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GPs and Physicians Must Bear in Mind that There Is Not One Depressive Illness but Many

January 7th, 2010

In the fields of psychology and psychiatry, the terms depression or depressed refer to sadness and other related emotions and behaviors. Late-life depression can have different causes, symptoms and treatment needs than that observed in younger persons. It is less likely to be grounded in family history, and more frequently associated with the medical and psychosocial problems of ageing or with cognitive deficit.

In studies conducted in the mid-1990s, within various care homes in Suffolk, it was reported that, among care home internists, “only 55% feel confident diagnosing depression, and 35% are confident prescribing antidepressants” and that “one third of family physicians are unaware of depression practice guidelines, and one fourth use screening tools.”

People with a depressive illness cannot merely “pull themselves together” and get better. Without treatment, symptoms can last for weeks, months, or years. Physicians need to bear in mind that there is not one depressive illness but many. “In the extreme, one could assert that each depressive illness is unique and individual. Elderly persons should not be exempt from that rule”.

Depression is an illness that affects millions each year. It is a silent but relentless state of mind that should be diagnosed and treated early.

Depression can be classified as a disease, however it is better described as a disorder. Disease often implies a condition is contagious which depression is not. Adaptation to the difficulties of old age is gradual. Those in the 75 age group may have better perceptions of their own health than those in the 55-64 age group” as a result of ‘positive ageing’. Such an explanation could raise important new issues for the professional approach to prevention and treatment of depression at different stages.

Most GPs are not trained in the intricacies of elderly depression, and the customary few minutes spent face-to-face by doctor and patient will tend to confirm each in their preconceived attitudes and provoke disagreement.

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