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Depression Treatment For Elderly People Depression in older adults can worsen their health and increase the chance of dying. It is important for them to consult their doctor and make sure they receive the correct treatment. A number of factors can make it difficult to identify depression in older adults. These include misidentifying depression symptoms as normal part of the aging process or obscuring them by claiming they are co-existing medical conditions, a absence of social support and stigma. Antidepressants In many cases, the first step in treatment is to start taking antidepressants. These medications can boost neurotransmitters in the brain, which can enhance mood and can also help reduce symptoms of depression. They are usually employed in conjunction with psychotherapy. It may take several weeks for them to begin working, and it is important to take them exactly as instructed. It is crucial to check elderly patients with depression for co-morbidities and manage them accordingly. Often medical illnesses like stroke, heart disease and chronic pain can trigger depression in patients who are older. They are also more vulnerable to the adverse effects of certain medications. The stigma of aging prevents people from seeking medical attention for their emotional issues. Depression symptoms can be confused with other illnesses like pain or eating problems caused by dentures. These symptoms are exacerbated by the lack of social support and it can be difficult to communicate with family members. Seniors are more likely to develop vascular depression, which is caused by the decrease in the flow of blood to the brain. As compared to other forms of depression, vascular depression is associated with more severe cognitive impairment and less responsiveness to treatments. This type of depression is treated by a variety of drugs such as SSRIs SNRIs TCAs. Medications used to treat depression in elderly patients should be tailored to the individual, as they are more prone to adverse reactions. Doctors should start with lower doses and then increase the dose gradually to be aware of the pharmacokinetic changes associated with age. They should also consider the impact of other supplements and medications on the patient's response to antidepressants. It is important for doctors to inform patients and their families about the signs of depression and available treatment options. This will help patients comprehend their conditions and stick to their medication regimens. It is also important to inform patients know about the time lag for antidepressant effects. To assess depression in people who are elderly, a detailed history must be taken. This should include the date when depression first began to manifest and its connection to other stressors in the life as well as previous episodes of depression, and any underlying medical or physical illness. It is also important to assess if the symptoms of depression are the result of medication or other health-related factors like menopausal or seasonal affective disorder. Electroconvulsive Therapy Electroconvulsive therapy, or ECT can help the brain do a kind of reset to reduce depression symptoms. It is usually prescribed to people who are unable to respond to medication or who have severe and life-threatening depression for example, those with suicidal thoughts or medical conditions that could be dangerous. Medicare and the majority of insurance companies cover ECT. It is usually administered in the hospital. You'll be given an general anesthetic as it's done and you will not feel anything during the procedure. It can take six ECT treatments to improve your depression. There is a possibility of experiencing confusion for a number of hours or even days after the treatment. It's possible to lose memory during or immediately after ECT. These issues tend to be temporary. You may need several weeks to begin recalling. If you have a history of cardiac disease, you could be at increased risk for complications resulting from ECT. Those who have preexisting cardiac ailments should stay away from ECT unless recommended by your doctor. A recent study looked at the risk of complications to the heart during ECT in patients without and with pre-existing heart disease. Researchers found that the frequency of complications was significantly higher in the group with already existing heart disease. Researchers have suggested that a decrease in the use of ECT in elderly patients with underlying heart conditions could reduce complication rates. ECT is effective for a wide range depressive disorders including unipolar, bipolar and mania. It can also be used to treat other mental health issues such as schizophrenia that has catatonic features and psychosis induced by antiparkinsonian medications. It's also a possibility of treatment for people suffering from severe dementia, particularly when it's caused by a medical condition that is life-threatening. If you're thinking of ECT or ECT, you and your doctor should do a thorough psychiatric evaluation before you have the procedure. depression management strategies should go through your medical records in order to determine if you have any medical issues that could impact your treatment. If you suffer from heart disease, your doctor may recommend an electrocardiogram (EKG) or chest X-ray prior to receiving ECT. Psychotherapy It can be challenging to recognize and treat depression in the elderly. Older adults typically have a difficult time admitting that they are depressed because of the stigma associated with mental illness. They may also be too proud to seek help and are afraid of being a burden on their families. Depression also increases the risk of heart disease and makes it harder to recover from other illnesses. Psychotherapy is a successful treatment for depression in older people. Depression is a common disorder in the elderly, however the majority of patients aren't treated or diagnosed. This is due to a variety of reasons, including misdiagnosis and lack of awareness by health professionals. Patients may experience symptoms like inactivity, apathy in everyday activities, sleep disorders and frequent thoughts of death. These symptoms are usually blamed on aging and dementia but are often caused by depression. A comprehensive evaluation should include a thorough history, a review of the results of previous treatments as well as laboratory tests. A minimum battery of tests should include a haemogram aswell liver function tests, kidney function tests and urine analyses. Numerous tests such as thyroid function test, folate and vitamin B12 levels should be conducted in the event of a nutritional deficiency as these can cause the onset, progression and maintenance of depression in the older. The initial phase of treating depression must be focused on achieving remission. It must be tailored to the individual's needs. When combined with antidepressant medicines and a psychotherapy program, a psychotherapy program is recommended. This therapy could be short-term, but it may be long-term. It could focus on dealing with apparent behavior and cognition issues or it may involve learning to understand and change deep-rooted emotional and relationship problems. In the maintenance and continuation phase the same antidepressant must be employed as in the acute phase. This should be done with careful monitoring of rate of remission and relapse. Careful monitoring of the relapse rate is vital for older patients since they are more likely to relapse than younger patients. Social support Social support is a crucial aspect of mental health. People with strong social networks have a lower chance of developing depression and are better able to handle stress. It is also crucial to maintain an immune system that is strong. This is particularly applicable to older adults who are more stressed and have fewer effective coping strategies. This may explain why social support is more important to them than it is for younger adults. In reality, the absence of social and family support is associated with poor health outcomes in older adults. Social support can help lessen the impact of negative events in life, like the loss of a loved one or a serious illness. It can also have a positive effect on the hypothalamic-pituitary-adrenal cortex (HPA) and noradrenergic systems. It is therefore crucial to recognize and fix any problems in this area to improve the patient's quality of life. There are a variety of ways a healthcare provider can offer social assistance to an elderly person who is depressed. These include psychotherapy and pharmacotherapy, electroconvulsive therapy, and transcranial magnetic stimulation. In addition to improving mood the treatments also improve function and increase independence. However, the quality of care patients receive is the most important element in their recovery. Social support is defined as emotional support and instrumental support, in addition to an underlying sense of belonging and community. Emotional support can be defined as the capability of a person to express their emotions and concerns to others. Instrumental support refers to receiving help with tasks. Informational support is obtaining guidance from a trusted source. There are many types of social support available in Vietnam, including immediate family members neighbors, friends, and professional aids. In the case of psychiatric treatment social support has been shown to enhance the quality of life for geriatric patients, as well as reduce mortality and morbidity due to suicide and other medical conditions. This is also associated with decreased costs for psychiatric care and health treatment. This is a significant benefit for both public and private healthcare systems.