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26 Cards in this Set
- Front
- Back
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Facts About Depression
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The most common psychiatric illness for people of all ages
Of the 35 million Americans aged 65 years & older 2 million have major depression 5 million have minor depression Usually under- or mis- diagnosed in older adults Mistaken for “problems of aging” |
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Facts About Depression
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Believed to be due to changes in chemical neurotransmitters in the brain.
Like other illnesses, depression is often very treatable -- both by medications & by talking therapies. Depression that does not meet the full criteria for major depression, can cause considerable suffering & lost of quality of life. Facts About Depression |
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Depression Risk Factors
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Female gender
Chronic & disabling illness Lack of social support Recently bereaved Prior history of depression 40% of nursing home residents have undiagnosed depression |
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Suicide in Older Adults
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Represent 13% of the population
Account for 1/5 (20%) of all reported suicides Lowest rate of ATTEMPTS Highest rate of COMPLETED SUICIDE |
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Passive Indirect Suicide
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Starvation, refusing to eat
Refusing needed medications Mixing medications Alcohol abuse Loss of “will to live” |
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Signs and Symptoms of
Depression Change in mood |
Sadness - discouragement - crying - felling down - having the blues - despair - irritablilty - being on edge - anxiety - brooding - panic attacks
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Symptoms of depression
Perception |
Withdrawal - hopelessness - self reproach for momr failings - inablility to express pleasure - delusions - hallucinations - worthlessness - unreasonable fears - critical of self and others
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Depression (change in behavior)
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appetite change - weight loss/gain - sleep disturbance - fatigue - slowed speech - health concerns - can't concentrate - thoughts of death - tachycardia - constipation - pacing, wringing hands
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Major Depression
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Depressed mood most of the day, everyday OR
Loss of interest or pleasure nearly every day & at least 4 additional symptoms |
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MINOR Depression
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Also known as
subsyndromal depression subclinical depression mild depression Responds to same treatments 2 - 4 times more common than major depression |
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Biological Depression
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Genetic cause vs. “reaction” to stress
seems to come out of “nowhere” family, personal history more common increased risk of severity, reoccurrence |
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Physical Illness & Depression
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Physical illness directly cause symptoms of depression
metabolic endocrine neurologic pulmonary cardiovascular musculoskeletal others: cancer, anemia |
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Physical illness can cause a reaction of depression by causing
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chronic pain, fear of pain
disability, loss of function loss of self esteem increased dependence fear of death |
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Depressed elderly may present with somatic (physical) complaints
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aches, pains
appetite, weight fatigue, loss of energy constipation tachycardia insomnia |
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Medications can cause symptoms of depression
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antihypertensives
psychotropics analgesics cardiovacscular antimicrobials steroids |
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Environment in which physical illnesses are treated may contribute to depression
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Isolation
Sensory deprivation Enforced dependency |
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Geriatric Depression Scale
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Depression Rating Scale to screen the person for depression.
This scale has two versions, a short & a long form. |
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Suicide Assessment
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Before we look for physical illness, check out any thoughts of death, or feeling that life is not worth living.
Listening carefully to what the person says & think carefully about their behavior. This can help identify people who may be having suicidal thoughts. Older adults are MOST LIKELY to complete suicide. Even a frail person living in a “protected” care setting can find the means & motivation |
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Suicide Assessment Questions
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Have you thought that life isn’t worth living?” If YES, then . . .
“Have you thought about harming yourself? If YES, then . . . “Do you have a plan?” If YES, examine lethality. Is the plan viable? Can they execute it? Are the means deadly & available? |
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Depression Treatments
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Talking therapy
Medications Daily contacts |
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First Line Interventions for depression
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Communicate caring
Help see they are unusually sad or blue Provide accurate information about depression Create a healthy physical & social environment. |
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Things to monitor for health in depressed persons
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Nutrition
Elimination Sleep/rest Physical comfort Pain management |
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Implimentations for depression
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Focus on Positive ( currant abilities, knowledge, wisdom attributes )
Reminiscence ( helps them see they have lived through some very difficult times and will survive this too) |
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Alternative Therapies
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Pet therapy
Horticultural therapy |
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Professional Interventions
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Individual therapy
Group therapy Medication therapy -anitdepressants, most common - others may be needed for anxiety or psychotic symptoms. |
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Depression Therapies
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Therapy (counseling)
Supportive Therapy Medication therapy (medication alone is rearely effective, changing daily routines and habits is critical) |
