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Depression in Older Adults

Introduction

Depression can affect the well-being of all people regardless of their age, gender, or social status. However, older adults are more likely to be diagnosed with depression, which can be explained by a variety of problems faced in this period of life. For instance, physical health issues, movement from work into retirement, and the death of a family member significantly impact psychological health. Nowadays, the majority of older adults struggling with depression can be successfully treated with the help of medications. At the same time, counseling is considered one of the most effective methods to minimize the symptoms of mild and moderate depression, although some patients require a more comprehensive approach to their treatment.

Specific Features of Depression Counselling

Counseling focuses on supporting and addressing normal life and developmental issues. It is not intended to provide healthcare services, although representatives of this profession may come across individuals who present with symptoms that indicate significant mental health problems. In other cases, counselors aim to teach individuals how to handle daily difficulties associated with their problems. In turn, the treatment of depression is frequently based on the use of a combination of medications called antidepressants, as well as counseling. However, the mild and moderate forms of the illness can be treated without medications (Overend et al., 2015). Therefore, counseling is the most suitable method to treat depression in people who experience mild and moderate symptoms, such as hopelessness, feeling of guilt, anger, fatigue, appetite changes, and a lack of motivation.

Simultaneously, some individuals are unable to detect the difference between counseling and psychotherapy. These types of treatment have numerous similarities, although they are used for different forms of depression. In context of counseling, it can be defined as a short-term therapy (up to 6 months) that is intended to provide appropriate medical help to individuals with mild and moderate symptoms of the illness (Bruin et al., 2018). In turn, psychotherapy is usually based on communication with a highly-trained mental health professional who treats severe symptoms of depression.

Nowadays, there are three main types of counseling that can be used to treat depression, cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and problem-solving therapy. As CBT, this type of counseling is the most commonly used strategy to minimize the effect of depression (Avasthi & Grover, 2018). The vast popularity of this kind of treatment can be explained by its intention to replace negative thoughts and beliefs of individuals with positive thinking. Additionally, CBT is a short-term therapy, which is considered one of its main advantages (Mirkena et al., 2018). Interpersonal therapy is usually used for acute episodes of depression when people suffer from the issue of poor social support. In turn, problem-solving therapy is beneficial for teaching patients how to improve their ability to cope with stressful life experiences (Park & Reynolds, 2015). In case the patients experience severe symptoms of depression, such as suicidal thoughts or trouble concentrating, they should be referred to another service.

Evaluation of Depressive Symptoms

To offer the highest quality treatment, mental health professionals are required to determine the severity of symptoms experienced by the patients. For example, the K10 evaluation test and DASS evaluation test are frequently used to indicate the form of depression faced by adults (Raue et al., 2017). Also, counselors can take into consideration other types of assessments, including physical examination, psychiatric evaluation, and DSM-5. Thus, the evaluation session is used by the counselors to determine several essential factors, such as medical history, cultural context, demographics, family history, substance use, and involvement with other mental health professionals.

In terms of physical examination, it can be used by counselors to detect whether a person suffers from physical health issues. This examination can be represented by monitoring vital signs like weight, blood pressure, cholesterol, and other markers (Jelastopulu et al., 2015). If some health issues are detected, a therapist will be invited to join the counselor. Second, to evaluate depressive symptoms, mental health professionals take into consideration psychiatric assessment (Kok & Reynolds, 2017). This procedure is usually performed through a conversation with a patient. The main intention of these conversations is to increase the level of awareness of the patient’s symptoms, thoughts, feelings, and behavior patterns (Stark et al., 2018). Therefore, personal interviews and questionnaires are usually considered the most effective assessment tool for psychological well-being. The combination of these measures is expected to provide the counselor with appropriate information regarding the health status of the person.

Lastly, healthcare providers tend to rely on DSM-5 to evaluate the symptoms of depression. If at least 5 symptoms from this diagnostic criterion are noticed, the individual can be diagnosed with major depressive disorder. The symptoms can include being depressed for several days in a row, considerable weight loss, permanent fatigue, as well as recurrent thoughts of death (Perkovic et al., 2018). Nowadays, this criterion is perceived as the highest quality diagnostic tool in terms of depression.

Counseling Interventions

Counseling sessions require comprehensive planning from the perspective of mental health professionals. A regular conversation can help a patient diagnosed with depression express personal thoughts, beliefs, and fears. However, some patients have difficulties communicating with others. In this case, it is essential to use a mix of different approaches. Taking into consideration that behavioral activation is predicted to be useful for initiating mood changes, it is important to use this strategy in counseling sessions. For instance, the counselor can offer the patient to lengthen the spine (Smith et al., 2015). It can be explained by the fact that the human body is strongly associated with psychological well-being. Therefore, when people lengthen the spine, they feel more confident and motivated.

Also, individuals diagnosed with depression can be offered to complement this daily life with new activities. To accomplish this goal, the counselor should develop a «pleasurable activity list» in combination with patients (Zis et al., 2017). This list should include at least several new activities, such as reading a book, listening to music, or running in the morning. As a result, it is expected that people with depression will be able to learn how to enjoy life regularly.

Furthermore, counselors should use the intervention of orienting. Once the patients enter a new room, their nervous system can partially block the mind. To make them relax and encourage honest conversation, the counselor should demonstrate to the patient how to orient in the environment (Yuenyongchaiwat et al., 2018). In case the person still experiences the fear to talk, the healthcare provider should use the interventions of verbal experiments, encouragement of movement, and social engagement systems.

In conclusion, it is important to note that depression is a severe mental health issue that affects millions of individuals throughout the whole world. Accordingly, mental health professionals are required to provide high-quality care promptly. To serve this function efficiently, counselors should be able to detect the symptoms of the illness and treat them with appropriate methods. Usually, doctors can diagnose a person with depression based on 3 examinations, such as physical examination, psychiatric testing, and DSM-5. If the person is diagnosed with a mild or moderate form of depression, mental health professionals can use cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), or problem-solving therapy. In case the psychological state of the patient is associated with a severe form of depression, the person should be referred to another service.

References

Avasthi, A., & Grover, S. (2018). Clinical practice guidelines for management of depression in elderly. Indian Journal of Psychiatry, 60(Suppl 3), S341–S362. Web.

Bruin, M., Comijs, H., Kok, R., Van der Mast, R., & Van den Berg, J. (2018). Lifestyle factors and the course of depression in older adults: A NESDO study. International Journal of Geriatric Psychiatry, 33(7), 1000-1008. Web.

Jelastopulu, E., Argyropoulos, K., Bartsokas, C., Argyropoulou, A., & Gourzis, P. (2015). Depressive symptoms in late life in urban and semi-urban areas of South-West Greece: An undetected disorder. Indian Journal of Psychiatry, 57(3), 295. Web.

Kok, R., & Reynolds, C. (2017). Management of depression in older adults. JAMA, 317(20), 2114. Web.

Mirkena, Y., Reta, M., Haile, K., Nassir, Z., & Sisay, M. (2018). Prevalence of depression and associated factors among older adults at ambo town, Oromia region, Ethiopia. BMC Psychiatry, 18(1), 1-8. Web.

Overend, K., Bosanquet, K., Bailey, D., Foster, D., Gascoyne, S., Lewis, H., Nutbrown, S., Woodhouse, R., Gilbody, S., & Chew-Graham, C. (2015). Revealing hidden depression in older people: A qualitative study within a randomised controlled trial. BMC Family Practice, 16(1), 1-10. Web.

Park, M., & Reynolds, C. (2015). Depression among older adults with diabetes mellitus. Clinics in Geriatric Medicine, 31(1), 117-137. Web.

Perkovic, R., Sucic, A., Vasilj, I., & Kristo, B. (2018). The incidence of depression and anxiety among the elderly in the area of Livno, Bosnia and Herzegovina. Materia Socio Medica, 30(2), 176. Web.

Raue, P., McGovern, A., Kiosses, D., & Sirey, J. (2017). Advances in psychotherapy for depressed older adults. Current Psychiatry Reports, 19(9), 22-27. Web.

Smith, M., Haedtke, C., & Shibley, D. (2015). Late-life depression detection. Journal of Gerontological Nursing, 41(2), 18–25. Web.

Stark, A., Kaduszkiewicz, H., Stein, J., Maier, W., Heser, K., Weyerer, S., Werle, J., Wiese, B., Mamone, S., König, H. H., Bock, J. O., Riedel-Heller, S. G., & Scherer, M. (2018). A qualitative study on older primary care patients’ perspectives on depression and its treatments: Potential barriers to and opportunities for managing depression. BMC family practice, 19(1), 2. Web.

Yuenyongchaiwat, K., Pongpanit, K., & Hanmanop, S. (2018). Physical activity and depression in older adults with and without cognitive impairment. Dementia & Neuropsychologia, 12(1), 12-18. Web.

Zis, P., Daskalaki, A., Bountouni, I., Sykioti, P., Varrassi, G., & Paladini, A. (2017). Depression and chronic pain in the elderly: Links and management challenges. Clinical Interventions in Aging, 12(3), 709-720. Web.

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ApeGrade. 2022. "Depression in Older Adults." November 14, 2022. https://apegrade.com/depression-in-older-adults/.

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