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A Guide to Mental Wellness in Older
Age: Recognizing and Overcoming Depression
Getting Good Medical
Care—Talking to
Your Physician About Depression
There are many safe, effective treatments
for depression and with proper care most people experience
substantial
improvement or disappearance of all symptoms. Although
talking with your family and friends is a good
beginning, it is not enough to treat depression. Do
not try
to treat yourself. Work with your doctor to find
the best
course of treatment for you.
Before You Go to the Doctor
Find a doctor you can trust—and
if you feel more comfortable, take a friend or family
member with you.
Take a complete list of all medicines you are now taking,
including prescriptions, over-the-counter medications,
and vitamin, mineral and herbal supplements. Bring
your health insurance information.
In the Doctor’s
Office
Your physician should:
- Ask about your symptoms
- Ask about your general health
- Check your medications
- Ask about your family medical history including
mental illness
- Give you a physical exam
- Conduct some laboratory tests
Diagnosing late-life depression
is difficult. A number of physical conditions can
cause or contribute to depression.
For example, some diseases may cause symptoms of
depression. Before prescribing any treatment, your
doctor should
take the time to make sure that the diagnosis of
clinical depression is accurate.
Describe any difficult issues
in your life that may be impacting the way you feel.
Your doctor should listen
to you carefully and answer your questions. It is important
to have a trusting relationship with your health care
provider and feel comfortable with his or her knowledge,
skills, and interest in helping you. Do not leave a
doctor’s office until all of your questions have
been answered. It is all right for you to question
the doctor about his or her experience dealing with
depression in older persons. Take notes so you can
remember what was said.
If you are uncomfortable with
your doctor’s diagnosis
or treatment suggestions, get a second opinion
or change doctors. If you feel that your doctor appears
unwilling
to listen to you—as an older adult—or isn’t
taking your complaints seriously, find another doctor.
There are doctors who specialize in treating older
adults (called geriatricians) as well as those who
specialize in treating older adults with depression
(called geriatric psychiatrists). When suggesting a
treatment plan, a physician should have knowledge about
which treatments are more effective for people over
60 years of age. There is very little research that
is specific to people who experience late-life depression
and it is important to seek out a health professional
who has experience and education specific to older
adults. While some primary care physicians have the
training and experience to diagnose depression and
prescribe medications, others do not. You should consult
a psychiatrist if your symptoms of depression continue,
are disabling, fail to improve after two medications
have been tried, or if suicidal thoughts are present.
Mental Health Professionals During your course of treatment,
you may have contact with several different types
of health care professionals.
Geriatric Psychiatrists are physicians who have completed
medical school, four years of psychiatric training,
and at least one additional year of training focused
on illnesses of adults over 60 years of age.
Psychiatrists are physicians who have had some specialized training
in late-life mental illness and are specialists
in prescribing and managing medications.
Primary Care Physicians have three years of clinical training
in all aspects of disease management and include
family physicians and internists. Your first visit
to a doctor regarding your symptoms of depression
would probably be to your primary care physician or
your
family doctor.
Geriatricians are family physicians or
internists who have specialized training in treating
older adults.
Psychologists diagnose mental illness, provide psychotherapy and
carry out psychological testing. If one of your
treatment options includes talk therapy, you may
be referred to a psychologist. Social
Workers are health
professionals trained to assist patients and family
members coping with difficult
issues. They can provide information on housing,
finance, and respite care. If you are helping a loved
one who
needs institutional care or is currently in a nursing
home, social workers can be of assistance.
Advance
Practice Nurses are registered nurses with advanced
degrees. They often work in partnership
with physicians. Some APRNs have specialized training
in
mental illness. A Guide to Mental Wellness in Older
Age: Recognizing and Overcoming Depression
©
Geriatric Mental Health Foundation 2004
7910 Woodmont Avenue, Suite 1050
Bethesda, Maryland 20814
301.654.7850
info@GMHFonline.org
www.GMHFonline.org
Expert assistance was provided by
Lissy F. Jarvik, M.D., Professor Emerita of Psychiatry
and Biobehavioral
Sciences, University of California-Los Angeles, School
of Medicine; Susan Lieff, M.D., M.Ed., Assistant
Professor, Department of Psychiatry, University of
Toronto; and
Stephen J. Bartels, M.D., M.S., Associate Professor
of Psychiatry, Dartmouth Medical School.
The Geriatric
Mental Health Foundation grants permission to print,
photocopy, and distribute this material.
Please cite the Foundation, including the address,
phone and website.
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