Depression in Older Adults
By Team PCPA

Research suggests that depressive symptomatology affects up to about 20 percent of adults 65 and older (Payne & Marcus, 2008; Lynch et al., 2003). Nonetheless, older adults, particularly those with depression, are considerably less likely than younger populations to seek mental health services. Depressive symptomatology and clinical depressive disorders, such as Major Depressive Disorder or Dysthymic Disorder, comprise a significant portion of the mental health issues that are commonly unrecognized, unreported, and/or untreated in the older-adult age group (Lynch et al., 2003; Thompson et al., 2000).
Depressive symptoms, such as sadness, grief, fatigue, and even physical symptoms like chronic pain, are oftentimes regarded as normal responses to various difficulties that older adults commonly experience as part of the aging process. These common aging-related experiences include loss of a spouse and/or loved one(s), decreased sense of purpose and/or feelings of social isolation following retirement, increased dependency on others, stress about financial planning, and so forth (Thompson et al., 2000). While sadness, grief, and discouragement are indeed natural responses to these largely universal aging-related experiences, it is important for elders—as well as those who care about them—to know there is a meaningful difference between feelings, thoughts, and behaviors that constitute a healthy response to losses or difficult adjustments (e.g., sadness following a loved one’s death) and more impairing and/or unrelenting coping responses that may be signs of depression (e.g., feelings of hopelessness).
Certainly, it can be difficult for elders and those around them to distinguish between healthy coping and depressive symptoms. However, simple awareness of this important difference can increase the likelihood that an older adult—whether independently or through a relative, friend, or physician’s referral—will connect with a mental health professional who can assess for depression and provide any appropriate treatment. Ultimately, this could lead to improved quality of life for that elder individual.
Depression in older adults is also frequently accompanied by anxiety symptoms. Studies have shown that 65 percent of older individuals with Major Depressive Disorder (MDD) experience concurrent anxiety symptoms, while 28 percent of older adults with MDD actually meet diagnostic criteria for Generalized Anxiety Disorder (GAD) (Lenze, 2003). This overlap, or comorbidity, of depression and anxiety in older adults makes it even more challenging for an older person—and for loved ones and caregivers—to recognize signs of depression/anxiety that may require or benefit from behavioral health services.
Despite considerable research evidence for the effectiveness of active treatment of depression—such as with medication and/or talk therapy—relatively few seniors, compared to other populations, are referred for psychiatric treatments (Mottram et al., 2007). This may be due to any combination of factors, including but not limited to: shame, fear of diagnosis/prognosis, embarrassment, lack of information, and negative stigmas associated with mental health issues/services.
Therefore, if an older adult—or an individual of any age—is reluctant to seek mental health services, it may be helpful for that person to know that he or she can speak to a trusted physician about mental health concerns. A familiar physician’s referral to a behavioral health clinician can increase one’s comfort with the referred clinician and boost the likelihood that the individual will pursue and follow through with behavioral health services (Conner et al., 2010; Bartels, 2005). Furthermore, integrated medical settings—in which the physician and referred behavioral health clinician work together to provide coordinated, comprehensive care—are well suited to serve older adults who often have concurrent physical and mental health needs. Through close integration with medical practices located throughout the Chicago area, Primary Care Psychology Associates (PCPA) provides quality behavioral health services to older adults, with the unique convenience of being located within the offices of primary care physician groups. PCPA clinicians work closely with patients’ physicians to inform and optimize both medical and behavioral health services, so older adults can be confident they are receiving the best possible care.
Call or email today to find out more about Behavioral Management of Depression for older adults and the other services we provide at PCPA!
References
Bartels, S.J., Blow, F.C., Brockmann, L.M., & Van Citters, A.D. (2005). Substance abuse and mental health care among older Americans: The state of the knowledge and future directions. Rockville, MD: WESTAT.
Conner, K. O., Copeland VC, Grote NK, Koeske, G., Rosen D, Reynolds, C.F. 3rd, Brown, C. (2010). Mental health treatment seeking among older adults with depression: the impact of stigma and race. American Journal of Geriatric Psychiatry, 18(6), 531-543. doi: 10.1097/JGP.0b013e3181cc0366
Lenze, E. J. (2003). Comorbidity of depression and anxiety in the elderly. Current Psychiatry Reports, 5, 62-67
Lynch T. R., Morse, J. Q., Mendelson, T., Robins, C. J. (2003). Dialectical behavior therapy for depressed older adults: A randomized pilot study. American Journal of Geriatric Psychiatry, 11(1), 33–45.
Payne, K. T., & Marcus, D. K. (2008). The efficacy of group psychotherapy for older adult clients: A meta-analysis. Group Dynamics: Theory, Research, and Practice, 12(4), 268-278. doi: 10.1037/a0013519
Mottram P. G., Wilson, K. M., Scally, L., &Vassilas, C. (2007). Psychotherapy for older depressed people (protocol). The Cochrane Library.
Thompson, L. W., Powers, D. V., Coon, D. W., Takagi, K., McKibbin, C., & Gallagher-Thompson, D. (2000). Older Adults. In White, J. R. & Freeman, A. S. (Eds), Cognitive-behavioral group therapy: For specific problems and populations, (235-261). Washington, DC, US: American Psychological Association. doi: 10.1037/10352-009
Depressive symptoms, such as sadness, grief, fatigue, and even physical symptoms like chronic pain, are oftentimes regarded as normal responses to various difficulties that older adults commonly experience as part of the aging process. These common aging-related experiences include loss of a spouse and/or loved one(s), decreased sense of purpose and/or feelings of social isolation following retirement, increased dependency on others, stress about financial planning, and so forth (Thompson et al., 2000). While sadness, grief, and discouragement are indeed natural responses to these largely universal aging-related experiences, it is important for elders—as well as those who care about them—to know there is a meaningful difference between feelings, thoughts, and behaviors that constitute a healthy response to losses or difficult adjustments (e.g., sadness following a loved one’s death) and more impairing and/or unrelenting coping responses that may be signs of depression (e.g., feelings of hopelessness).
Certainly, it can be difficult for elders and those around them to distinguish between healthy coping and depressive symptoms. However, simple awareness of this important difference can increase the likelihood that an older adult—whether independently or through a relative, friend, or physician’s referral—will connect with a mental health professional who can assess for depression and provide any appropriate treatment. Ultimately, this could lead to improved quality of life for that elder individual.
Depression in older adults is also frequently accompanied by anxiety symptoms. Studies have shown that 65 percent of older individuals with Major Depressive Disorder (MDD) experience concurrent anxiety symptoms, while 28 percent of older adults with MDD actually meet diagnostic criteria for Generalized Anxiety Disorder (GAD) (Lenze, 2003). This overlap, or comorbidity, of depression and anxiety in older adults makes it even more challenging for an older person—and for loved ones and caregivers—to recognize signs of depression/anxiety that may require or benefit from behavioral health services.
Despite considerable research evidence for the effectiveness of active treatment of depression—such as with medication and/or talk therapy—relatively few seniors, compared to other populations, are referred for psychiatric treatments (Mottram et al., 2007). This may be due to any combination of factors, including but not limited to: shame, fear of diagnosis/prognosis, embarrassment, lack of information, and negative stigmas associated with mental health issues/services.
Therefore, if an older adult—or an individual of any age—is reluctant to seek mental health services, it may be helpful for that person to know that he or she can speak to a trusted physician about mental health concerns. A familiar physician’s referral to a behavioral health clinician can increase one’s comfort with the referred clinician and boost the likelihood that the individual will pursue and follow through with behavioral health services (Conner et al., 2010; Bartels, 2005). Furthermore, integrated medical settings—in which the physician and referred behavioral health clinician work together to provide coordinated, comprehensive care—are well suited to serve older adults who often have concurrent physical and mental health needs. Through close integration with medical practices located throughout the Chicago area, Primary Care Psychology Associates (PCPA) provides quality behavioral health services to older adults, with the unique convenience of being located within the offices of primary care physician groups. PCPA clinicians work closely with patients’ physicians to inform and optimize both medical and behavioral health services, so older adults can be confident they are receiving the best possible care.
Call or email today to find out more about Behavioral Management of Depression for older adults and the other services we provide at PCPA!
References
Bartels, S.J., Blow, F.C., Brockmann, L.M., & Van Citters, A.D. (2005). Substance abuse and mental health care among older Americans: The state of the knowledge and future directions. Rockville, MD: WESTAT.
Conner, K. O., Copeland VC, Grote NK, Koeske, G., Rosen D, Reynolds, C.F. 3rd, Brown, C. (2010). Mental health treatment seeking among older adults with depression: the impact of stigma and race. American Journal of Geriatric Psychiatry, 18(6), 531-543. doi: 10.1097/JGP.0b013e3181cc0366
Lenze, E. J. (2003). Comorbidity of depression and anxiety in the elderly. Current Psychiatry Reports, 5, 62-67
Lynch T. R., Morse, J. Q., Mendelson, T., Robins, C. J. (2003). Dialectical behavior therapy for depressed older adults: A randomized pilot study. American Journal of Geriatric Psychiatry, 11(1), 33–45.
Payne, K. T., & Marcus, D. K. (2008). The efficacy of group psychotherapy for older adult clients: A meta-analysis. Group Dynamics: Theory, Research, and Practice, 12(4), 268-278. doi: 10.1037/a0013519
Mottram P. G., Wilson, K. M., Scally, L., &Vassilas, C. (2007). Psychotherapy for older depressed people (protocol). The Cochrane Library.
Thompson, L. W., Powers, D. V., Coon, D. W., Takagi, K., McKibbin, C., & Gallagher-Thompson, D. (2000). Older Adults. In White, J. R. & Freeman, A. S. (Eds), Cognitive-behavioral group therapy: For specific problems and populations, (235-261). Washington, DC, US: American Psychological Association. doi: 10.1037/10352-009