September 21, 2018
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Separating fact from fiction in late-life depression

Dreamstime | TNS
Dreamstime | TNS
By Olivia Bogucki, Special to the BDN
Updated:

Late-life depression is an important public health concern in Maine. Over 15 percent of senior citizens in Maine have depression. Unfortunately, myths and misconceptions about late-life depression make it more challenging for older adults struggling with this debilitating disorder to obtain an accurate diagnosis and timely treatment.

Depression is a serious mental illness that is associated with sad mood and/or loss of interest or pleasure in previously enjoyed activities. It is estimated that 322 million people currently experience depression, making it the most common psychological disorder worldwide.

Depression has a serious impact on health and well-being. The disorder commonly occurs with other physical and psychological conditions, leading to poorer medical and mental health outcomes. Depression also makes it more difficult for individuals to complete everyday activities, which results in increased disability rates and decreased workplace productivity. Together, the complications associated with depression have been estimated to cost the United States $210.5 billion every year. Depression is a significant burden for individuals suffering from the disorder as well as society at large.

Several myths and misconceptions about depression in the elderly exist. First, many assume that depression in older adults is more often caused by psychological factors such as loneliness or worry about death and dying. Second, some believe that older adults with depression exhibit more physical symptoms like changes in appetite, sleep, or energy level. Finally, it is often assumed that depression is more common and difficult to treat in older adulthood. There is a significant amount of evidence that contradicts these myths and misconceptions. Instead, it appears that the cause, symptoms, rate, and treatment of depression are similar across adulthood.

One belief about late-life depression does appear to be true. Depression among the elderly tends to run a chronic course. More specifically, older adults are more likely to experience another episode of depression in a shorter amount of time compared to younger and middle-aged adults.

The chronic nature of late-life depression can lead to negative consequences that warrant significant concern. Research has found that older adults are more likely to die due to suicide or other causes compared to their younger counterparts. This finding is pertinent to Maine, as the suicide rates among senior citizens are higher than regional and national averages. Together, these startling statistics indicate that depression in older Mainers is a serious public health concern that must be addressed.

What can be done to make meaningful change? Clearly communicating what we know about late-life depression can help to dispel the aforementioned myths and misconceptions. Accurate information enables medical and mental health professionals to appropriately identify and treat depression and increases the likelihood that older adults struggling with depression seek mental health services in a timely manner.

Accurate information also helps elected and government officials craft public policy that best serves the people of Maine. Public policy addressing the challenges associated with accessing mental health services should be a priority for the next Maine Legislature and the candidates in Maine’s 2018 gubernatorial race.

For instance, more information on depression, effective treatments, and mental health providers in the community could be included on the Office of Aging and Disability Services website. Evidence-based health promotions programs targeting depressed mood could be developed and delivered online or in the community. More training and support could be provided to health professionals who serve older adults in medical settings, nursing homes, and assisted living facilities. Such measures could be modeled after a recently proposed bill focused on youth mental health. While some of these programs are relatively low cost, more funding for the Department of Health and Human Services may be necessary to implement the larger scale programs.

Now that the nature of late-life depression is better understood, more must be done to ensure that older Mainers struggling with this debilitating disorder have accurate information and access to mental health services. While policymakers can implement structural changes to change how we manage depression in senior citizens, we all have an important role to play.

If you or someone you know is struggling with depression or suicidal thoughts, there are resources available including the Behavioral Health Treatment Services Locator and National Suicide Prevention Lifeline.

Olivia Bogucki is a doctoral candidate in clinical psychology at the University of Maine. This column reflects her views and expertise and does not speak on behalf of the university. She is the graduate fellow of the Maine chapter of the national Scholars Strategy Network, which brings together scholars across the country to address public challenges and their policy implications. Members’ columns appear in the BDN every other week.

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