Patient's Query
Hello doctor,
My dad is 67 and has struggled with really severe depression his whole life. He told me recently that he feels like he lost decades of his life to this illness and that grief has actually made his depression worse lately. He is on Sertraline 100 mg right now, and while it is helping a little bit, he still has days when he barely gets out of bed and cries for reasons he cannot even explain.
How does a 67-year-old cope with the grief of decades lost to severe depression?
Is there any kind of therapy that actually helps with this kind of thing at his age?
Kindly help.
Hello,
Welcome to icliniq.com.
I understand your concern.
Geriatric depression is very difficult to manage, as co-morbidities often limit the use of medicines. However, there are several psychotherapies that are equally effective in old age. One of the best is cognitive behavioral therapy (CBT). This therapy works on cognitive and behavioral components.
Similarly, the Sertraline dose is adequate in old age, and if there is no response, it can be switched to another selective serotonin reuptake inhibitor (SSRI). An antipsychotic can be augmented as well.
Similarly, behavioral activation, which is part of cognitive behavioral therapy (CBT), is effective, and you can help him follow it. This includes asking him to start with three kinds of activities that he used to do previously and can do easily now:
One activity should be from the things that he used to enjoy.
Another should be a responsibility.
The last should be a mastery activity.
Combine these activities and start with the easiest one.
For instance:
Ask him to brush his teeth. This comes under responsibility.
Similarly, ask him to listen to music, which comes under pleasure activities.
This helps gradually change the thinking pattern.
Similarly, get all his baseline investigations, including a thyroid profile. You can contact me later with all the details, including history, vitals, the names of the medicines that he has taken, current symptoms, sleep, appetite, and functioning.
I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.
Thank you.
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