For some older adults, the later years are not as fulfilling as they should be. In fact, because of a combination of health problems, pain, and psychological and social conditions, many of them feel depressed. One of the most unfortunate — and dangerous — symptoms of depression is suicidal thoughts. Every year, more than 6,300 older adults commit suicide — but this situation is entirely preventable with the right diagnosis and treatment.
Because of an observed tendency among seniors to avoid mental health care specialists such as psychiatrists and psychologists, researchers decided to test out a new program: “Improving Mood: Promoting Collaborative Treatment (IMPACT) for Late-Life Depression in Primary Care.” It’s a mouthful, but it’s actually quite simple.
In the study, 1,800 older adults aged 60 or older (average age 72) suffering from depression were randomized to receive one of two types of care. Both groups were prescribed antidepressants and received counseling from their primary care doctor. Here’s where the difference was: One group of depressed patients was referred to a specialist, while the other was placed in the IMPACT program.
In the IMPACT program, there’s a “depression-care manager,” who is usually a registered nurse or a psychologist. This person provides depression education (“Problem Solving Treatment in Primary Care”) and counseling for the depressed patient, in addition to monitoring their drug treatment. However, the patient’s primary care doctor is involved, as is a psychiatrist, mainly in a supervisory capacity. So, it’s really a team of people working to improve the mental and physical well-being of the depressed person.
The IMPACT group had a better outcome than did the group referred to a specialist. At the outset of the study, 13.3% of participants in the control group and 15.3% of IMPACT-assigned participants were having suicidal thoughts. At the one-year mark, 15.5% of the control group still had thoughts of suicide versus 9.8% in the group receiving the team-based therapy. Even after one year out of the program, the IMPACT patients were still doing better, with 10.1% experiencing the negative thoughts compared to 13.9% in the control group.
These numbers just mean that the people in the IMPACT program did significantly better than those in the other group did when it came to reducing thoughts of suicide. So, older patients suffering from depression can still get the care they need while staying in their comfort zone with their primary care physician.
It’s important to note two things in this study: 1) no information on suicide attempts or hospitalization for suicidal thoughts was documented; and 2) some people with severe depression were not enrolled in the study, as they were deemed as needing immediate treatment. There were no deaths due to suicide during the course of the study.
Symptoms of depression include fatigue, bouts of unexplained crying, concentration and memory problems, overeating or lack of appetite, sleep difficulties, lack of self-esteem, general low mood, and loss of interest in life, including work, hobbies, and/or family and friends. If you have any combination of these signs, or feel you or someone else close to you might be suffering from depression, talk to your family doctor.
If you have been having suicidal thoughts, get immediate help. You can reach crisis counselors at 1 (800) 273- TALK, or check your local listings for a hotline in your area. For more information on this condition, check out http://www.allaboutdepression.com/gen_04.html