Episode 52: Beat Depression to Stay Healthier with guest Dr. Gary Moak
About Dr. Gary Moak
Dr. Gary Moak is a past president of the American Association for Geriatric Psychiatry and 2011 recipient of its clinician-of-the-year award. He is a practicing geriatric psychiatrist with over 30 years experience treating older adults with a wide range of psychiatric and behavioural problems related to diseases of aging. Dr. Moak started studying mental health and aging after seeing an opportunity to do some good in a population of people that really needed help due to a definite shortage of specialists working with older adults. It also allowed for a more holistic approach by looking at the whole person in trying to understand and help them with their problems as the aging population requires a much different approach to treatment than younger people. He is the author of the book "Beat Depression to Stay Healthier and Live Longer: A Guide for Older Adults and Their Families.” Dr. Moak is director of the Geriatric Psychiatry Fellowship Program at Dartmouth-Hitchcock Medical Center, and Assistant Professor of Psychiatry at the Geisel Medical School at Dartmouth, where he serves as Chief of Geriatric Psychiatry at the New Hampshire Hospital.
Why it is important to talk about mental health in aging populations
Many people develop mental health problems later in life but they usually come about for a different set of reasons. They often have to do with processes of aging that affect other aspects of health, that have a similar impact on the brain and how it works.
In older adult population it is common for people to be taking a range medications for various health problems. These medicines all interact with each other and they interact with how the brain works in a way that can cause a whole slew of mental health problems. Although no one should simply stop medications on their own without getting assistance from a medical specialist, sometimes people are on medications that they may no longer need or may actually be causing side effects that contribute to or cause the problem they're seeking help for from a Geriatrician.
Would someone know if they were clinically depressed?
Clinical depression is a brain disease that causes a very pervasive disturbance in emotional functioning. The person experiences a blue, sad, gloomy down in the dumps mood or maybe feels emotionally empty inside that's very hard to shake off. It's there day in and day out. It doesn't come and go with different circumstances. Clinical depression affects people of all ages but in older adults it can occur in response to a difficult, stressful life event. Clinical depression can come on out of the blue as a result of changes in the brain that are occurring due to the aging process or age related illnesses that affect the brain.
What Are The Symptoms
It can affect someone's day to day functioning and their thinking
They may become completely inactive
The person may stop taking care of themselves
They may not feel motivated to get up or get dressed or change their clothes
They may eat poorly or not eating at all for days at a time
They may stop taking needed medicines
An Important Conversation To Have With Older Adults and Their Families
We live in a society where there's an assumption that old age is a bad thing and that people can't be happy when they're older. The damaging belief that there is nothing to look forward to in old age may lead some people to believe that there is no point in getting medical attention for feeling depressed (you just need to live with it.) But the opposite is actually true. If you look at different age segments of society, from childhood all the way to old age, the levels of satisfaction with life and the levels of happiness are actually highest among older adults (assuming they remain relatively healthy and free of serious illness or brain disease.) Depression is not a normal part of aging. Depression not only can be diagnosed and treated, but the treatment can prevent a whole slew of downstream chain reactions that can lead to more serious illness, disability, having to go into a nursing home and even dying prematurely years before your time.
What health problems have been linked to clinical depression?
Living with depression is not a harmless thing and it can really take a toll on a person’s health. Depression is associated with a number of serious consequences for general physical health:
Persistent depression leads to cardiovascular disease and it increases the risk of dying from sudden cardiac arrest.
It contributes to worsening congestive heart failure and dying sooner because of it.
It increases the chance of having a stroke just about as much as smoking cigarettes does.
Depression makes people more likely to develop diabetes, and if they have diabetes, it makes the diabetes harder to control and more dangerous to their health.
It makes the course of chronic lung diseases worse.
It makes arthritis more painful.
It increases the chances of developing Parkinson's disease.
It increases the chance of developing Alzheimer's disease. Periods of depression throughout life that goes untreated can actually quadruple the risk of getting Alzheimer's when you get older
The Unseen Dangers of Depression
Depression can be thought of as a state that is similar to chronic stress. We're learning more and more about the harmful effects that chronic stress has on our bodies, including our brains. Depression basically causes a state of chronic stress that gets the brain going in hyper-drive chronically and the nervous system is cranked up chronically which makes the heart more irritable. It makes the heart beat faster and it has to work harder. It makes the blood more prone to clot because chronic stress prepares us to deal with injuries. We know that depression creates a state of heightened oxidative damage as well and the cumulative effect of all these things can lead to organ damage. So it's bad for the kidneys, bad for the liver, bad for the heart, bad for the bones and muscles, bad for the brain, as well as bad for the immune system.
What Are Some Barriers To Treatment?
There is definitely a stigma surrounding mental health issues and finding help might be difficult due to the shortage of mental health professionals. Many have to rely on their primary care doctor who might share the same biases regarding depression and older age.
The book “Beat Depression to Stay Healthier and Live Longer”
Dr. Moak wrote this book specifically for older adults and members of their family who were concerned about depression and don't know where to turn for help. It's really for people that don't have access to a specialist and need to figure out how to get the help they need from the health care system and how to make it work. The book is divided into three sections:
What exactly depression looks like later in life
The relationship between depression and different general health problems like cardiovascular disease, stroke, diabetes, cancer, chronic lung disease, Parkinson's disease, Alzheimer's disease, etc.
Where you can find a geriatric mental health specialist. It provides some tips and suggestions for how to go about doing that.
Conclusion
To learn more about Dr. Gary Moak and to purchase his book:
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