Health needs related to risk for depression in adults
Serotonin is a neurotransmitter that aids in transmitting signals in the brain. Its primary source and area of function are in the brain. However, 90% of the serotonin produced is found in the blood platelets and the digestive tract. Serotonin influences various functions in the body, especially the brain cells linked to appetite, mood swings, sleep, sexual functioning, temperature regulation, learning and memory, and social behavior.
It also influences the functioning of the muscles, endocrine system, cardiovascular system, and breast milk production. The burden of handling this vulnerable group lies with the primary care providers (Shellman, Granara & Rosengarten, 2011). They face the complication of identifying the depression symptoms because other medications or medical conditions can lead to depression. These include hypersomnia or insomnia, loss of appetite and weight, energy loss, psychomotor retardation, and concentration difficulties.
Determinants and contributing factors
Many studies indicate that an imbalance in the level of serotonin may affect one’s moods causing depression, especially in old age. This may be due to reduced production of serotonin by the brain cells, absence of receptor sites that serotonin can work on, the inability of serotonin to be transported to the receptor sites, or a reduced level of tryptophan. These factors cause depression in old age together with other symptoms such as anxiety, panic, or anger (Hussain, 2010). The development of depression dominates in the regeneration of new brain cells. The production of serotonin mediates the process of cell regeneration and proceeds in the entire lifetime of an individual.
Depression results from the inhibition of newly formed brain cells, with the most determining precipitator of depression being stress. It is, however, not clear if the reduction in levels of serotonin leads to depression, or depression results in a drop in the levels of serotonin (Hussain, 2010). Common medications of antidepressants have been designed to increase the levels of serotonin, aid in the production or regeneration of new brain cells, and reduce the levels and incidences of depression. There is a common belief that deficiency or low levels of serotonin cause depression, but it is still not possible to estimate the levels of serotonin in the brain (Shellman, Granara & Rosengarten, 2011).
Use of PHQ9 as a screening tool for depression
The challenge of depression in the elderly is the recognition of signs and symptoms or the frequent underreporting of the symptoms of depression in adults over the age of 65. Patient Health Questionnaire-9 (PHQ9) is a screening tool for identifying the symptoms of depression and can be applied in elderly patients. It enables straightforward identification of depression symptoms and improved treatment strategies that ultimately improve the survival, function, and life quality. A PHQ-9 depression scale is a self-reporting form of a questionnaire that serves the purpose of primary care usage and reflects the diagnostic depression criteria derived from the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders).
The PHQ-9 scale evaluates the endorsed number of items as well as their pattern in diagnosing minor and major depression. Its suitability for use in elderly patients links to the shorter period for testing than measures of screening for depression, excellent criteria, responsiveness, improved test reliability, and construct validity (Shellman, Granara & Rosengarten, 2011).
Plan of action and steps to take to minimize the risk of depression in adults
Exercise proves to be an effective depression treatment in the same or higher magnitude than psychotherapy or antidepressant medication. A simple plan of exercising can result in tremendous effects in improving one’s moods, which translates to reduced depression levels (Lach, Chang & Edwards, 2010). However, the mechanism by which exercise reduces depression is still not clear, even though several studies have been interested in exploring the antidepressant impact of exercise on depression. For example, an exercise intervention group for the elderly can plan to walk for 30 minutes, thrice a week for 8 weeks.
This will yield effective results in alleviating depression symptoms. An individual plan of walking on a treadmill for about 40 minutes twice or thrice a week can also achieve significant results in reducing the symptoms of depression. According to Lach, Chang & Edwards, (2010), the elderly group can join various related community groups or resources to get motivation, determination, and consistency in dealing with depression.
Intervention
It is also evident that the benefits of involvement in exercise are long-lasting, with the elderly people involved in a fitness program reporting significant achievements in alleviating depression symptoms, self-concept, and anxiety, than those who never enrolled in such fitness or exercise programs. The elderly patients tend to be sedentary and must be motivated before initiation into a fitness or exercise program (Hussain, 2010). Recommendations can be issued on the exercising routines, for example, all participants must exercise daily for 30 minutes each day with a vigorous intensity. The elderly patients also need counseling in a stepwise magnitude and making them begin with enjoyable exercises. They should also be taught techniques for self-monitoring in order to add to the awareness of reinforcement and involvement in exercises (Lach, Chang & Edwards, 2010).
References
Hussain D. (2010). Stress, Immunity, and Health: Research Findings and Implications. International Journal of Psychosocial Rehabilitation. Vol 15(1) 94-100.
Lach, H. Chang, Y. & Edwards, D. (2010). Can Older Adults with Dementia Accurately Report Depression Using Brief Forms? Journal of Gerontological Nursing, 5: 30-37.
Shellman, J. Granara, C. & Rosengarten, G. (2011). Barriers to Depression Care for Black Older Adults: Practice and Policy Implications. Journal of Gerontological Nursing, 37: 13-17.