One issue that can make older people reluctant to get treatment for depression — or make it tough for those who love them to coax them to go to a doctor — is the belief that getting treatment for depression is a sign of weakness or lack of moral fiber.
“For patients over 85, in particular, there tends to be a lot of stigma associated with depression. Often, patients have the sense that if they’re depressed, it means they don’t have the backbone that they used to have,” says Dr. Adelman. “One thing we try to do at the Irving Sherwood Wright Center on Aging (part of NewYork-Presbyterian’s Ambulatory Care Network) is make it clear that depression is a disease just like high blood pressure — it’s not something the patient is responsible for,” he explains. “And it requires aggressive treatment. If you don’t treat it, it can cause prolonged suffering and significant loss of function.”
“As part of the Division of Geriatric Medicine and Aging at NewYork-Presbyterian/Columbia, we provide comprehensive assessment and care for older adults — medical, functional, cognitive, and psychosocial care — and that includes looking out for signs of depression,” says Dr. Granieri.
The good news is that treatment for depression, whether medication, therapy, or a combination of both, can be just as effective in older people as in younger people.
“Once depression is treated, cognitive abilities can come right back, as well as quality of life,” says Dr. Adelman. “One of the key principles in geriatric medicine is that you have to look at the person as a whole, rather than merely trying to diagnose a disease. Because geriatricians ask older people about a wide range of medical issues, psychological issues, social issues, and advance care planning — they are always on the lookout for depression.”
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