Depression in Seniors is Often Unnoticed
Family members and even primary healthcare providers often mistake an older adult’s symptoms of depression as just a natural reaction to illness or an unavoidable part of the aging process. Older adults themselves often share this belief and suffer unnecessarily because they don’t understand that they could feel better with appropriate treatment.
Statistics on Mental Health and Seniors
Recent data indicate that an estimated 20.4 percent of adults aged 65 and older met criteria for a mental disorder. (Karel, Gatz & Smyer, 2012). The CDC’s 2013 report on The State of Aging and Health in America identified “addressing mental distress among older adults” as one of its primary Calls To Action needed to improve the health and well-being of older adults. The CDC estimates: About 25% of adults aged 65 years or older have some type of mental health problem, such as a mood disorder not associated with normal aging. Mental distress is a problem by itself, and it has been associated with unhealthy behaviors than can interfere with self-management and inhibit recovery from an illness.
How Can we Help Change these Statistics?
Talking to seniors about their mental health can be challenging. Family members, caregivers, and even many medical professionals are not trained to assess mental disorders. Conversations can be awkward. Seniors are often reluctant to talk about their symptoms.
The most common mental disorder among older adults is depression. Depression, once diagnosed, often responds quickly to treatment. Most older adults with depression improve when they receive treatment with an antidepressant, psychotherapy, or a combination of both. If left untreated, however, depression may result in the onset of physical, cognitive, functional, and social impairment, as well as decreased quality of life.
If you suspect an older adult has depression, there is an easy, direct way to talk with them about their symptoms. The Geriatric Depression Scale (GDS) is a reliable 15-question assessment that anyone can use. Ask the senior to answer the following questions:
Geriatric Depression Scale: Short Form
Choose the best answer for how you have felt over the past week:
1. Are you basically satisfied with your life? YES / NO
2. Have you dropped many of your activities and interests? YES / NO
3. Do you feel that your life is empty? YES / NO
4. Do you often get bored? YES / NO
5. Are you in good spirits most of the time? YES / NO
6. Are you afraid that something bad is going to happen to you? YES / NO
7. Do you feel happy most of the time? YES / NO
8. Do you often feel helpless? YES / NO
9. Do you prefer to stay at home, rather than going out and doing new things? YES / NO
10. Do you feel you have more problems with memory than most? YES / NO
11. Do you think it is wonderful to be alive now? YES / NO
12. Do you feel pretty worthless the way you are now? YES / NO
13. Do you feel full of energy? YES / NO
14. Do you feel that your situation is hopeless? YES / NO
15. Do you think that most people are better off than you are? YES / NO
Answers in bold indicate depression. Score 1 point for each bolded answer.
A score > 5 points is suggestive of depression.
A score ≥ 10 points is almost always indicative of depression.
Source: http://www.stanford.edu/~yesavage/GDS.html
This scale is in the public domain.
Any score greater than 5 warrants a follow-up assessment by a medical professional. If your senior scores higher than 5, help them schedule an appointment to discuss the results and form a treatment plan with a healthcare provider.
If you or someone you care about is in crisis, please seek help immediately using one of the following methods:
- Call 911
- Visit a nearby emergency department or your health care provider’s office
- Call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (4889) to talk to a trained counselor
Sources:
Centers for Disease Control and Prevention. The State of Aging and Health in America 2013. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2013.
Karel, M. J., Gatz, M. & Smyer, M. A. (2012). Aging and mental health in the decade ahead: What psychologists need to know. American Psychologist, 67, 184-198.
Lyness JM, Noel T, Cox C, King DA, Conwell Y, Caine ED. Screening for Depression in Elderly Primary Care Patients: A Comparison of the Center for Epidemiologic Studies—Depression Scale and the Geriatric Depression Scale. Arch Intern Med. 1997;157(4):449-454. doi:10.1001/archinte.1997.00440250107012.
U.S. Department of Health and Human Services, National
Institutes of Health, National Institute of Mental Health. (2015).
Depression (NIH Publication No. 15-3561). Bethesda, MD: U.S.
Government Printing Office.
Cognitive Behavioral Therapy and Cognitive Restructuring
Cognitive Behavioral Therapy (CBT) is based on the theory that our Thoughts, Emotions, and Behaviors all impact each other.
During therapy, the client learns how to identify distorted thinking patterns. The client then learns the connection between distorted thinking and her emotions and behaviors. By making changes to distorted thinking, the client experiences changes in feelings.
A CBT therapist teaches clients techniques to make theses changes. Cognitive restructuring is a key technique of CBT therapy. Dr. Aaron Beck, the founder of Cognitive Therapy, talks about cognitive restructuring techniques.
Symptoms of Depression & How Talk Therapy can Help
While the number of suicides is at its lowest in December, the number of people who report symptoms associated with depression is at its highest. During the holidays, many of my clients report new symptoms of depression, including:
- Fatigue and decreased energy
- Inability to make decisions
- sadness or unhappiness
- Irritability or frustration, even over small matters
- Loss of interest or pleasure in normal activities
- not wanting to be around other people
One of the most common issues my clients struggle with during the holidays is that of managing expectations about people, events, and feelings. Many people have beliefs about the holidays that are simply not true, such as:
It is the best time of the year.
Everyone will show their love for everyone else.
Family will all gather together and feel only joy.
Carefully chosen presents will be appreciated.
My partner is going to give me that gift I have always wanted.
I am going to love going to 12 cocktail parties.
I have to eat and drink all that is offered.
I am going to use this family time to “fix” all our problems.
I can get by with only 4 hours of sleep.
This tree and my decorations are so fabulous, everyone will know and appreciate how hard I worked.
It is OK to stay up until 3:00am on a work day, because I have to have 4 dozen decorated cookies.
My child will not be able to survive if she does not get DaisyDoItAll Doll.
Everyone else is going to parties every night, I am only invited to one.
I lied to my friend and told her I was busy the night of her party, now I feel guilty.
Why is everyone else have such a great time, and I am miserable? What is wrong with me?
This list goes on and on. What are your expectations for the holiday time? Do you share any of the above beliefs? Your therapist may be able to help you see the connection between these unreasonable expectations and your symptoms of depression.
Some things you can try to help prevent falling into the holiday depression cycle are:
Plan ahead, make a schedule.
Only say “Yes” when you want to say “Yes”. Be okay with saying “No”.
Get your regular number of sleep hours each night.
Let go of Perfection, you can buy cookies at the store, eight strands of lights on the tree are enough.
Prepare a neutral response to conflictual situations, especially with family members.
Don’t expect anyone to behave in a way significantly different from the way they behaved last year, the holidays are not a good time to do a family “intervention” or “rescue”.
Don’t expect a partner of friend to be able to read your mind and deliver the perfect gift.
Create activities that you truly enjoy, even if they are outside your usual holiday traditions.
Challenge yourself to set realistic goals for your holiday time. Remember, there will be things that do not go as planned. Try to enjoy the good times.
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Songs and Family

Question Of The Week: What Song Describes Your Family?
by ROBIN HILTON
November 18, 2013 5:31 PM
We need some help putting together next week’s show. Thanksgiving is coming up, and for a lot of you, this means you’ll be spending some close time with family. Maybe it’s more time with family than you want. Or maybe you can’t get enough of it. Either way, it’s an opportunity to reflect on the people in our lives and how they’ve shaped who we are. This is where you come in. Tell us about a song that describes your family. It can be a happy song or sad, a literal or not so literal one. Whatever reminds you of your family. Tell us about the song in the comments section.

What songs describes your family?
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Convoy of Hope – TYPHOON RESPONSE

Convoy of hope
For other ideas on how to send your support, I also like the recommendations from the folks at Rewire Me in their post, Join Us in Helping Typhoon Haiyan Victims
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Holly Scott, MBA, MS, LPC sees clients at Uptown Dallas Counseling. Holly is trained in the specialty of Cognitive Behavioral Therapy, and holds the position of Diplomate in the Academy of Cognitive Therapy. Holly works with clients to help them overcome challenges in their daily lives that may be preventing them from achieving happiness. She helps clients with stress management, depression, parenting, marriage counseling, and other mental health concerns. If you are looking for a counselor or therapist, explore this website to see if Holly may be able to help you.
To make an appointment for therapy or counseling with Holly at her Uptown Dallas Counseling, you have the option of using the Online Patient Portal to register and schedule.
Life Goals: Are They Actually Distractions?

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Holly Scott, MBA, MS, LPC sees clients at Uptown Dallas Counseling. Holly is trained in the specialty of Cognitive Behavioral Therapy, and holds the position of Diplomate in the Academy of Cognitive Therapy. Holly works with clients to help them overcome challenges in their daily lives that may be preventing them from achieving happiness. She helps clients with stress management, depression, parenting, marriage counseling, and other mental health concerns. If you are looking for a counselor or therapist, explore this website to see if Holly may be able to help you.
To make an appointment for therapy or counseling with Holly at her Uptown Dallas Counseling, you have the option of using the Online Patient Portal to register and schedule.
Benefits of Sleep: it Cleans your Brain.

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Holly Scott, MBA, MS, LPC sees clients at Uptown Dallas Counseling. Holly is trained in the specialty of Cognitive Behavioral Therapy, and holds the position of Diplomate in the Academy of Cognitive Therapy. Holly works with clients to help them overcome challenges in their daily lives that may be preventing them from achieving happiness. She helps clients with stress management, depression, parenting, marriage counseling, and other mental health concerns. If you are looking for a counselor or therapist, explore this website to see if Holly may be able to help you.
To make an appointment for therapy or counseling with Holly at her Uptown Dallas Counseling, you have the option of using the Online Patient Portal to register and schedule.
Controlling Emotions: Is it possible?
This discussion about controlling emotions compares two different women’s reactions to the same event.
First Woman’s Reaction: Take a Picture

From Hannah Price’s collection, City of Brotherly Love
When photographer Hannah Price moved from Colorado to Philadelphia, she began to experience something new to her – catcalls from men on the street. After several catcalling episodes, she decided to take action. She would either snap a photo of the man immediately; or she would talk with him about the incident, and then ask if she could make his portrait. Ms Price created a project called “City of Brotherly Love” from these photographs.
Ms Price states her project is not meant to be an aggressive rebuttal to the individuals in the photos. It is, she states, “just a way of trying to understand it. It was way for me to just deal with it on another level besides avoiding it. Sometimes it’s easier to … just respond….. you just start talking to people, you find out more about them than your initial [impression].”
To see the complete 17-photo collection, see the NPR blog post of Code Switch by Kat Chow.
Second Woman’s Reaction: Send a Message

Tatyana Fazlalizadeh’s original posters on Tompkins Ave. in Bedford-Stuyvesant, Brooklyn. (Stephen Nessen/WNYC)
Brooklyn artist Tatiana Fazlalizadeh’s response to her experiences in Brooklyn is very different from Ms. Price’s response with the photography project. She created posters with direct negative messages to the catcallers and posted them around her neighborhood. Ms Fazlalizadeh states she can’t walk down her street without getting catcalled or harassed. “It happens almost daily to me where I get frustrated or annoyed or upset by something that someone has said to me or done to me outside on the street.”
Why the Difference?
Why does one woman feel okay to take photos and even have a conversation about the experience, and another woman feel anger and frustration? Our individual responses to catcalls are a result of our thoughts about the experience. If we think: “wow, someone thinks I’m cute.”, “I still have it”, or “this is going to be a good day”, our response may be: happiness, a big smile, a skip in our step, better posture.
If we think: “that reminds me of my abusive former boyfriend”, “will he try to come after me?”, “they must think I am promiscuous”, our response may be: fear, increased heart rate, hunched posture, a frown, anger.

Newshttp://www.wnyc.org/story/282239-not-taking-it-anymore-one-woman-talks-back-street-harassers/
Kat Chow, A Photographer Turns Her Lens On Men Who Catcall, October 17, 2013.
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Treating depression in Cancer Patients
Cecelia Gittleson writes in Memorial Sloan-Kettering‘s Cancer Center newsletter about the importance of diagnosing and treating depression in cancer patients. She discusses sources of support for patients, survivors, and their caregivers.
Ms. Gittelson quotes a physician who specializes in the psychological treatment of people with breast cancer and their families on the importance of psychosocial support, “We’ve learned that depressed people generally do less well in the oncology setting,” explains Memorial Sloan-Kettering psychiatrist Mary Jane Massie. “This is probably due in part to the fact that because they feel bad — psychologically, physically, or both —they decide it isn’t useful to take their medications. And there can be a domino effect: They stop filling their prescriptions and may even start to miss medical appointments. But there is a lot of help available.”
Holly Scott, MBA, MS, LPC sees clients at Uptown Dallas Counseling. Holly is trained in the specialty of Cognitive Behavioral Therapy, and holds the position of Diplomate in the Academy of Cognitive Therapy. Holly works with clients to help them overcome challenges in their daily lives that may be preventing them from achieving happiness. She helps clients with stress management, depression, parenting, marriage counseling, and other mental health concerns. If you are looking for a counselor or therapist, explore this website to see if Holly may be able to help you.
To make an appointment for therapy or counseling with Holly at her Uptown Dallas Counseling, you have the option of using the Online Patient Portal to register and schedule.
Postpartum Depression: Tragic Consequences
Did Miriam Carey have Postpartum depression?
![]() From CBS News: Emergency personal help an injured person after a shooting on Capitol Hill in Washington, Thursday, Oct. 3, 2013. Police say the U.S. Capitol has been put on a security lockdown amid reports of possible shots fired outside the building. (AP Photo/ Evan Vucci) The small photo comes from what is believed to be the Facebook page of Miriam Carey, who according to multiple police sources, allegedly led authorities on a car chase near the U.S. Capitol on Oct. 3, 2013. / FACEBOOK / EVAN VUCCI/AP/FACEBOOK |
![]() From USA Today |

• Showing unusual or nonsensical behavior
• Acting fearful or paranoid
• Believing bizarre ideas, such as thinking that the baby is the devil
![]() printed with permission from deamstime |
The Truth About Postpartum Psychosis There is more to this devastating condition than what the media reports
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Friday Fun Post: Happiness

Fall Colors 2013 provides a color-coded map of the US indicating where the leaves have begun to change, where colors are at their peak, and where the leaves have fallen. The site also provides a toll-free number where you can get updates on specific areas. It is a great resource of you are planning a trip to see fall foliage.
Happy Fall and Happy Friday!
Holly Scott, MBA, MS, LPC sees clients at Uptown Dallas Counseling. Holly is trained in the specialty of Cognitive Behavioral Therapy, and holds the position of Diplomate in the Academy of Cognitive Therapy. Holly works with clients to help them overcome challenges in their daily lives that may be preventing them from achieving happiness. She helps clients with stress management, depression, parenting, marriage counseling, and other mental health concerns. If you are looking for a counselor or therapist, explore this website to see if Holly may be able to help you.
To make an appointment for therapy or counseling with Holly at her Uptown Dallas Counseling, you have the option of using the Online Patient Portal to register and schedule.
Just Discovered Alana Karsch on Upworthy.com
As I was doing my evening internet browsing, I read some posts on Upworthy.com and tweets by Alana Karsch. Liked them so much, I wanted to share her information here:
![]() Alana Karsch |
By day I’m a transformative photographer and art therapist. At night, I sleuth the web for outrageously important stuff. I want you to be happier, smarter, healthier, and more generous. Also, I want to paint the world with watercolors and glitter. Share all this important goodness with me on Facebook and Twitter.- Alana Karsch |
I love her goals and the approach she uses to try to achieve them. Take a look. You may also like them.
