DEPRESSION AMONG THE ELDERLY
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Depression is a psychological health disorder that results from loss of interest in some activities leading to impairment. Depression occurs in the amygdala, a region deep in the brain associated with emotions such as pleasure and anger. Inappropriate fear and anxiousness are a disorder caused by the amygdala.
Depression affects the brain by decreasing its size causing it to shrink. According to chapter 11.10, the limbic system becomes the region of emotion and indicates depression when there is decreased hippocampal volume, releasing cortisol hormone which slows the growth neurons in the hippocampus leading to memory problems.
The uptake of cortisol stimulated by depression causes the amygdala to increase in size and become leading to sleep disturbances and change in other hormones level according to chapter 13.2
Persistent depression can lead to brain inflammation causing the death of brain cells. Some complications such as reduced functions of neurotransmitters, reduced ability of the brain to change as one gets older, and brain shrinkage. (Psomiades, 2017) Hypoxia is a condition that increases in specific immune cells of individuals with bipolar and depressive disorders. This leads to oxygen restriction hence brain cell injury and death.
Depression affects the body in that it causes an increased risk of heart diseases such as heart failure and coronary artery disease. It can lead to weight gain or loss due to a change in appetite. People with this condition may also experience painful headaches, fatigue, breast tenderness, and muscle pains.
The thyroid gland and the brain relate to each other in response to depression in that hypothyroidism can result from damage in thyroid hormone transport receptor and low uptake of thyroid hormone into the brain cells and neuronal cells thus leading to the low level of cerebral spinal fluid in the brain. (Bouomrani,2019)
The thyroid gland produces thyroid hormone that helps in maturation of the human brain, myelinated sheath, and synthesis of enzymes responsible for the production of neurotransmitters. Depression leads to thyroid deficiency thus brain damage and mental retardation.
According to World Health Organization, over 20% of adults of the age of 60 years and above suffer from depression thus a mental health disorder of which about 7% account for older adults who have this disability. (Patra,2017) According to the Centre for Disease Control and Prevention, approximately 7 million American adults aged 65 years encounter depression annually.
Risk factors such as health problems like heart disease, stroke, and cancer. Drop-in socioeconomic status due to retirement increases the chances of mental disorders among older adults. According to chapter 11.9 adults are at high risk of inadequate thyroxine which results in myxedema, undiagnosed hypothyroidism, that is triggered by infections and depression in the body. Other risk factors include fear of death, social isolation, and not able to talk about their feelings.
Depression can be treated by the use of medicines such as antidepressant drugs like mirtazapine and selective serotonin reuptake inhibitor. Other medications include the use of antipsychotic and anxiolytic drugs. This can be combined with behavioral therapy and psychotherapy done by a clinical psychologist. The use of such medication and therapy helps normalize brain functions.
Antidepressant drugs act as reuptake inhibitors and target different neurotransmitters preventing them from being taken up by the nerve cells in the brain. Instead, these neurotransmitters stay in the synapse. For example, a selective serotonin reuptake inhibitor relieves major depression by affecting serotonin transporter and receptor.
The forebrain discussed in chapter 11.8 of the book is an important area that is made up of the hypothalamus and limbic system, it determines emotions therefore most affected by depression. Hypothalamus which is part forebrain controls the functioning of the pituitary gland which in turn controls the thyroid gland. thyroid gland hypersecretion of thyroid hormone leads to hypothyroidism which causes a low level of the cerebral spinal fluid hence major cause of depression.
In chapter 13.10 of the book disorders of the endocrine system are discussed. (Johnson,2007) diabetes mellitus is one of them which is caused by inadequate blood sugar. This condition is manifested when there is an inability of the cells to utilize glucose thus body metabolizes some fats and protein. It is a risk factor of depression as the patients suffering from this disease should inject themselves every day to administer the insulin hormone. Some characteristics of the disease such as sugar in the urine, ketonemia, and glycosuria can be the major cause of depression.
Reference
Johnson, M. (2007). Media manager to accompany Human biology, concepts and current issues, 4th ed. by Michael D. Johnson. [San Francisco, Calif.]: Benjamin Cummings.
Psomiades, M., Fonteneau, C., Suaud-Chagny, M. F., Haesebaert, F., & Brunelin, J. (2017). Does Prefrontal Noninvasive Brain Stimulation Alleviating Symptoms in Depression and Schizophrenia Impact Mood and Emotion Processing?. Sante mentale au Quebec, 41(1), 223-239
.Bouomrani, S., Guermazi, M., Yahyaoui, S., Trabelsi, S., & Ghanmi, L. (2019). Depression of the elderly revealing primary hypothyroidism. Advances in General Practice of Medicine, 2(1), 1-4.
Patra, P., Alikari, V., Fradelos, E. C., Sachlas, A., Kourakos, M., Gil, A. P. R., … & Zyga, S. (2017). Assessment of depression in the elderly. Is perceived social support related? A nursing home study. In GeNeDis 2016 (pp. 139-150). Springer, Cham.