Registered Nurses' Association of Ontario

Interventions for Depression

A number of interventions have been shown to be effective to varying degrees in older adults with depression. This list is not exhaustive but reflects key findings from the literature and clinical guidelines.

Non-pharmacological Interventions
Psychotherapy
Depending on the person/severity of depression, psychotherapy may be used alone or in combination with antidepressants

Examples of psychotherapy:

  • Behavioural therapy
  • Cognitive behavioural therapy (CBT)
  • Interpersonal therapy
  • Problem-solving therapy (should be delivered by highly qualified or experienced therapists)
    (see the guideline for definitions and details)

Exercise
Exercise programs/ group physical activity, exercise therapy and tai chi have shown potential benefits, depending on the setting and severity of depression
See the guideline for details
Note: Excercise should be tailored to an individual’s abilities

Psychological and social interventions
Examples of psychological and social interventions

  • Reminiscence (should be facilitated by a trained practitioner)
  • Behavioural activation
  • Mindfulness
  • Peer support or self-help
  • Music therapy (must be individualized)
  • Animal therapy (may have benefits for older adults with depression living in long-term-care settings or psychiatric institutions)

Electroconvulsive therapy (ECT)

ECT may be considered for treatment of severe, life-threatening depression, or when other treatments have failed

Pharmacological Interventions

Antidepressants

  • Antidepressants are important for the treatment of severe major depression
  • SSRIs are usually the preferred antidepressants
  • Antidepressants are recommended together with non-pharmacological treatments
  • The evidence supporting the use of antidepressants for people with depression and dementia is unclear
     
Older Adults
Delirium, Dementia, and Depression in Older Adults: Assessment and Care
Point of Care Resources