Psychotherapie bei Depressionen im Alter - Beziehungsgestaltung und Ressourcenaktivierung

Abstract

Depression in old age often manifests as disturbed adaptation to individual life situations caused by illness or social problems. In the event of recurrent episodes, dysthymia is often observed, in particular in persons whose personality structure tends towards dependence. The focus of psychotherapy in old age is not on conflicts in early childhood, but on dying and death, life's purpose, freedom and isolation, which represent a priori fundamental sources of anxiety. Psychological psychotherapy gives hope and helps depressive patients by activating their resources through tailored therapeutic relationships. Building on the results of brain research, it creates a learning situation for ambulatory or institutionalized patients and, by activating explicit memories of the patient's achievements during his lifetime, makes it possible for him to recognize his own resources and, aided by external options, to reactivate them. Neurobiologically speaking, activation of resources is effected via cortical synapses with the hippocampus as organizer. This is achieved most readily in a learning situation with relationships that enables emotiponal reassessment by actualising implicit burried memories and perceptions of social situations via subcortical neuronal synapses with the amygdala complex as the centre. The treatment of depressive elderly persons requires a setting that utilizes the specific therapeutic competencies of various disciplines. Whether treatment of depressive patients is permanently successful depends on the quality and specificity of the interventions and the intensity of relationships.