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Symptoms of depression include persistent sadness, withdrawal from previously enjoyed activities, difficulty sleeping, physical discomfort, self-medication via substance misuse, and feeling lethargic, according to the CDC. They go on to note that depression is not considered a normal part of growing older, and while it is normal to experience sadness, grief, loss, and mood swings, depression that impacts a person’s ability to function requires treatment and support.
Anxiety often goes hand in hand with depression, according to a publication from the CDC and the National Association of Chronic Disease Directors (NACDD . The report goes on to highlight how almost half of older adults who are diagnosed with depression also meet the criteria for anxiety. The effects of anxiety include persistent worry along with physical symptoms that can include muscle tightness, restlessness, difficulty sleeping, stomach problems, and nausea all lasting for an extended period of time.
The APA outlines how serious the physical consequences of depression and anxiety can be: “The feelings of hopelessness and isolation that often spur thoughts of suicide are more prevalent among older adults, especially those with disabilities or confined to nursing homes.”
The rate of suicid among both men and women ages 65 to 74 has steadily increased over the past two decades. In 2014, the highest suicide rate in the country was among people 85 years or older.
The Role of Primary Care
There are several reasons why treating depression in the elderly poses a unique challenge. Common among patient’ concerns are: “inadequate insurance coverage, stigma around mental health… denial…and lack of transportation,” according to the APA . Systemic reasons include things like a shortage of trained geriatric mental health providers and miscommunication between health care providers.
In addition, when older adults visit their primary care providers, they tend to focus on physical symptoms rather than talk about how they’re feeling or what they’re experiencing mentally and emotionally, according to a fact sheet from the Illinois Department of Public Health. This can lead to mental health issues that go unrecognized, untreated, or undertreated. For example, the AARP External points out that depression is sometimes misdiagnosed as dementia.
The good news is that there are effective treatments for depression, and adults with depression can improve from treatment if they receive it. Primary care providers such as Family Nurse Practitioners play an important role by identifying at-risk older adults and taking necessary follow-up actions by implementing routine mental health screenings and treating symptoms that negatively impact quality of life.
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