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Depression: Part II

LTC Nursing Assistant Trainer, January 26, 2005

Depression is an illness just like diabetes or heart disease. It is not "all in your head." It's important that nursing home residents are properly diagnosed with depression, because its symptoms often mimic those of dementia. With proper treatment, depression can be controlled or cured.

There is no one cause of depression, although there appears to be a strong familial tendency towards developing the illness. It can also be caused by some medications, emotional stress, hormones, and certain physical conditions, especially with chronic pain. Women are twice as likely to develop depression as men.

Diagnosis of depression is primarily from symptoms and physicians often give patients a standardized questionnaire to help measure the degree of the illness. Previous occurrences or a family history of their disease helps confirm the diagnosis.

Medication is the most popular treatment for depression. However, psychotherapy and electroconvulsive therapy may also be prescribed, either alone or in combination with medication.

• Medication
  Medications usually take a couple of weeks to take effect. There are many antidepressant drugs available, so physicians sometimes change a prescription if a drug is not working well or is producing too many side effects.

• Psychotherapy
  When used in conjunction with medication, psychotherapy can have great results. For mild cases of depression, psychotherapy alone may be enough to help the resident return to normal life.

• Electroconvulsive therapy (ECT)
  ECT is a very effective treatment for severe depression. Usually five to seven treatments are given, one every other day. With ECT, electrodes are attached to the head and an electric current is used to produce a brain seizure. Temporary memory loss can occur following the treatment. ECT is usually reserved for suicidal or catatonic residents.

Depression can be successfully treated in more than 80% of people with the disease. When untreated, most people will eventually feel better, but will have continuous mild symptoms for extended periods of time. Most people who have had one episode of depression will have four or five more during their lifetimes. Next week, we'll finish our lesson on depression when we discuss depression in the elderly and nursing care for depressed and suicidal residents.

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