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Summary
Summary
Depression affects people of all ages, but is both more common and more serious for those over 60. As many as half of all nursing home residents have depression, as do up to 40 percent of those who visit primary-care clinics. Late-life depression is a disease with unique risk factors. Health problems, physical limitations, the loss of loved ones, and fears about financial issues all contribute to an increased incidence of depression, which, despite its prevalence, is not a normal part of the ageing process. It can intensify existing medical conditions such as chronic pain and is far more likely to lead to suicide than does depression in younger people. There is good news, however: 80 percent of older people who receive treatment for depression make a complete recovery and enjoy fulfilling lives.
Author Notes
Mark D. Miller, M.D., is an associate professor of psychiatry at the University of Pittsburgh School of Medicine and medical director of the Late-Life Depression Prevention Clinic at the Western Psychiatric Institute and Clinic
Charles F. Reynolds III, M.D., is a professor of psychiatry, neurology, and neuroscience at the University of Pittsburgh School of Medicine and director of the NIMH-funded Intervention Research Center for Late-Life Mood Disorders
Reviews (1)
Library Journal Review
Both geriatric psychiatrists at the Western Psychiatric Institute and Clinic, Miller and Reynolds here share their 20-plus years' experience of working with older people suffering from depression. As the authors remind readers, the incidence of depression significantly rises with age, and suicide, highly associated with depression, is five times more common in later life. This important, thorough work covers the various forms of and medical reasons for depression and how it's related to Alzheimer's and other diseases; reviews how to evaluate and treat depression, including medication and psychotherapy; and presents numerous strategies for staying free of depression for the long term. The helpful appendix contains hotline numbers of organizations that focus on depression and URLs related to depression and late-life issues. Though several works for health professionals contain similar information, this is the first book to address lay readers. Strongly recommended.-Dale Farris, Groves, TX (c) Copyright 2010. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
Table of Contents
| Foreword | p. xi |
| Preface | p. xv |
| I. Understanding Late-Life Depression | |
| 1. Recognizing Depression | p. 3 |
| What is Depression? | p. 3 |
| The Mind-Body Connection | p. 9 |
| Pain or Physical Disability | p. 12 |
| Psychotic Symptoms | p. 14 |
| Suicide | p. 14 |
| Depression and the Quality of Life | p. 16 |
| 2. The Many Forms of Depression | p. 19 |
| Dysthymia | p. 20 |
| Bipolar Disorder | p. 21 |
| Recurrent Depression | p. 25 |
| Postpartum Depression | p. 28 |
| Premenstrual and Postmenopausal Depression | p. 28 |
| Bereavement-Related Depression | p. 29 |
| 3. Medical Reasons for Depression in Later Life | p. 34 |
| Inherited Risk Factors | p. 35 |
| Biomedical Risk Factors | p. 36 |
| Medications That Can Cause or Contribute to Depression | p. 45 |
| Recreational Drugs and Alcohol as Depressants | p. 48 |
| 4. Psychological and Social Reasons for Depression in Later Life | p. 53 |
| Psychological Risk Factors | p. 53 |
| Anxiety with Depression | p. 56 |
| Social Risks: The Loneliness Factor | p. 56 |
| The Role of Personality or Coping Style | p. 58 |
| The Stress Response | p. 60 |
| What Can Be Done about Stress? | p. 61 |
| The Aftermath of September 11, 2001 | p. 63 |
| II. Evaluating and Treating Depression | |
| 5. Getting Help for Depression: Where to Go, What to Expect | p. 67 |
| Which Health Professional Should You Choose? | p. 70 |
| A Thorough Assessment for Late-Life Depression | p. 74 |
| Barriers to Treatment | p. 77 |
| Finding Help in Your Area | p. 78 |
| The Benefits of Treatment and the Consequences of Untreated Depression | p. 78 |
| Advice for Family Members | p. 79 |
| 6. Talking Therapy for Late-Life Depression | p. 82 |
| What Is Psychotherapy? | p. 82 |
| Types of Psychotherapy | p. 83 |
| How Psychotherapy Helps | p. 89 |
| How to Find a Good Psychotherapist | p. 91 |
| Good Grieving | p. 96 |
| 7. What Modern Medicine Can Offer for Late-Life Depression | p. 97 |
| Antidepressant Medication | p. 98 |
| Types of Antidepressant Medications: A Brief Overview | p. 99 |
| Strategies for Making Antidepressants Work | p. 105 |
| Managing Side Effects of Antidepressant Medication | p. 106 |
| Combined Treatment: Medication and Psychotherapy | p. 107 |
| Electroconvulsive Therapy, or Shock Treatment | p. 107 |
| How Do Medical Treatments Work? | p. 109 |
| The Maintenance Therapies in Late-Life Depression Study | p. 110 |
| A Word about Insomnia | p. 114 |
| 8. Complementary or Alternative Treatments Used for Mental Health | p. 116 |
| A Historical Perspective | p. 116 |
| Our Own Perspective | p. 117 |
| The Alternative Health Care Movement | p. 119 |
| Standards of Safety and Efficacy | p. 121 |
| Alternative Treatments | p. 122 |
| Buyer, Beware | p. 131 |
| III. Staying Free of Depression for the Long Term | |
| 9. Strategies for Living Depression Free for the Long Term | p. 135 |
| Finding the Help You Need | p. 138 |
| Friends and Family Members--An Early-Warning System | p. 139 |
| The Importance of Daily Routine | p. 140 |
| Successful Aging | p. 144 |
| Later Life as a Developmental Stage | p. 146 |
| Planning for the Final Phase of Life | p. 148 |
| Making Plans for Needing Help--A Way to Stay in Control | p. 150 |
| End-of-Life Issues | p. 151 |
| 10. Future Research | p. 154 |
| New and Promising Developments | p. 154 |
| Special Considerations of Research | p. 156 |
| Participating in Research: What Is Involved? | p. 157 |
| Appendix | p. 159 |
| Information Hotlines | p. 159 |
| Websites of Interest | p. 161 |
| References | p. 167 |
| Index | p. 179 |
