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    Undoing Depression

    Many treatment options exist for elderly depression.

    Treatment Choices

    If the interplay of biology, psychology, and society all play a role in the development of depression in the elderly, it makes sense that curing depression must take them all into account.

    A physician may recommend antidepressant medication along with psychotherapy. Depression in the elderly is usually treated over a six- to 12-month period, says Charles Reynolds III, M.D., a professor of psychiatry and neuroscience at the University of Pittsburgh Medical Center. In his study, published in the January 5, 1999 issue of the Journal of the American Medical Association, Reynolds found that using both medication and therapy prevented recurrence in 80% of patients over a three-year period.

    Pipher believes psychotherapy works best in elderly people who are lonely, verbal, and willing to try something new -- which, she acknowledges, doesn't often fit the profile of a depressed person. "Those elders for whom it has worked best in my experience have been bright but lonely, so the relationship with me was important to them,'' she says. "They treat me more like their daughter than a therapist."

    Beyond Traditional Treatments

    Medication and therapy may not be best for every one. "I pushed my mother, who had worked as a doctor, into therapy, when what she really needed was a sense of being useful and important in the community,'' Pipher says. ''I should have suggested getting involved in a program in the school where she was a reading buddy to a child, or doing more work with the senior center."

    Depending on the level of depression, a variety of activities might help. Joining a support group (ask a physician for a referral) or helping to coach a sports team are some possible activities. Having pets and gardening can also ease mild depression, Pipher finds. "The trick is to connect older people to things they love and to let them feel useful,'' she says.

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