Most of the psychosocial problems affecting the elderly are due to depression, and depression can be traced to any of a numbers causes, like the death of a loved one or close friend, a senior transition such as retirement or transfer to a new home, pain from chronic health conditions, insomnia, or even a violent event such as burglary or assault.
There is a lingering misconception that older patients are poor candidates for mental therapy or psychotherapy. The reasons for this are unclear, but scientific studies have shown that psychotherapy has produced encouraging results in treating geriatric depression. Health professionals, such as psychologists and psychiatrists, are able to work with the elderly and devise an effective depression treatment program based on psychotherapy and, if needed, prescription medication, like antidepressants to restore mental health.
Psychotherapy, also called talk therapy, may be most appropriate in treating older adults with mild to moderate depression. The therapist, or other mental health practitioner, will encourage the patient to talk about both the issues and feelings that concern him or her. The main goal is to get the patient to voice all factors that may be causing stress, emotional or social problems and other possible causes of depression.
A skilled therapist will be able to adapt standard psychotherapy programs for elderly patients. In essence, this means designing a more structured approach with a more moderate pace and achievable therapy goals. The approach will focus on specific issues that need to be addressed, based on the individual circumstances of the patient. The psychotherapist will want to identify the factors that caused or contributed to the depression and address them as necessary.
Depression after a loss. If the depression is related to bereavement, for instance, the psychotherapist will attempt to establish whether the patient has grieved appropriately. If not, the therapist will guide the patient through the process of coming to terms with their grief. Further assistance may be given to help the patient develop a new social network and gain emotional support needed to deal with the effects of their loss.
Depression after a transition. When depression can be traced to an emotional transition, say after moving from a beloved home to a senior facility or after retiring from a job they were passionate about, the psychotherapist may try to get a good understanding of the individual’s strengths and skills. The goal is to identify opportunities where these skills can be used so that a new role in retirement can be defined for them.
If there is some disharmony in a marriage after one partner’s retirement, for instance, the therapist can help the couple adjust to their new life. For example, to avoid getting in his wife’s way around the house, a husband may be encouraged to develop hobbies, pursue interests or explore activities that will engage him on a regular basis.
Depression after a crime. If the depression follows the trauma of a burglary or, worse, an assault, the older adult may have to undergo specific treatment for post-traumatic stress disorder. In some cases, a practical intervention such as arranging a move to a safer living situation will be very helpful.
Depression due to pain. Physical pain is felt more intensely when a person is depressed, as the decreased activity and increased isolation associated with depression make coping with pain’s physical limitations even more difficult. If the patient has resorted to painkillers to deal with their chronic pain, there is also the possibility of drug dependence, which will have to be addressed as well. The therapist may be able to find ways to encourage more socialization and activity. Relaxation therapy for tension headaches, which is a very common source of pain in older adults, is another treatment approach to explore.
Depression due to sleep issues. There are many causes of sleep problems in the elderly, and a therapist will try to identify the particular cause(s) for each individual. A lack of sleep lack for a few nights does not produce serious impairments, but a consistent pattern of lost or non-restorative sleep needs to be corrected because sleep disturbances can increase depression. The therapist will also teach tips to develop healthy sleep habits, known as good "sleep hygiene"—going to sleep and waking up at the same times every day is one lifestyle change that promotes better sleep, and exercise (though not late in the day) is another.
The most important takeaway is that seniors, no matter their age, should seek counseling for depression. It is not something they have to just live with, and should not be ignored or passed off as part of aging, especially since therapy can be just as effective as for someone younger.