This
article appeared in Aging Today, January/February 1998, copyright American
Society on Aging, 1998. It appeared in the newspaper's Research Today section,
aupported by a grant from the AARP Andrus
Foundation.
Books, a CD-ROM and More
RESOURCES--THE BASICS AND BEYOND
What exactly is late-life depression? Here are some definitions and resources useful not only to health and other service professionals who work with older people, but also to elders and their families.
Geriatric depression is not a homogeneous disorder, according to the Handbook of Mental Health and Aging, Second Edition (San Diego, Calif.: Academic Press/Harcourt Brace Jovanovich, Publishers, 1992). Most commonly, medical illness can trigger psychosocial depression (reactive or situational depression). The book explains that this type of depression often is a psychological reaction to the disability and discomfort associated with severe mental illness.
Other forms of depression manifest themselves in physical symptoms. According to the handbook, with masked depression, elders complain of such problems as difficulty sleeping, loss of energy and loss of appetite, at the same time completely denying that they feel depressed. The handbook says that "this is the most difficult depression to diagnose."
Another type of depression results from physiological or biological derangements brought on by physical illness or medications.
Intermittent depressive symptoms have been reported in up to half of all dementia patients, the handbook reports. Depression accompanied but not necessarily caused by cognitive impairment is also common, particularly among elders. "The relationship between depression and dementia makes distinction between these primary disorders difficult," the handbook states.
A new book by Pearl Mosher-Ashley and Phyllis Barrett, A Life Worth Living: Practical Strategies for Reducing Depression in Older Adults (Baltimore, Md.: Health Professions Press, 1997), discusses a creative array of therapies, including reminiscence, horticulture, animal-assisted, music and drama programs. This comprehensive and intriguing paperback was written for practitioners involved in planning psychosocial treatments for depressed elders.
The CD-ROM, When Depression Turns Deadly, developed by the American Society on Aging (ASA), is a self-paced, interactive training program including three levels of instruction on recognizing and working with depressed older people, plus a consumer's reference library on major antidepressants and special sections on cultural diversity issues. To order the CD-ROM, contact ASA's Mental Health and Aging Network at (415) 974-9600.
In addition to the CD-ROM, ASA and the National Mental Health Association (NMHA) are coproducing a video and coordinator's manual to enable agencies serving older adults to develop their own local programs on late-life depression. A special component of the ASA project will be a small grants program to help organizations set up innovative outreach efforts. For more information, contact ASA's Nancy Ceridwyn at (415) 974-9615.
The NMHA also offers a helpful pamphlet, "Overcoming Depression in Later Life." For free copies, call (800) 228-1114. Additional resources are available from the American Association of Retired Persons' Social Outreach and Support Office at (800) 424-3410, and the National Institute of Mental Health's Depression Awareness, Recognition and Treatment Program (D/ART) at (800) 421-4211