INTRODUCTION
Depression in seniors is an increasing concern, often neglected or misdiagnosed as part of aging. In crowded cities like New York City, older adults often face isolation, have chronic illness, experienced the death of loved ones, or a combination—each leads to some decline in emotional wellbeing.Â
New York City has some of the most comprehensive therapeutic depression services specializing in providing services to meet the unique needs of older adults. From in-home counseling, to community based programs and support, geriatric mental health clinics, and teletherapy, older adults in New York City have access to many services.Â
In this blog, we will explain how these services operate in NYC, what is available, and how they can find hope and recovery as they age.
Understanding Depression in Seniors
Depression is a mood disorder where a person experiences recurring sadness, hopelessness, and loses interest in things they once liked. Unlike regular grief or temporary lows in mood, depression is a serious medical condition that can last for weeks, months, or even years, if untreated.Â
- For older adults, clinical depression is a common but typically overlooked concern. About 6 million Americans aged 65 and older, and about 10% receive treatment for the disorder.Â
- The underreporting of depressive symptoms and the lack of treatment represents a gap in care for many older adults largely because the symptoms of depression present differently in the older population and may be attributed to aging, coexisting medical problems, or due to medications prescribed.Â
Older adults also may be more prone to depressive disorder considering several potential risk factors in combination:Â
- Chronic medical illnesses like arthritis, cancer, diabetes
- Cognitive impairment/dementia
- Bereavement/grieving
- Loss of independence or mobility
- Financial difficulties
- Lack of social support and allocating freedom
- Isolation and/or loneliness
An understanding of these all impactful concerns will assist with the identification and treatment of depressive disorder among our elderly population.
Signs and Symptoms of Depression in Seniors
Symptoms of depression can often look different in seniors than in a younger person: many times, sadness is not overtly expressed, but is conveyed through physical complaints.Â
- Emotional and cognitive signs may include persistent sadness or anxiety, a feeling of hopelessness, irritability, loss of interest or pleasure in previously enjoyed activities, difficulty concentrating, death/suicidal thoughts, etc.Â
- Physical symptoms can include chronic fatigue, restlessness/sleep problems, an increase or decrease in appetite, weight gain or loss without an explanation, and other aches, pains, or digestive problems.Â
- Symptoms can easily be misidentified as being due to the aging process or another medical issue, but remain concerning when present for two weeks or more.Â
Accurate identification of symptoms of depression, combined with treatment, can have a significant impact on quality of life and decrease risk of serious issues, like isolation or thoughts of self-harm or suicide.Â
Why Depression in Seniors Often Goes Untreated
Depression is often left untreated in older adults. Often this occurs because of the stigma associated with depression and the misconception that depression is normal in the aging process.Â
There are critical consequences of these misunderstandings. Such consequences can include older adults missing mental health issues that could be contributing to their depression.Â
- Physically many seniors often go through a mental health crisis but rationalize the emotional distress due to aging, or family members or friends explain the distress either as part of the natural process of aging or just what they would expect with their loved ones aging.Â
- The stigma of mental health, the blending of physiological vs psychological symptoms; lack of Geriatric specialists, the client’s reluctance to worry about being a burden can contribute to older adults being undiagnosed and untreated for depression.Â
- Better education, improving awareness, and compassionately conversing where barriers exist could help improve on the diagnosis and treatment of depression in older adults.
Treating depression, not simply a part of the aging process, as one of the means of recovery is an important step in addressing healing.
Depression Therapy for Seniors: NYC Services at Glance
When seniors experience depression, the condition is very manageable through a detailed and individualized approach that includes therapy, medication, and lifestyle and community support.Â
- Psychotherapy is a key part of treatment and types of psychotherapy that are found to be effective include Cognitive Behavioral Therapy (CBT), Interpersonal Therapy (IPT), and Reminiscence Therapy.Â
- CBT therapies have patients rethink negative thought patterns. IPT therapies are focused on developing coping skills and working to improve relationships after life changes.Â
- Group and family therapies may be included in treatment because seniors receive social support, and communication skills improve.Â
- Antidepressant medication is also used to treat depression with SSRIs or SNRIs being the most effective. Caution however should be used when medicating elderly patients because of changes due to aging, potential side effects of medication, and polypharmacy.Â
- Complementary therapies for depression include exercise and physical activity, mindfulness therapy, and creative activity therapies such as art therapy, and music therapy.Â
- Pet therapy (and animal-assisted therapy) provides companionship, and comfort for illness and troubles.Â
- Lifestyle factors such as eating a balanced diet and good sleep hygiene, engaging in daily routines, continuing social connections that are meaningful, and living intentionally, also serve to support recovery from depression.Â
- Teletherapy and tele-mental health apps can alleviate some of the mobility and geographical barriers that seniors sometimes face in accessing care, as well as accessing mood tracking and mindfulness exercises.Â
Seniors who successfully use a variety of therapy modalities and support systems can make real and authentic improvements to their mood, ability to function, and quality of life.
Role of Caregivers and Families
Caregivers and family members are important in the identification of geriatric depression and the support of older adult’s treatment.Â
- By learning about late-life depression, one will gain insight on symptoms to watch for, recognize, and intervene as necessary.Â
- Offer to accompany a loved one to therapy appointments (possibly emotional reassurance to attend).Â
- Encourage friends and hobbies to eliminate isolation
- Be patient and nonjudgmental
Final Thought
Depression in older adults is very serious but manageable particularly with the many supports available to individuals in a dynamic place like New York City.Â
- Early identification, appropriate therapy, and ongoing efforts by the caregiver are essential in order to make progress.Â
- Fortunately, in NYC, there are many options for therapy including in-home therapy, teletherapy (remote therapy), and community-based senior services for counseling, programs and support services based on the unique needs of seniors.Â
- As seniors find the support and emotional care they need, they can build hope, joy and quality of life.Â
- If you are looking for compassionate care, the next step in that journey can be to connect with a qualified Depression Therapist in New York who can offer you the best chance of getting there.
Reference
- Fiske, A., Wetherell, J. L., & Gatz, M. (2009). Depression in Older Adults. Annual Review of Clinical Psychology, 5, 363. https://doi.org/10.1146/annurev.clinpsy.032408.153621
- Pickett, Y., Raue, P. J., & Bruce, M. L. (2012). Late-Life Depression in Home Healthcare. Aging Health, 8(3), 273. https://doi.org/10.2217/ahe.12.28
- Depression and aging. (2024, September 3). Healthy Aging. https://www.cdc.gov/healthy-aging/about/depression-aging.html
- Bruce, D. F., PhD. (2024, September 3). Depression in older people. WebMD. https://www.webmd.com/depression/depression-elderly
- Liu, Z., Yang, F., Lou, Y., Zhou, W., & Tong, F. (2021). The Effectiveness of Reminiscence Therapy on Alleviating Depressive Symptoms in Older Adults: A Systematic Review. Frontiers in Psychology, 12, 709853. https://doi.org/10.3389/fpsyg.2021.709853
- Bilbrey, A. C., Laidlaw, K., Cassidy-Eagle, E., Thompson, L. W., & Gallagher-Thompson, D. (2022). Cognitive Behavioral Therapy for Late-Life Depression: Evidence, Issues, and Recommendations. Cognitive and Behavioral Practice, 29(1), 128-145. https://doi.org/10.1016/j.cbpra.2020.02.003
- Van Schaik, A., Van Marwijk, H., Adèr, H., Van Dyck, R., De Haan, M., Penninx, B., Van der Kooij, K., Van Hout, H., & Beekman, A. (2006). Interpersonal Psychotherapy for Elderly Patients in Primary Care. The American Journal of Geriatric Psychiatry, 14(9), 777-786. https://doi.org/10.1097/01.JGP.0000199341.25431.4b
