Distinguishing Distress in the Context of Aging: Demoralization vs. Depression

AbstractPurpose  of ReviewOlder adults face unique age-related challenges that evoke existential themes. Demoralization and depression are clinical concerns at the interface of the physiological and psychosocial worlds. This review highlights the utility of demoralization as a clinical construct distinct from depression, as well as common tools for measuring it; discusses the prevalence of demoralization in the clinical context and related sociodemographic factors; and outlines potential treatment approaches for restoring morale in demoralized patients.Recent FindingsDemoralization is characterized by a sense of hopelessness, helplessness and persistent inability to cope due to a loss of meaning and purpose in life. In contrast, depression is better differentiated by anhedonia and apathy. Demoralization is highly prevalent across clinical settings, and often occurs independently of a mood or anxiety disorder. Demoralization is a stronger predictor of suicidal ideation than depression. Social isolation, unemployment, physical symptom burden, and inadequately treated mood and anxiety disorders may increase risk for demoralization. Family support, higher income, and secure interpersonal attachments are potential protective factors. Psychotherapeutic interventions aimed at resilience-building and meaning-making may be helpful treatment modalities for demoralization.SummaryDemoralization and depression are two distinct psychological conditions that can exist independently and in ...
Source: Current Geriatrics Reports - Category: Geriatrics Source Type: research