Living Longer Depression Free: A Family Guide to Recognizing, Treating, and Preventing Depression in Laterlife

by Miller, Mark D.; Reynolds, Charles F.

• ISBN13: 9780801869433
• ISBN10: 0801869439
• Edition: 1st
• Format: Paperback
• Copyright: 2002-09-23
• Publisher: Johns Hopkins Univ Pr

Summary

Depression affects people of all ages, but is both more common and more serious for those over sixty. 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 aging 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. In Living Longer Depression Free, Mark D. Miller, M.D., and Charles F. Reynolds III, M.D., draw on their considerable experience in geriatric psychiatry to help elderly persons, their families, and their physicians accurately diagnose and treat late-life depression. This comprehensive, up-to-date guide begins with a discussion of the different types of depression, their causes, and symptoms. The authors then describe how doctors evaluate depression; present the treatment options available to patients today, including psychotherapy, medication, and alternative treatments; and offer strategies for achieving long-term mental health. Each chapter opens with a list of frequently asked questions and uses case studies to personalize the information provided, and the book closes with a useful list of resources for further information, including hotlines and websites. Compassionate and accessible, Living Longer Depression Free is an invaluable guide for older people and their families striving to overcome this debilitating disease and prevent its recurrence.

Author Biography

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, where he is also director of the NIMH-funded Intervention Research Center for Late-Life Mood Disorders.

Table of Contents

Foreword	xi
Barry D. Lebowitz
Preface	xv
I UNDERSTANDING LATE-LIFE DEPRESSION
Recognizing Depression	3	(16)
What Is Depression?	3	(6)
The Mind-Body Connection	9	(3)
Pain or Physical Disability	12	(2)
Psychotic Symptoms	14	(1)
Suicide	14	(2)
Depression and the Quality of Life	16	(3)
The Many Forms of Depression	19	(15)
Dysthymia	20	(1)
Bipolar Disorder	21	(4)
Recurrent Depression	25	(3)
Postpartum Depression	28	(1)
Premenstrual and Postmenopausal Depression	28	(1)
Bereavement-Related Depression	29	(5)
Medical Reasons for Depression in Later Life	34	(19)
Inherited Risk Factors	35	(1)
Biomedical Risk Factors	36	(9)
Medications That Can Cause or Contribute to Depression	45	(3)
Recreational Drugs and Alcohol as Depressants	48	(5)
Psychological and Social Reasons for Depression in Later Life	53	(14)
Psychological Risk Factors	53	(3)
Anxiety with Depression	56	(1)
Social Risks: The Loneliness Factor	56	(2)
The Role of Personality or Coping Style	58	(2)
The Stress Response	60	(1)
What Can Be Done about Stress?	61	(2)
The Aftermath of September 11, 2001	63	(4)
II. Evaluating and Treating Depression
Getting Help for Depression: Where to Go, What to Expect	67	(15)
Which Health Professional Should You Choose?	70	(4)
A Thorough Assessment for Late-Life Depression	74	(3)
Barriers to Treatment	77	(1)
Finding Help in Your Area	78	(1)
The Benefits of Treatment and the Consequences of Untreated Depression	78	(1)
Advice for Family Members	79	(3)
Talking Therapy for Late-Life Depression	82	(15)
What Is Psychotherapy?	82	(1)
Types of Psychotherapy	83	(6)
How Psychotherapy Helps	89	(2)
How to Find a Good Psychotherapist	91	(5)
Good Grieving	96	(1)
What Modern Medicine Can Offer for Late-Life Depression	97	(19)
Antidepressant Medication	98	(1)
Types of Antidepressant Medications: A Brief Overview	99	(6)
Strategies for Making Antidepressants Work	105	(1)
Managing Side Effects of Antidepressant Medication	106	(1)
Combined Treatment: Medication and Psychotherapy	107	(1)
Electroconvulsive Therapy, or Shock Treatment	107	(2)
How Do Medical Treatments Work?	109	(1)
The Maintenance Therapies in Late-Life Depression Study	110	(4)
A Word about Insomnia	114	(2)
Complementary or Alternative Treatments Used for Mental Health	116	(19)
A Historical Perspective	116	(1)
Our Own Perspective	117	(2)
The Alternative Health Care Movement	119	(2)
Standards of Safety and Efficacy	121	(1)
Alternative Treatments	122	(9)
Buyer, Beware	131	(4)
III. Staying Free of Depression for the Long Term
Strategies for Living Depression Free for the Long Term	135	(19)
Finding the Help You Need	138	(1)
Friends and Family Members---An Early-Warning System	139	(1)
The Importance of Daily Routine	140	(4)
Successful Aging	144	(2)
Later Life as a Developmental Stage	146	(2)
Planning for the Final Phase of Life	148	(2)
Making Plans for Needing Help---A Way to Stay in Control	150	(1)
End-of-Life Issues	151	(3)
Future Research	154	(5)
New and Promising Developments	154	(2)
Special Considerations of Research	156	(1)
Participating in Research: What Is Involved?	157	(2)
Appendix	159	(8)
Information Hotlines	159	(2)
Websites of Interest	161	(6)
References	167	(12)
Index	179