2023-10-28 08:52:59
Ms. A, 68, has her children living outside the home and only comes home occasionally. After retirement, she took care of her elderly parents at home. However, after her parents passed away one after another, she began to feel very tired, achy all over, did not want to move or speak, and her memory changed. She has poor concentration, poor sleep at night, poor appetite, reduced interest and does not want to go out with friends. She suspects that she has a serious physical illness, but does not want to seek medical treatment.
Until Ms. A’s daughter came home and noticed something strange, she was taken to the hospital for diagnosis and it was discovered that Ms. A was suffering from MDD. Dr. Qiu Nanying, deputy director of Lukang Christian Hospital and director of the psychiatric medical system of Changhua Christian Hospital, said that the causes, symptoms and symptoms of depression in the elderly and depression in young people are somewhat different, and the suicide mortality rate in the elderly is higher than that in the young people. There are many, and relatives and friends around you should pay special attention to them.
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The symptoms of depression, which are common in the elderly, are closely related to social factors, physical conditions and loss.
Depression (MDD) is often called major depressive disorder or severe depression by the outside world, but Vice President Qiu Nanying mentioned that the full English name of MDD does not mean “severe”, but “major depression.” , In addition, MDD actually has differences between mild, moderate and severe.
Depression can occur at any age, but the causes of depression in the elderly are somewhat different from depression in young people. Vice President Qiu Nanying said that a high proportion of young people are due to genetic factors, but the elderly are closely related to social factors (such as lower social class, lack of social support), etc., and are also related to the following factors:
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Loss: The feeling of loss caused by deterioration of physical condition, deterioration of autonomy, retirement, loss of relatives and friends, etc.
Loneliness: Loneliness caused by living alone, changes in family structure, changes in living environment, reduction of existing support, etc.
Physiological factors:
The body’s functions become worse, limited, and disabled.
Neurobiological risk factors (such as changes in the hypothalamus-pituitary-adrenal axis caused by aging, or changes in the concentrations of corticosterone, serotonin, norepinephrine, etc.).
Degeneration and atrophy of the brain.
Other physical illnesses.
Drug effects.
Personality traits: People who are prone to losing their temper, are hostile to others, have poor impulse control, low stress resistance, and are more likely to rely on others. People with obsessive personality, perfectionism, and inflexibility are all prone to depression. produce.
Nutrition: The deterioration of cognitive function in the elderly is related to the concentration of vitamins, especially vitamin B complex, which affects the occurrence of depression.
Depression in the elderly often manifests itself with physiological symptoms, so you should pay attention to “these” warning signs
In addition to the different causes, the symptoms of depression in the elderly are also somewhat different from those of younger people. Vice President Qiu Nanying said that from phenomenological observation, patients with depression in the elderly may often say where they are in pain or uncomfortable. , or cognitive functions (such as memory, attention, executive ability, etc.) deteriorate; they often think that they have physical problems, but they rarely say “I am in a bad mood” directly.
Vice President Qiu Nanying mentioned that if relatives and friends notice changes in the behavior and expression of the elderly, they may become uneasy, anxious, lose their temper, often have unexplained pain, or may be overly worried about their physical condition, and may even refuse to seek medical treatment or seek excessive medical attention. Special attention should be paid to inappropriate medical behaviors such as using patent medicines by oneself, especially a significant reduction in interest, not wanting to talk, not wanting to move, and social withdrawal. Everyone should seek medical assistance as soon as possible and receive diagnosis and active treatment.
How to treat geriatric depression? What should the elderly do if they are unwilling to seek medical treatment?
Regarding the treatment of depression in the elderly, Vice President Qiu Nanying said that not all depression requires medication. Mild depression can consider psychotherapy, consultation, support, etc., but if it is moderate and above, it must be treated with medication. The use of drugs requires at least about 8-12 weeks of acute treatment, followed by 4-9 months of continuous treatment; if it is more severe, has repeated attacks, has a risk of suicide, or is a special case, maintenance treatment must be at least one year.
If drug intervention is required, for depression itself, textbooks recommend that the first-line drug treatment is selective serotonin retrieval inhibitors (SSRIs). However, from a clinical perspective, its efficacy is not very good. Now there are some new ones. Medications are relatively helpful. Take the rapid antidepressant nasal spray as an example. It is currently indicated in Taiwan for people with depression and suicidal thoughts. It can help patients relieve symptoms and block suicidal thoughts in a short period of time.
In addition, the drug treatment of depression in the elderly also needs to be comprehensively evaluated and adjusted from various aspects such as depression, other diseases such as hypertension or hyperglycemia, nutrition, and life. Depression treatment is not only about using medication to relieve symptoms, but also includes diet, sleep, exercise, sunshine, life adjustments, support, etc., in order to achieve the treatment goals of reducing the risk of self-injury and suicide, and restoring functions and social activities.
Vice President Qiu Nanying emphasized that the support of relatives and friends is very important, especially now that many elderly people live alone and are less likely to notice changes in depression. She hopes that relatives and friends, especially children, will pay attention. Nowadays, many elderly people do not like to seek medical treatment for fear that it will affect the work of young people. At this time, we can let them understand that “the health of our parents is the greatest happiness for our children”, encourage and accompany the elders at home, and allow them to obtain appropriate diagnosis and treatment.
(Changchun Monthly/Compiled by the Editorial Department, Authorized Article provided/Health Medical Network, Image Source: Dreamstime/Dianjiang Image)
Further reading:
·“Care for the elderly” tragedies happen frequently! Can anyone help?Psychiatrists urge you to do 3 things to relieve your emotions
·Elders are afraid that taking medicine will harm their health, so they go to the hospital to get medicine? Is your illness half better if you see a doctor? “Real reason” revealed
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