Question

Twenty-five-year-old Ben and his 65-year-old dad, Stiller, both believe that they may be clinically depressed. How would this disorder be properly diagnosed? What are some common types of therapy, and how would the effective treatment for the disorder likely vary for father and son?

Answer 1

Clinical depression or Major Depressive Disorder is a mood disorder characterized by persistent feelings of sadness, loss of interest in activities that the individual once found enjoyable, loss of energy, sleep, and concertation, and feelings of guilt and hopelessness.

Major Depressive Disorder is usually diagnosed in the following ways:

1. Physical examination

Several physiological illnesses and usually the underlying cause of depression and a doctor may perform a thorough evaluation to rule out the possibility of a physical illness. For instance, changes in thyroid hormones cause symptoms of depression such as low mood and loss of energy.

2. Mental status evaluation

A mental status evaluation is conducted by asking the individual about their symptoms, feelings, thoughts, and behaviour patterns. In some instances, the individual may be asked to fill out a questionnaire that assesses mood disorders in order to determine the severity of the condition.

If the individual’s symptoms match the criteria listed in the DSM-V a diagnosis of Major Depressive Disorder is made.

Depressive disorders are usually treated with a combination of drug therapy and cognitive behaviour therapy.

In this scenario, the intervention that Ben and Stiller receive are likely to be very different.

Ben is likely to be prescribed with an antidepressant and would be required to see his therapist for talk therapy regularly.

Since Stiller is comparatively older and is likely to have other health conditions that further worsen his depression, treatment is likely to be slightly different. According to research, older adults do not respond as quickly to antidepressants as younger adults and therefore require smaller doses of medication. Additionally, older adults usually tend to be on medication for other physiological illnesses, and there is a chance that antidepressants can interact with those medications.

Psychotherapy has found to be useful in older adults. Support groups and encouragement from family and friends has found to have a positive impact in treating depression in older adults.

Another possible treatment method is Electro Convulsive Therapy (ECT), when an older adult is on medication that could have side-effects when combined with antidepressants.