Depression in Later Life: A Multidisciplinary Psychiatric Approach

Depression in Later Life: A Multidisciplinary Psychiatric Approach

Depression in Later Life: A Multidisciplinary Psychiatric Approach

Depression in Later Life: A Multidisciplinary Psychiatric Approach

Excerpt

During Sigmund Freud's long career, he got many things right. These included his early recognition of the means of distinguishing conversion from the organic paralyses, the importance of subconscious motivations on our conscious behavior, and the impact of early experience on the developing personality.

However, he also got some important things wrong. The most widely publicized of these have been his views on female development and sexuality. Another error, which for many years hobbled our advances, was the notion that people over 50 were less able to benefit from psychotherapy. Time and experience have clearly proven this view to be an egregious error.

Increasing longevity-the result of better nutrition, cleaner water, and advances in medicine-has resulted in a larger and aging population. The aged and their problems have necessarily attracted the attention of the medical specialties to their care. Unfortunately, the illnesses afflicting the elderly are myriad, and often many are present in a single individual. This presents us with difficulties in diagnosis and in planning appropriate treatment. Is the patient's apathy the result of occult infection, dementia, depression, or some combination of these? If it is depression, is it a primary depression, or is it a reaction to illness or life circumstance? It is essential that the careful clinician untangle these threads, and then treat each effectively while keeping in focus the potential interactions of medications and other interventions, both good (as is often true

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