Dec. 23--ARLINGTON, Texas -- Depression is not a normal part of growing old, but often people assume it is and never seek treatment. "People think that everybody gets depressed when they're old," said Rebecca Gutherie, clinical liaison-geriatric services at Millwood Hospital in Arlington. "But people can recover."
Depression affects about 15 out of every 100 people 65 and older, according to the Geriatric Mental Health Foundation. But with medication and psychotherapy, most people with depression return to their normal lives.
As people age, they have special needs that must be considered when treating a mental illness, Gutherie said. To address these needs, Millwood Hospital plans to open a 16-bed geriatric unit in January.
The unit will have a living room, be handicapped-accessible and offer other features specifically for older patients, said Thomas Rourke, Millwood Hospital chief executive officer.
"We wanted to create an environment that is comfortable and comforting," he said.
There is a need for specialized care because the issues facing the aging are very complex, said Laura Lee Harris, executive director of the Tarrant County Mental Health Association. Millwood is one of two hospitals in the area with a geriatric psychiatric unit, she said.
Dementia, Alzheimer's disease and other physical illnesses can have mental health components that need to be addressed at a special unit, she said. Having a geriatric psychiatrist on staff to deal with these issues is really beneficial, Harris said.
Often with geriatric patients, depression is situational and related to multiple losses that go along with aging, Gutherie said.
"Adults may experience one or two losses over 10 years," she said. "But an older person may have several losses over a very short period."
These losses can make it difficult for families to distinguish normal grief from serious depression. After the death of a spouse it's not usual to grieve for six months to a year, Gutherie said. But if it goes beyond that or is getting worse, that's a sign of depression.
"When the depression goes on day after day and is unrelenting, it's time to get help," she said.
Because older patients often take a dozen or more medications, introducing antidepressants to stabilize their mood must be done slowly to avoid overmedicating them, Gutherie said.
Older people are sensitive to medications and may require hospitalization when their drugs are changed, Harris said.
The stigma that older people often associate with mental illness also makes treating depression and other problems difficult.
"Often they take the attitude that they should pull themselves up by their bootstraps," Gutherie said.
Although the older person might insist there is not a problem, families should watch for signs of depression, such as losing interest in something that the person used to find enjoyable. The risk of suicide is high among this population, so family members should watch for any signs of depression, Gutherie said.
After inpatient treatment, which typically lasts a week to 10 days, most adults recover and are able to return to their homes. Some continue with outpatient treatment, Gutherie said.
'After a while they start coming alive and connecting," she said.
IN THE KNOW
Symptoms of depression
Adults should tell their doctor if they:
--Feel nervous or empty
--Feel guilty or worthless
--Feel very tired and slowed down
--Feel restless and irritable
--Feel like no one loves them
--Feel like life is not worth living
--Are sleeping more or less than usual
--Are eating more or less than usual
--Have chronic headaches, stomach aches or pain
Source: National Institute of Mental Health
Depression and suicide involving the elderly:
--Depression is not a normal part of aging.
--Older Americans make up 13 percent of the U.S. population but account for about 18 percent of all suicides.
--White men 85 years and older make up one of the highest rates of suicides with 59 deaths per 100,000.
--Of the nearly 35 million Americans age 65 and older, an estimated 2 million have a depressive illness and another 5 million have depressive symptoms.
--Depression often occurs with other illnesses such as heart disease, diabetes and cancer.
--Several studies have shown that up to 75 percent of older adults who die by suicide have visited a primary care physician within the past month.
Source: National Institute of Mental Health
Online: www.aagponline.org; www.nimh.nih.gov
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