What is Geriatric or Late Life Depression?

Geriatric depression is a type of depression that affects older adults, typically those over the age of 65. Depression is a common mental health condition in older adults, and it can have a significant impact on their quality of life.

Most older persons are satisfied with their lives and are not psychologically predisposed to depression. Nevertheless, some experience a demoralization and despair resulting not only from incapacities due to aging but also from a sense of not having fulfilled their life expectations (e.g., leading up to and/or after retirement).

Geriatric depression can occur when older persons need to adapt to many adverse life experiences. They must adapt especially to the losses of relatives and friends. In these circumstances, they often appear to respond to these losses without difficulty compared to persons who are younger. This in part is because older persons, for example, expect that they will lose family and friends through death, and those family and friends whom they do lose often have suffered chronic illnesses for some time, thus allowing older persons to grieve the loss, in part, before the actual loss.

As a result, an adjustment disorder with depressed mood secondary to physical disability and/or chronic illness is among the most frequent causes of depressed mood among older individuals. Geriatric depression is often accompanied by anxiety symptoms and/or insomnia.

It is important to note that geriatric depression is not a normal part of aging and should not be dismissed as such. With proper diagnosis and treatment, many older adults with depression can improve their symptoms and continue to lead fulfilling lives.

Symptoms of Geriatric Depression

Symptoms of geriatric depression may include persistent feelings of sadness, hopelessness, or helplessness, loss of interest or pleasure in activities, changes in appetite or weight, sleep disturbances, fatigue, irritability, difficulty concentrating or making decisions, physical symptoms such as headaches or stomachaches, and thoughts of death or suicide.

Sources of Late-Life Depression

Geriatric depression can be caused by a variety of factors, including biological, psychological, and social factors. Medical conditions such as chronic pain, heart disease, or stroke, as well as medications commonly prescribed to older adults, can increase the risk of depression.

Loss of a relationship
Loss of body parts or function
Loss of control or independence
Chronic pain
Guilt

Characteristics of Older Adults with Depression

Do not complain of depression spontaneously
Lose weight but rarely gain weight
Complain of insomnia but rarely of sleeping too much
Complain of problems with concentration and memory loss
Test positive for impairment on psychological testing
Suffer from loss of interest in previously pleasurable activities
May exhibit psychotic symptoms more than middle-aged adults

Consequences of Geriatric Depression

Poor compliance, nutrition, hygiene, and giving up
Passive or active suicidality

Diagnosis and Treatment

Diagnosing and treating geriatric depression is essential for improving an individual’s quality of life and preventing complications such as social isolation, cognitive decline, and increased risk of physical illness. Treatment may involve a combination of medication, therapy, and lifestyle changes such as exercise, social engagement, and stress management.

Our geriatric psychiatrist, Dr. David Merrill, offers kind, compassionate, thorough clinical evaluations and follows depression treatment guidelines, helping the patient to stay connected with the activities and people who matter to them. Contact us at 310-582-7641 to schedule a consultation.

How You Can Help an Individual with Geriatric Depression

Listen and understand
Encourage expression of sadness/grief related to illness
Offer specific and realistic reassurance
Emphasize a constructive treatment plan
Mobilize the patient’s support system
Combat learned helplessness
Elicit expression of preferences, encourage active steps
Psychiatric consultation for medications or TMS
Persistent and out of proportion symptoms or suicidality

Psychedelic-Assisted Therapy

Depression and anxiety can affect everyone and may manifest in addiction disorders to alcohol, drugs or prescription medications. Dr. Keith Heinzerling is an addiction medicine specialist who treats adults of all ages. Patients with depression, anxiety, PTSD, end-of-life distress, chronic pain, drug/alcohol problems, and other conditions may be eligible for psychedelic-assisted therapy with ketamine.

Resources

Anxiety & Depression Association of America

If you or someone you know is in crisis, call the National Suicide Prevention Lifeline (Lifeline) at 1-800-273-TALK (8255), or text the Crisis Text Line (text HELLO to 741741). Both services are free and available 24 hours a day, seven days a week. The deaf and hard of hearing can contact the Lifeline via TTY at 1-800-799-4889. All calls are confidential. Contact social media outlets directly if you are concerned about a friend’s social media updates or dial 911 in an emergency. Learn more on the Lifeline’s website or the Crisis Text Line’s website.