
- With Mayo Clinic psychiatrist
David Mrazek, M.D.
read biographyclose windowBiography of
David Mrazek, M.D.
David Mrazek, M.D.
Dr. David A. Mrazek is chair of the Department of Psychiatry and Psychology at Mayo Clinic, Rochester, Minn., and a professor of psychiatry at College of Medicine, Mayo Clinic. Dr. Mrazek has developed a federally funded psychiatric pharmacogenomics research program and implemented clinical psychiatric pharmacogenomics services at Mayo Clinic.
He has received numerous awards including the Award for Creativity in Psychiatric Education from the American College of Psychiatrists and the Agnes Purcell McGavin Award for Distinguished Career Achievement in Child and Adolescent Psychiatry from the American Psychiatric Association. He currently serves as chairman of the board of the American Board of Psychiatry and Neurology.
Dr. Mrazek has focused his current efforts on using pharmacogenomics testing to improve clinical care. One of his specific goals is to decrease the risks of taking psychiatric medications.
Latest entries
- Depression sometimes shifts to bipolar disorder
Jan. 21, 2012
- Antidepressant use soaring among Americans 12 and over
Dec. 7, 2011
- Transcranial magnetic stimulation offers hope treating depression
Oct. 19, 2011
- New antidepressant offers hope
Sept. 3, 2011
- Sorting out the evidence for antidepressants
July 22, 2011
Depression blog
-
Sept. 16, 2008
Depression and aging: Make sure to seek treatment
By David Mrazek, M.D.
| Need more help? |
|
Many of you think depression is a normal part of the aging process, but it is not. As with depression at any age, it is important to accurately diagnose and treat depression. Depression is treatable, and this is true in those 65 and older as well. Psychotherapy and/or medications may be used.
Older Americans are at higher risk for committing suicide than any other age group. The U.S. national suicide rate is about 11/100,000 persons. Males 85 and older have the highest suicide rate and it is 5 times the overall rate or 55/100,000 persons.
Symptoms are the same as in other age populations and can include:
- depressed mood (may include irritability)
- feeling guilty or worthless
- poor energy, feeling fatigued or tired
- poor concentration or focus (short-term memory problems that are not dementia)
- not enjoying things as one usually does
- isolating oneself form others, withdrawing
- feeling as if one is a burden or is not loved or cared about
- irritability, restlessness, nervousness
- changes in sleep patterns, may sleep more or less
- changes in appetite, may eat more or less
- persistent headaches, upset stomach or chronic pain
There are not medications recommended specifically for the elderly to treat depression. A medication choice will be based on other medications the patient is taking, patient preference, other medical illnesses and past medication trials, if any. Possible side effects can be used to one's advantage.
An example would be taking a sedating medication at bedtime when insomnia is a symptom of the depression. If poor appetite and weight loss are a part of the depression, a medication that may stimulate the appetite could be used.
If you are older and suspect you're depressed, see a health care provider. And if you know someone who is elderly and suspect they may have depression, encourage the person to see their health care provider.
Please share your experiences with us.
43 comments posted
November 9, 2011 1:55 p.m.
My dad, 93, resides in a long term nursing care. Early September, he passed out while out on the concrete patio, hit his head and was out 3 to 10 minutes, broke his hip. Surgery a success, two pins and a rod inserted. In October, he suffered a mild heart attack, got a pacemaker inserted. Ever since then, his appetite decreased substantially and now refuses to get up and fights with nursing staff trying to get him out of bed. Dr. put him on a mild antidepressant with an appetite inducer, Remeron. since this hasn't worked, dr has now switched him to Cymbalta. His lack of appetite and feelings of anger started after pacemaker was installed. Dad never displays any act of anger when I or other family members are around. Dad says he doesn't eat cause he gets nausea in his stomach or if he eats much, feels he will throw up. Could pacemaker have an effect on lack of appetite? Is cymbalta safe for someone who is 93?
- Idolina
September 22, 2011 11:52 p.m.
Denise, Not to attack you., but would you please get a clue as to punctuation, capitalization, and grammar.
- No name given
September 16, 2011 4:56 p.m.
dear lavanya: welcome to the blog, i'm glad u wrote in, i think u have some misunderstanding about the medicine that u r taking, serotonin is a chemical in the brain, not a drug, the best thing for u 2 do (in my opinion) is to look @ the bottle of medicine that ur taking & research it on the internet, i'm not a professional-just a patient like u, i think (again in my opinion), you should do some more research on it before you take it anymore, ck. with your pharmacist on this too, he/she will help you out, good luck, i hope this helped, think about getting a different dr. also, write back so we know how you are doing
- denise
September 14, 2011 4:57 a.m.
I was prescribed Seratonin at a higher dosage, which was then decreased. I did not understand what my problem was or how the medicine was supposed to help. So I stopped taking it. I was prescribed the drug in my 30 and now I am edging towards 50. My depression has increased, largely due to my circumstance. Should I go back on Seratonin?
- Lavanya
September 13, 2011 4:39 p.m.
I am 76 years old and have the displeasure of trying quite a few different antidepressants. The last one I used was Cymbalta and after a few months of use almost took my own life because it made the symptoms worse instead of better. Now they're advertised on TV for pain also. I think the company that produces and markets it is money hungry without thought to a person's health. After all, they can always blame the doctor who prescribed it (even though their pharmacutical sales people do anything to convince doctors to prescribe it.) We need more knowledgeable people running the FDA who cannot be bought off. The Cymbalta probably stayed in my system too long and accumulated doing more harm than good. Doctors should test us to find out if we are low in any one vitamin, mineral, etc. but i doubt that any such test exists outside of alternative medicine which most medical doctors won't touch.
- Mae
September 12, 2011 4:37 p.m.
I have an elderly friend who continues to try then stop an antidepressant prescribed for her painful circumstances. (physical pain) all who deal with her see an improvement in complaining of her physical situation each time she is on an antidepressant. My point is, depression does hurt in physical ways. I recently went off Celexa slowly and though my mental stafe appears good, I have body aches that were not apparent while on the medication.
- Dianne
August 27, 2011 4:10 a.m.
Aug 27,2011 2:25PM India My mother is suffring from severe depression from last five years,she is having strong feeling of insecurity and belive that someone among in the neighbour will kill her family members,due to which she is unable to stay in home.she is on treatment of antidepressent and antipsycotic agents such as amisulpride and venalafaxine.But only very minimal relief is seen.Please help me and suggest proper medication.I will be thankful to you.
- saket
June 13, 2011 12:02 a.m.
I am 68 yrs old and have suffered mostly with depression since I was a teen. The treatment then was ECT and meds. I was diagnosed as being Bipolar when I was in my early 30's. I was first put on Lithium Carbonate..for me it worked very well for many years. Then my medication was changed and I was put on Prozac. For some it is great, for me a disaster. I ended up in the hospital in a hypomanic state. But for me the worst was crashing down after the hypomania. It seems to take longer to get out of a depressive state. In one case it was 2 yrs. It has taken a toll on relationships with friends and a strain on my children. I am one of the lucky ones as I have a great support group and a wonderful Psychiatrist . I do now believe that exercise and breathing, yoga or anything you like to do that is physical can be of great benefit. On Nov.9/10 1:54 --Amy made a great statement in her blog. Suzanne
- Suzanne
January 29, 2011 10:52 a.m.
i am not sure if this is part of depression,but my wife does not not know where the teaspoon belongs,the remote becomes the cell phone,the clothes is packed in the wrong place.
- patrick
November 9, 2010 1:54 a.m.
There are many things to do when you have depression.First take your medication regulary at the same time of day.Morning is the best time for me.You really have to self talk to yourself.Tell yourself I am going to be happy and enjoy my life today.What really helps me is to do a act of kindness for anyone.Smiling really does make a you feel good.Get out with other people do not stay alone.Find something you truly enjoy doing.Remember to exercise your body your mind andd eat healthy brain foods.You will start to feel great !!!
- Amy
November 2, 2010 11:41 a.m.
What do you do when you live away from everything and cannot move?
- Lewis
October 16, 2010 11:05 p.m.
I am 70 yr old. I feel I have been depressed all of my life due to child abuse. I have checked into hospitals several times when I could not cope any longer. I was on prozac for a number of years. I took myself off prozac after 15 years and I didn't see any noticable difference. I am now on Wellbutrion SR and have been for over about 8 or more years. I am at a loss as to what direction to take. My depresasion has gotten worse over the past 4-5 years. I tell my internal medicine doc each time I see her that I am depressed and cry all the time. She raised the dose of my wellutrion but this has not changed anything. I tried to find out if there is a hospital anywhere in the US that treats only depression and was unsuccessful. I really need help. I feel being old and unable to find work to suplement my SS $'s and do things like get my car fixed or have the $'s to have my teeth worked on is very degrading. I have to get my teeth extracted instead. And on & on & on. No end in sight. It felt good to vent even if no one reads this. Good day.
- Cathy
August 6, 2010 7:55 p.m.
Someone wrote: "Aging is horrible. I sit with each passing day watching as my vitality, virility and relevance to the world slip away. It's just a long, slow march toward the inevitable. Of COURSE it's depressing and any older person who ISN'T depressed is a fool." FINALLY! Some honesty. I just turned 50 and even that is awful. There is no WAY I want to live to be as old as my parents (80s) as I see all of the health problems they have. I'm too cowardly to "off myself" but have given up all of my healthful habits (good eating, exercise, etc.). I just want to get this pitiful life over as quickly as possible.
- Scott
August 3, 2010 12:09 a.m.
I've got an 82 year old mother who has been diagnosed with post tramatic stress disorder, depression, and possible dementia. She also had a cat scan that reported she's got frontal lobe damage. We had taken her to a doctor who had placed her on risperdal and she developed parkinson like symptoms. The (2) doctors who were prescribing this medicine have since left the practice and did not monitor her. It was a nightmare to get her off of this medicine. As of July 27, 2010 She's now on the following antidepressants/anxiety meds celexa 10 mg daily seroquel 12.5 mg daily - their website strongly advises not to be used on elderly divalproex 250 mg. I do have concerns when I spoke with the nurse at the rehab/nursing home..... There is one medicine that is of great concern: seroquel at 12.5 mg daily. REA: FDA warnings about not using it on elderly with dementia. ( Passed standard test but feel she does have it ..... but are not proving it ). Warning of use with on patients with heart conditions : ( she had a heart attack 2 times in the past). I indicated these concerns to the nurse/manager who forwarded my concerns forward to her doctor. I strongly urged them to take her off of this medicine.... especially when they have her medical records. Their response : She signed a release and is aware of the (some )risks..... therefore they are not doing anything different. Note : She wasn't made aware of her risk to side effect potentials.
- Jeanne
July 13, 2010 3:50 p.m.
I have suffered from depression now for several years. I put myself under too much brain pressure by starting a business. When I closed my shop I thought this would be the start of new health but instead it brought new problems. I am now 52 with three grown up children and out off work. I find every day endless and continually wonder what I will spend my next day doing. My life has become a vicious circle. I wish I could find contentment but I do not now know where to look. I do voluntary work one day a week but this does not seem to give me satisfaction. Does anyone else of this age feel lost like me. I am taking antidepressants for my depression but each time I change to a different one they only seem to help for a short while and bang the light switch goes out again and I am back a square one. Is there really any cure for this ailment? Please help with a reply if you have felt like this.
- Petria
June 18, 2010 8:29 p.m.
I have been depressed for over two years due to the death of my husband and alot of really bad family problems. I have doctored with several, but to no avail.I have moved three times in two years and that has taken its tole on me. I have moved in and out of the same Retirement facility three times and this time I am convinced I am not retirement oriented. I do not like to mix with so many people. I love people but this is so different. I stay in my apt. most of the time and cook most of my own meals.I have such bad thoughts sometimes and it scares me., but I really feel that I would be better off. I have so many physical problems and that keeps me house bound somewhat. I find myself depending to much on my daughter,and I know that is not fair so I go on a guilt trip. I hope my new Dr. has the answer for me. I saw him on Wed. and he switched some of my medicine and added two others I Will not know for a month if it will work for me. I have high hopes and will do my part to get better.
- Helen
April 26, 2010 9:56 a.m.
My 93 year old mother moved in (8 months ago) with my wife and I (both 66 and retired), after my father passed 18 months previously after tying to maintain the home she lived in for 62 years. She takes no medicine, suffers from cataracts, macular, bad hearing, rheumatoid arthritis, sciatica, and is now regretting selling her home in Pa. and blaming all her ailments on her move to Ga. Even if prescribed, she expects drugs to work in 3 days, or stops taking them. She has her own “apartment” in our home, and insists on making her own breakfast, and sometimes lunch. Her dinner is prepared for her, and laundry, cleaning, and errands run by others. She recently fell in her bathroom, and is now terrified of falling again. Her depression seems to have intensified since that incident, feeling abandoned, lonely, useless, missing my father, even though she receives cards and letters from family members. She can make and receive calls, but they have to be repeated by us due to her hearing (we have a hearing impaired phone. . She is not very social, and adapting to a nursing home would be difficult. Her attitude, fixation on dying, and lack of participation or desire for help are starting to get frustrating to us, and we are looking for suggestions
- map
March 2, 2010 9:28 p.m.
My aging mom just unsuccessfully attempted suicide. I am looking for guidance. I ran accross this article and was most surprised at the responses. So many cries for help. Sad to read. Is there any response provided to these people. A phone number or something? Makes me feel like I'm going to find nothing in my search!
- Melanie
February 11, 2010 11:58 p.m.
Aging is horrible. I sit with each passing day watching as my vitality, virility and relevance to the world slip away. It's just a long, slow march toward the inevitable. Of COURSE it's depressing and any older person who ISN'T depressed is a fool.
- How can you NOT be depressed
December 2, 2009 9:20 a.m.
Eli, you may do that. Thanks for the interest. We request that you credit us this way. Source: MayoClinic.com. Thanks.
- MayoClinic.com staff
December 1, 2009 8:24 p.m.
I am writing a research essay on depression and the elderly and would like to cite and quote from your blog. May I have your permission Dr. Mellin to do so?
- Eli
November 18, 2009 1:28 a.m.
"see a health care provider." As if that does any good.
- John
August 27, 2009 3:27 a.m.
I am now 63 and have had depression since 1995! my medicine has been changed. I feel great and then all of a sudden - wham - I feel listless, tired, anxious, scared- I dont know what i am scared about, sometimes i think its the thought of ageing, full of wrinkles, no hair, bad health - I feel inadequate and this at my age! I thought by know I would be positive about everything.
- Magda
August 6, 2009 5:53 p.m.
With a wonderful recovering alcoholic (found that valium was also being used) Peryroinie's disease was a major factor with him, although found ways around this situation. Depressed due to family situation for some reason was always able to relate and be at ease together. Could understand problems, talked though, and his disease did not seem to be a major issue together. However with booze and valium could not see future when apart and needless to say no longer with us. Between personal problems, alcohol, booze I feel he felt no end at light of tunnel when apart. Is this a normal reaction for all these concotions added together? What more could have been done? Or was the lethel pills, booze and sexual disfunction when not together the ending point. Any help?
- Kit
May 14, 2009 8:23 a.m.
Hi - yeah meto - depressed for 9 years straight - got myself outta it all by myself - read - write - walk - run - talk w friends - eat right - calorie retsricted- lift weights- cut wood - lift and collect rocks - stay busy= find a hobby - exercise= focus on now- be here - now- only-focuson now - this moment - it is all you have- forget yesterday- tomorrow is an illusion - be here - be now - just be - best to all - good luck - this is hard hardhardhard - it hurtshurtshurtshurts - but you can do it - just be - be here - be in the now only - love John
- John Marine #70

43 comments posted