Talk Therapy
Depression research has shown that certain types of short-term psychotherapy, particularly
cognitive-behavioral therapy and interpersonal therapy, are effective treatments for late-life
depression. In addition, psychotherapy alone has been shown to prolong periods of good health free from depression.
By teaching new ways of thinking and behaving, CBT (cognitive-behavioral therapy) helps people change negative habits that may contribute to their depression. IPT (interpersonal therapy) helps people understand and work through troubled personal relationships or events that may cause their depression or make it worse.
For mild-to-moderate depression, psychotherapy may be the best treatment option. However, sometimes psychotherapy alone is not enough. A study examining
depression treatment among older adults found that patients who got better with medication and IPT were less likely to have the depression return if they continued their combination treatment for at least two years.
More studies are in progress on the longer-term effectiveness of
SSRIs and specific psychotherapies for depression in older persons. Findings from these studies will provide important data regarding the clinical course and treatment of late-life depression. Further research will be needed to determine the role of hormonal factors in the development of depression in older adults, and to find out whether
hormone replacement therapy with estrogens or androgens is of benefit in the treatment of late-life depression.
Electroconvulsive therapy (ECT)
When medication and/or psychotherapy does not help improve a person's depression, electroconvulsive therapy (ECT) is sometimes used. ECT, once known as "shock therapy," used to have a very bad reputation. But in recent years, it has greatly improved and can provide relief for people with severe depression who have not gotten better or improved with other treatments.
Before electroconvulsive therapy is given, a patient takes a muscle relaxant and is put under brief anesthesia. He or she does not consciously feel the electrical impulse from ECT. A patient will typically have ECT several times a week, and will often also need to take an
antidepressant or mood-stabilizing medication to keep the depression from returning. Although some patients will need only a few courses of ECT, others may need follow-up treatments, usually once a week at first, then gradually decreasing to once a month for up to one year.
ECT may cause some short-term side effects, including confusion, disorientation, and memory loss. But these side effects typically clear up within an hour of treatment. Research has shown that after one year of ECT treatments, patients show no harmful mental effects.
Previous
Add this article to your Favorites
Email this article
Print