Older people coping with low mood: a qualitative study

Abstract

Background:To gain new insight into support for older people with low mood, the perceptions, strategies, and needs of older people with depressive symptoms were explored.Methods:Two in-depth interviews were held with 38 participants (aged ≥77 years) who screened positive for depressive symptoms in general practice. To investigate the influence of the presence of complex health problems, 19 persons with and 19 without complex problems were included. Complex problems were defined as a combination of functional, somatic, psychological or social problems.Results:All participants used several cognitive, social or practical coping strategies. Four patterns emerged: mastery, acceptance, ambivalence, and need for support. Most participants felt they could deal with their feelings sufficiently, whereas a few participants with complex problems expressed a need for professional support. Some participants, especially those with complex problems, were ambivalent about possible interventions mainly because they feared putting their fragile balance at risk due to changes instigated by an intervention.Conclusion:Most older participants with depressive symptoms perceived their coping strategies to be sufficient. The general practitioners (GPs) can support self-management by talking about the (effectiveness of) personal coping strategies, elaborating on perceptions of risks, providing information, and discussing alternative options with older persons.

Factors influencing self-management of depression in older adults: a qualitative study

“…Timely help-seeking for a diagnosis and treatment is integral to the selfmanagement of depression (Atkins et al, 2015;Von Faber et al, 2016). Positive perspectives on older age and depression are strongly associated with help-seeking (Kessler et al, 2015).…”

“…Because much of the current research into depression in older age focuses on issues of prevalence, diagnosis and treatment, less is known about the personal experience of living with depression in older age (Ludvigsson et al, 2015). A deeper understanding of the self-management strategies older adults used to optimise well-being is also warranted (Turner et al, 2015;Von Faber et al, 2016).…”

Non-pharmacological interventions for depression/anxiety in older adults with physical comorbidities affecting functioning: systematic review and meta-analysis

“…The effect size is slightly higher for modified PST (1.79 [3.39,0.20], converting the MD from Figure 3[a] to SMD) than that reported for SSRIs in general older adult populations (SMD 1.2 [0.3-2.1]) (Kok et al, 2012). PST also has a high level of acceptability (Gellis et al, 2007;2008;Kiosses et al, 2010;2015) and may address the importance placed by older people with complex problems upon feeling a sense of mastery about solving issues and helping a combination of issues that older people with complex problems attribute depression to (Von Faber et al, 2016). Provision of this alternative therapy in routine care may support increasing the access to mental health support for frail older people.…”

"We can’t carry the weight of the whole world": Illness experiences among Peruvian older adults with symptoms of depression and anxiety

“…The main ideas was 'self-re ection and adaptation' to circumstances you cannot change and 'doing your part,' making an effort to feel better. Several studies among older adults have highlighted the importance of oneself in overcoming depression, calling it 'inner strength' or 'self-reliance' (16,43,44). Viewing personal responsibility as key to overcoming depression and anxiety can be seen in two opposing ways: as a potential barrier to health seeking behavior, since someone who sees the solution in their own mind may not recognize the purpose of seeking care from a professional (23), or as a potential gateway to introducing psychological techniques to strengthen cognitive self-coping mechanisms (43).…”