Physician offers warnings and advice regarding depression in the elderly


By Bonnie Adams, Managing Editor

According to Dr. Gary Moak, M.D., it’s a common misconception that depression is inevitable as you age. And in his new book, “Beat Depression to Stay Healthier and Live Longer: A Guide for Older Adults and Their Families,” he makes the case that depression is actually a serious brain disease, often related to changes in the brain associated with the aging process itself.

Moak bases the premise that depression is a disease of the brain based on his more than 30 years as a practicing geriatric psychiatrist who has treated thousands of patients with a wide range of psychiatric and behavioral problems related to diseases of aging. He is the former owner and director of the Moak Center for Healthy Aging in Westborough. He now is an assistant professor of psychiatry at the Geisel Medical School at Dartmouth in Hanover, N.H.

It is normal, he said, to be upset when a major life event occurs, such as loss of a spouse, change in living environment or illness.

“But it’s all in how you cope with the situation,” he said. “Not everyone gets depressed.”

According to the Centers for Disease Control and Prevention (CDC), nearly 7 million American adults over the age of 65 experience depression each year. Adults over the age of 65 made up 16 percent of all suicide deaths, with men over 85 the most successful in killing themselves. Depression is almost always a factor.

Signs of depression can include loss or increase in appetite, insomnia or too much sleep, isolation, feeling hopeless, cranky, nervous or guilty for no reason and a sudden lack of enjoyment in favorite pastimes.

Like any other disease, depression should be treated, Moak said.

“You would treat any other part of the body that is breaking down as you age, such as your heart or lungs,” he said. “So why wouldn’t you treat your brain as well?”

Depression can lead to catastrophic results, he said, when it is combined with another disease. It increases the rate of disease such as stroke, heart disease and Alzheimer’s disease and worsens conditions such as diabetes, chronic lung disease and cancer.

“It’s a very destructive and costly disease,” he said.

Compounding this problem is that many physicians do not have enough education or experience when it comes to treating depression in the elderly.

“Too often they do not have enough time to spend with their patients and truly understand what is going on,” he said. “Meds are prescribed in a knee-jerk reaction and often too little a dosage is prescribed.”

Geriatric psychiatry is a very specialized field – one needs to be able to understand traditional counseling as well as being able to understand the social systems in place for the elderly, end of life issues and ethical concerns, Moak said. But currently there is a severe lack of geriatric specialists, he noted – currently less than 2,000 in the country. And with approximately 70 million Americans expected to be 65 or older by the year 2030, he said, the results could be disastrous for those afflicted with depression as they age.

“That’s why I wrote this book,” he said. “I want to be able to help, in a clear, easy-to-understand manner, how serious this problem is but also show there are options.”

Moak’s book has four sections to help elders and their families:

  • Insight into the signs and symptoms of depression in later life;
  • First-hand accounts from patients suffering depression;
  • Suggestions for prevention and treatment of depression; and
  • The health problems those with depression may face if they do not treat it.

The book may be purchased on Amazon or at major booksellers.

Dr. Gary Moak Photo/Submitted
Dr. Gary Moak