The depressed patient: social antecedents of psychopathologic changes in the elderly

The importance of depression as a psychopathologic syndrome in the elderly is stressed by the estimate that about 30 percent of persons over the age of 65 may be expected to experience an episode of depression severe enough to interfere with daily functioning. Depression is the chief cause of psychiatric hospitalization among the elderly, and it bears great potential for death through inanition or suicide. Loss of mastery (ability to cope) and the onset of helplessness are frequent dynamic issues in the development of depression or behavioral problems in the elderly. Geriatric stereotypes contribute directly to helplessness by reinforcing such behavior. Stereotypes also minimize the chance of appropriate response outcomes relative to needs. Rolelessness, a partial result of stereotyping, leads to anomie, alienation, and lowered self-esteem. These issues are discussed and points of interaction among them are examined. The relevance to psychotherapy with older persons is outlined.