Treatment of Depression
The success of any treatment depends on multiple factors but one major component must be in working order for the treatment to be effective; cooperation and collaboration between the patient and the health care practitioner. It is important that the clinician have training in the bio-psycho-social needs of the older patient.
According to Knight, 1996 older adults have more maturity than younger adults but are facing some of the hardest challenges that life brings, grieving for loved ones, adjusting to disabling and chronic illness and coming to terms with death and dying issues. Many elders looking for help in therapy are experiencing major disruptions in their previous stable lives. Even though the older client may be less likely to recognize depression, there is evidence that the elder is more mature, has a multitude of life experiences and relationships, and has greater emotional complexity with better comprehension resulting in less impulsivity than the younger adult. There is a potential for further growth, greater self -knowledge and introspection in the elder that is actually conducive to treatment including psychotherapy.
There are several treatments for depression and most are successful. When choosing a treatment for the depressed elderly, the clinician has to outweigh the benefits versus the risks. Clinicians want the treatment to be effective, accepted by the patient (and family), and associated with minimal side effects. The choice of treatment depends on multiple factors. What is causing the depression, the severity of the symptoms, how available and practical are the treatment modalities and underlying conditions that contraindicate certain forms of treatment (severe cardiovascular disease may preclude the use of some antidepressants). It is fair to say that group therapies, medication, electroconvulsive, cognitive, behavioral, interpersonal, life-review and psychodynamic therapies have been effective in treating the elderly depressed person (Spar, LaRue 1997). Many times, a combination of the therapies is needed. The goal is for the particular depressive symptoms to improve or resolve, to restore and optimize functioning, and to avoid relapse or recurrence of depression. In other words, to live life to the fullest potential.
The rate of recurrence is high, 50% after one episode, 70% after the second episode and 90% after the third episode. Depression is often a chronic illness, not necessarily that is lasts for a long time but that it recurs. Your practitioner should be informing you of the diagnosis, prognosis, treatment options, possible side effects and cost of treatments.
