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[quote=Anonymous]My mom is 87 and has recurrent severe depression and GAD. It’s terribly hard for family to manage this so you have my sympathy.

I would try to find a good geriatric psychiatrist or psychiatric nurse practitioner. It can be so hard to find someone good…my mom’s last major episode was during Covid and it was impossible. You need someone to be available when you need it.

First, watch the UTIs - they can cause liver enzymes or blood ammonia levels to be abnormal and high ammonia levels especially have psychological effects. My mom regularly has bloodwork to check - now just the regular panel. It can be hard to distinguish physical from mental symptoms and my mom is always having some physical effects of her anxiety - trouble swallowing, insomnia, tremors, weakness, fatigue.

Seeing a therapist is also really important…manly for us it’s talking about how to manage her anxiety and break out of anxious thought spirals when they happen.

Regular exercise, outdoors if possible, too - I go on walks with my mom maybe 4x per week now and she goes to the exercise class at her senior living facility on the other days. (She’s in independent living). When I’m with her we link arms and walk at a faster pace than she can manage on her own. Getting your heart rate going and being a little out of breath is especially helpful for the mental health benefits of exercise.

For meditation my mom takes sertraline (an SSRI - generic Zoloft). I don’t think it does much. We are going to work on possibly changing medications. It’s so individual what works and what doesn’t.

We also tried Buspirone, one of the only anti anxiety meds considered safe for elderly people but my mom would get so anxious about taking it we eventually dropped it. That was beyond frustrating.

Last, if your mom isn’t living in senior living, consider it. The daily activities with other people is key and can really help. It brought my mom out of her last depression.

Last - if she isn’t sleeping well this is very foundational to anything else being able to work. My mom had terrible insomnia and we followed a book on cognitive behavioral therapy (CBT) for insomnia. It worked like a charm. Now my mom goes to bed & wakes at the same time every day. Without this she’s so miserable it’s impossible to work on anything else.

In sum since this was long:
1. See a psychiatrist/psychiatric nurse practitioner for medication management and diagnosis 
2. Exercise
3. Daily activities with other people 
4. Get regular sleep/treat insomnia

We are 10 months in to this current episode. It’s a lot better than it was, but it’s still a work in progress. Best of luck to you.

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