MENTAL HEALTH

& AGING
Chapter 10
PY 219
Spring 2022
Defining “Abnormal” and “Mental Health”
On a spectrum

4 Ds

Context

• Including social disparities

Considers a Multidimensional Life-span Approach

• Biological, Psychological, Sociocultural, Life-cycle forces/factors

 4

Assessment

Assessment linked Clinical interviews

with identity of are the most
clinical frequent assessment
psychologists tool
Syndromes as
Clusters of SX
 6

Interviews: Types

Intake interviews

Diagnostic

Mental Status Exam

Crisis Interviews
 Medical treatments:
• The ways medications work change with age.
• Over-the-counter medications can interfere with Rx
medications.

Interventions Psychotherapy
• Positive approach
• Effectiveness based on age-related needs

Both require one to be sensitive to

developmental issues of older adults.
THE BIG 3
Depression, Delirium, Dementia
 Depression

Less than 5% of older adults living in the community

show signs of depression.
Rates of clinical diagnosis vary across ethnic groups.

Depression commonly accompanies other chronic

conditions.
 Symptoms of Depression

Depressed mood out of proportion to any cause

Anhedonia—Lost interest in everything in life
Changes in appetite, sleep, and activity levels
Psychomotor retardation or agitation
Excessive worthlessness, guilt, hopelessness, or thoughts of suicide
Problems concentrating
Losing touch with reality, experiencing delusions, and hallucinations
 Diagnosing Depressive Disorder

Major depressive disorder Persistent depressive disorder

• Symptoms lasting 2 weeks or • Milder depressed mood for

more
• Major depressive disorder,
single episode
• Major depressive disorder,
recurrent episodes
most of the day for at least 2
years
• One year for children and
adolescents
 Assessment

Beck Depressi Geriatric Depr

on Inventory ession Scale
Causes
◦ Biological
o Genetics, brain changes, neurotransmitters
◦ Psychosocial theories
o Psychological effects of loss are the most common basis for depression.
◦ Cognitive-behavioral
o Internal belief systems are affected by experiencing unpredictable and uncontrollable
events.
 Causal Physical Dx

CORONARY
NEUROLOGICAL METABOLIC
ARTERY
DISORDERS DISTURBANCES
DISEASE

CANCER OTHER DX

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 Treatment
Medication:

• SSRI (e.g. Zoloft, Lexapro)

• SNRI (e.g. Cymbalta)
• NDRI (e.g. Wellbutrin)
• Combined reuptake inhibitors and receptor blockers
• Tetracyclic antidepressants (e.g. Sumycin)

Electroconvulsive therapy (ECT)

Psychotherapy

• Behavioral
• Cognitive

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