Older people depression

Copeland JR, Beekman AT, Braam AW et al. (2004) Depression among older people in Europe the EURODEP studies. World Psychiatry 3 (1) 45-49... 

Whereas many metabolic defects affect only a small number of individuals, emotional illnesses including depression, schizophrenia, and other affective disorders at one time or another afflict a large fraction of the population. Autism affects thousands of children.1055 Parkinson disease and Alzheimer disease are just two of a number of degenerative neural diseases attacking older people. Less commonly, young persons contact multiple sclerosis and muscular dystrophy, which is often a disease of neuromuscular junctions. 

Mark McGuire, the former major league baseball player who holds the record for home runs in a season, is a famous user of DHEA, although he did not use it for its antidepressant abilities, instead hoping the multi-tasking hormone would improve his game. However, there is no proof that this substance is what improved his batting power. Nor is there substantial proof that DHEA reduces depression. In any case, the population that would probably receive the most benefit from this hormone is older people, who have depleted levels of DHEA. 

According to Butler, Lewis, and Sunderland (1998) as many as 20% of those 65 years or older suffer from various mental health disorders. Depression in older people is sometimes difficult to diagnose and has traditionally been linked to physiological and medical changes resulting from the aging process. Difficulties in accurately assessing depressive... 

Suicidal thoughts are one of the symptoms of depression. Paradoxically, one of the best-publicized dangers of SSRIs is their potential to increase the risk of suicide. This heightened risk is especially well established for children, adolescents and young adults. In their most recent analysis of the data, the FDA concluded that, when compared to placebos, SSRIs double the risk of suicidal thoughts and behaviour in depressed patients up to the age of 24/ There also seems to be an increased risk for people who are older than 24, but the interpretation of these data is still disputed.8... 

Thyroid deficiency (hypothroidism) has been connected to cretinism and myxedema. Cretinism occurs when hypothyroid children are born intellectually handicapped, are small, and have coarse hair and thick skin. Myxedema, seen in older hypothyroid people, is characterized by subcutaneous semifluid deposits, causing puffiness of the hands and face. The basal metabolism of these patients is depressed to 30 0% below normal, and their body temperature and pulse rate are also reduced. Women suffering from hypothyroidism may give birth to children afflicted with cretinism. 

Secondly, the sedative and calming effects of ECT may produce improvement especially in people with agitated depressions. As discussed in more detail later, depression-rating scales contain many items that would respond to sedative effects of drugs or ECT such as sleep difficulties, agitation and various manifestations of anxiety. Some older accounts suggest that it was indeed people with agitated depression who responded best to ECT (Paterson 1963 p. 87). 

Major depression is a common psychiatric illness associated with significant morbidity [25]. The illness is usually episodic and manifests with a depressed mood reduced energy changes in appetite, sleep, and concentration and psychological symptoms, such as reduced self-esteem and suicidal ideation. As many as 10% of people may experience a depressive episode at some point in their lives, with women more commonly affected than men. Despite its frequency, more than half of the patients with this illness remain untreated [26]. Unfortunately, the longer the duration of the illness, the poorer the outcome, with an increased rate of recurrence [27]. Effective treatment for depression has been available for nearly two generations. Older medications, the tricyclic antidepressants and... 

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