More than two million Americans age 65 and older suffer from depression, but research says almost 80 percent don't receive adequate help for this serious, but treatable disorder.
Seniors tend to minimize their depressive symptoms and believe that depression is a part of getting older.
This is not true.
Depression at any age is considered an illness.
Types of Psychotherapies
Depression in later life requires a different application of treatment than when depression occurs in earlier life stages.
These evidenced based treatments are short-term, provide symptom reduction, and enhance well being.
Behavior Therapy for Older Adults (BT-OA) is a psychotherapy that focuses solely on understanding the relationship between your mood and your behaviors. Treatment concentrates on heightening your awareness of your negative behaviors and helping you better identify positive moments. You’ll monitor your moods and behaviors, record pleasant and unpleasant events, notice the connection between interactions and your mood and ultimately increase participation in more positive experiences.
Cognitive-Behavioral Therapy for Older Adults (CBT-OA) stresses that specific thinking patterns cause depression. Does sadness leave you thinking that there’s no way out? Are your thoughts an endless stream of self-critical statements? Do you think in all-or-nothing terms? Are your thoughts about issues truly realistic? In this therapy, you’ll meet with a therapist to begin identifying the belief systems you use on a daily basis, with the end goal of correcting unrealistic beliefs by replacing them with more realistic attitudes. Essentially, changing how you think will change the way you feel.
Cognitive Bibliotherapy (CB) uses books and writing exercises to help seniors identify and challenge negative thinking, fight fatigue, minimize helplessness, and challenge the maladaptive ways you think. Generally, a therapist will recommend books on the subject of depression or related writing exercises and check in via email, telephone or in person with you.
Dialectical Behavior Therapy (DBT) for late life depression emphasizes acceptance of what can and cannot be changed. This is attained by using the skill sets of mindfulness, interpersonal effectiveness, emotion regulation and distress tolerance. You and your therapist will treat your symptoms by identifying emotional experiences that lead to depression; reducing your emotional vulnerability and decreasing your depressive symptoms.
Intensive Short-Term Dynamic Psychotherapy (ISTDP) focuses on identifying conflicts, unresolved emotional issues, heightening your insight, and getting you to see issues beyond your awareness. The theory of ISTDP is that depression arises because you aren’t aware of the problematic patterns or core relational themes which impact your life. The goal of this therapy is to reduce symptoms and bring about insight, so you can use your new awareness to shift decisions, change behaviors, and kick depression to the curb.
Interpersonal Psychotherapy (IPT) focuses on current interpersonal difficulties rather than behaviors, thoughts or unresolved issues. IPT is based on the idea that negative social interactions often precede depression and that depression can lead to further negative interpersonal conflicts. For seniors, IPT looks at four areas of conflict: 1) grief after the loss of a loved one; 2) conflict in significant relationships; 3) difficulties adapting to changes in relationships and 4) life circumstances and difficulties stemming from social isolation. With IPT, you’ll learn how to identify where the glitches occur in your life, how to better address them and, finally, how to prevent relapse of late life depression.
Life Review Psychotherapy (LRP), sometimes called Reminiscence Therapy, helps seniors put their life story into perspective with the goal of coming to terms with losses, failures, and missed opportunities as well as marking significant moments. Life Review Psychotherapy works from the long held belief that reminiscence is a universal and naturally occurring mental process where you visit your past, your lost loved ones, unresolved conflicts, or moments of joy so you can reintegrated them into your life in a newfound way.
Problem Solving Therapy (PST), sometime called Solution-Focused Therapy, is a short term, intensive intervention for seniors who do not have any cognitive issues. In this therapy you and your therapist will identify problems that you’re facing and develop an action plan to solve the problems. With PST, you’ll learn a number of different things, including how to clarify and define the problem; how to set a realistic goal; how to generate multiple solutions; how to evaluate and compare your solutions and then how to put your chosen solution into action.
Problem Solving Therapy for Executive Dysfunction (PST-ED) is used for adults in later life who have both depression and cognitive functioning issues. It differs slightly from Problem Solving Therapy in that you and your therapist will address ways to help improve your day-to-day life living with cognitive decline; improve your coping by helping you find ways to communicate more effectively; structure your day better and any other issues that arise.
Problem Adaptive Therapy (PATH) is a treatment designed for depressed seniors that are physically challenged or have mild dementia. This kind of treatment occurs in your home, where you, your caregiver and a therapist work together to create a home environment that will enhance your well-being, minimize your struggles by having step-by-step approaches laid out and address any emotional depression or anxieties you may experience.
Dr. Deborah Serani is an award-winning author and a professor at Adelphi University.