to see me are on multiple other medications. Cardiac medicines, medicines for pulmonary disease, medicines for pain, chronic osteoarthritis is a very common presentation for many of my patients,” said Dr. Allan A. Anderson, a specialist in geriatric psychiatry and past President of the American Association of Geriatric Psychiatry. “It’s uncommon for me to have a geriatric patient who isn’t on any medication.”

One of the ways Dr. Anderson helps patients taking multiple medications is through the GeneSight^® Psychotropic test. Analyzing a person’s DNA can help healthcare providers develop an individualized treatment plan for their patients. The report includes helpful information about how the patient’s genetic makeup may affect their response to medications used to treat depression, anxiety, ADHD and other psychiatric conditions.

While genetics provides an important piece of the puzzle, there are many other factors that influence medication response and susceptibility to side effects, such as drug-drug interactions, diet, environmental factors, age, etc. The GeneSight test can serve as an objective tool that can be used in concert with these other factors to help guide medication selection.

You can watch Dr. Anderson talking about how he treats patients with geriatric depression here: https://www.youtube.com/watch?v=dXhv6HvHs0M.

How to Get Help for Depression

As always, recognizing the signs of depression is the first step. And while you might not recognize it – or want to admit it – you may be depressed.  Your loved ones may see a change in your behavior and encourage you to get help.

In fact, in a U.S. News & World Report article, Dr. Philip R. Muskin, a professor of psychiatry at Columbia University Medical Center and a member of the American Psychiatric Association’s Scientific Program Committee, says that it is the responsibility of family and friends to look for signs of depression in their elderly loved ones – and take action.

“If you think it, don’t let it slide,” he says. “Bring it up. When grandma says go jump in the lake, bite your tongue and encourage her to see her doctor. It’s hard to do, but once done, it may really save a life. It is treatable, whatever it might be.”