Casa Corner: The holidaze and depression: Part II

In Part I, we reviewed some of the causes, signs and symptoms and risk factors for depression. In Part II, we will review treatment options and what you can do to help yourself prevent and cope with depression.

Treatment

The best prevention of depression is early detection. Most cases of depression can be treated on an outpatient basis. Even if the depression is mild, make sure that you are evaluated and treated, if necessary.

If the symptoms listed in Part I have lasted longer than two weeks, don’t delay in contacting your doctor or a mental health professional.

Ask your doctor for a geriatric medical evaluation to rule out physical reasons for symptoms of depression and to receive treatment for depression, if diagnosed.

Your doctor may treat your depression with antidepressant medications or recommend psychotherapy, or prescribe a combination of both.

For some, electroconvulsive therapy (ECT) may work. Doctors may discontinue or switch other medications you may be taking that have a tendency to intensify depressed conditions.

If you chose to start with a mental health professional, you may want to participate in a new service at Casa de Esperanza.

Pathways Out of Depression, funded by the White Elephant, offers depression screening, assessment and a written evaluation to identify the actions needed to start feeling better.

Antidepressant medicines

Most of the available antidepressants are believed to be equally effective in older adults, but the risk of side effects or potential reactions with other medicines must be carefully considered. Antidepressants may take longer to start working in older people than they do in younger people.

Since older people are more sensitive to certain medicines, doctors may prescribe lower doses at the beginning.

Generally speaking, the length of treatment for depression in the older adult is longer then it is in younger patients. Thoroughly discuss any concerns with your physician! Come prepared with a list to make sure you cover all your questions and take notes to review later.

Ask what protocol the doctor would like you to follow if the medication doesn’t seem to be working within a set time period. You can always call your doctor if you have more questions.

Electroconvulsive therapy (ECT)

ECT has been shown to play an important role in the treatment of severe depression in older adults.

Because many older patients are unable to take traditional antidepressant medicines due to side effects or interactions with other medications they may be taking, ECT may be an effective alternative.

Because this has been a controversial treatment in the past, you may want to do some preliminary research on your own and come prepared with questions to ask your doctor.

Psychotherapy

Psychotherapy/counseling is a very effective treatment for depression. Sessions can focus on helping clients deal with people and situations in their daily lives.

Some people avoid counseling/therapy because they don’t want to “dredge up the past.” Dealing with the past is a choice of the client and this is something you can approach if and when you want.

If you prefer not to take medications or you are not able to take medication because of side effects, interactions with other medicines, or other medical illnesses, psychotherapy alone can be beneficial.

Participation in support/self-help groups and group therapy can help you understand that others have the same problems and are able to work through them.Talking with others in a structured, purposeful manner can make a big difference.

Local churches and organizations offer grief recovery groups on a periodic basis. Casa de Esperanza’s Behavioral Health program offers individual and family counseling and can also make referrals to other local and Tucson providers.

Helping yourself / Preventing depression

People with broad social networks enjoy better physical and mental health. Isolation increases vulnerability to depression.

The Caregiver Education & Support program at Pima Health Systems (PHS) recommends allowing others to give to you and to reflect on the courage it takes to ask for what you need.

Caregivers can get respite and support by bringing their loved one to the Casa de Esperanza Adult Day Health Care program and attending the PHS support group.

Avoiding alcohol, getting enough sleep, eating a healthy diet and staying busy through activities and exercise can all help prevent depression or keep it from getting worse.

Exercise does not have to be strenuous to be beneficial.

Doing volunteer work at a local organization such as La Posada, Friends in Deed or the Community Food Bank, sharing your spiritual connection to life with others, taking an OLLI class or having lunch with friends at the Casa Community Center are all activities that get you out into the world and keep you from feeling isolated.

Think back to activities that used to spark an interest. Listen to or make music, garden, or spend time with a pet you adopted from the Animal League.

Protective factors/maintaining a high quality of life:

Make new acquaintances and maintain your network of social supports

Pursue activities you like, particularly ones that involve other people

Seek solutions to your problems instead of just trying to control your emotions about difficult situations

Keep an open mind about life experiences

Maintain as much independence as you can, including making your own decisions

Take risks and try new things, without necessarily expecting to be successful immediately

Even if you’re afraid or embarrassed, ask for help; it’s a sign of health and maturity, and a way of being in control of your life

Sage Bergstrom is a licensed clinical social worker with 30 years’ experience. She has been the Clinical Director of Casa de Esperanza since 1999.