Older adults with existing depression show resilience during the pandemic

A study involving older adults with pre-existing major depressive disorder living in Los Angeles, New York, Pittsburgh, and St Louis found no increase in depression and anxiety during the COVID-19 pandemic.

Researchers from five institutions, including UCLA, found that the older adults, who were already enrolled in ongoing studies of treatment resistant depression, also exhibited resilience to the stress of physical distancing and isolation. The findings were published in peer-reviewed journal, The American Journal of Geriatric Psychiatry.

"We thought they would be more vulnerable to the stress of COVID because they are, by CDC definition, the most vulnerable population," said Helen Lavretsky, MD, a professor-in-residence of psychiatry and biobehavioral sciences at the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA. "But what we learned is that older adults with depression can be resilient. They told use that coping with chronic depression taught them to be resilient"

For the study, researchers conducted interviews with the participants, all of whom were over the age of 60, with an average age of 69, during the first two months of the pandemic. Using two screening assessments of depression and anxiety, PHQ-9 and PROMIS, researchers found no changes in the participants' depression, anxiety or suicidality scores before and during the pandemic.

Researchers further determined that:

t
• Participants were more concerned about the risk of contracting the virus than the risks of isolation.
t
• While all maintained physical distance, most did not feel socially isolated and were using virtual technology to connect with friends and family.
t
• While they were coping, many participants said their quality of life was lower, and they worry their mental health will suffer with continued physical distancing.
t
• Participants were upset by the inadequate governmental response to the pandemic.

Based on the findings, the study authors wrote that policies and interventions to provide access to medical services and opportunities for social interaction are needed to help older adults maintain mental health and quality of life as the pandemic continues.

Lavretsky said many participants reported their quality of life to be lower, and they worried that their mental health will suffer with continued physical distancing. She said further research is needed to determine the impact of the pandemic over time.

She added that the findings offer takeaways for others while weathering the pandemic. "These older persons living with depression have been under stress for a longer time than many of the rest of us. We could draw upon their resilience and learn from it."

The study identified several self-care and coping strategies used by the participants, which included maintaining regular schedules; distracting themselves from negative emotions with hobbies, chores, work or exercise; and using mindfulness to focus on immediate surroundings and needs without thinking beyond the present.

The authors further emphasized that access to mental health care and support groups, and continued social interaction are needed to help older adults whether the pandemic.

Researchers from the University of Pittsburgh, Columbia University College of Physicians and Surgeons/the New York State Department of Mental Health, Washington University in St. Louis and the Centre for Addiction and Mental Health/University of Toronto.

The study was funded by the University of Pittsburgh Department of Psychiatry.

Journal Reference:

Megan E. Hamm, Patrick J. Brown, Jordan F. Karp, Emily Lenard, Flor Cameron, Alicia Dawdani, Helen Lavretsky, J. Philip Miller, Benoit H. Mulsant, Vy T. Pham, Charles F. Reynolds, Steven P. Roose, Eric J. Lenze. Experiences of American Older Adults with Pre-existing Depression During the Beginnings of the COVID-19 Pandemic: A Multicity, Mixed-Methods Study. The American Journal of Geriatric Psychiatry, 2020; 28 (9): 924 DOI: 10.1016/j.jagp.2020.06.013