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Depression & Dispiritedness in Later Life: A ‘gray drizzle of horror’ isn’t inevitable.

Butcher, Howard K. PhD, RN, APRN, BC; McGonigal-Kenney, Meghan BSN, RN

AJN, American Journal of Nursing: December 2005 - Volume 105 - Issue 12 - pp 52-61
FEATURES: A New Look at the Old

OVERVIEW: The misconception that aging and depression are inevitably entwined is not only common but also dangerous. It can lead to a variety of adverse events, which might have been avoided had the depression been recognized and treated. However, recognizing depression in older adults can be difficult as it may present differently in this population than it does in younger adults. Furthermore, while treatment options are similar, adjustments may need to be made to deal with the physiological changes inherent to age. The authors address the recognition and treatment of depression in older adults. They also propose a diagnosis of dispiritedness, “a feeling of being in low spirits” that they have found to be common among older adults and suggest appropriate nursing interventions.

The writer William Styron has described depression as “a despair beyond despair,” and it’s not always recognized in older adults. The authors review the varied characteristics of depression in older patients, discuss its diagnosis and treatment, and present a definition of “dispiritedness.”

Howard K. Butcher is an associate professor and a John A. Hartford Foundation (2002–2004) Building Academic Geriatric Nursing Capacity Postdoctoral Scholar at the University of Iowa College of Nursing, Iowa City, where Meghan McGonigal-Kenney is a doctoral student and research assistant. Contact author, Howard Butcher: This article is ninth in a series that’s supported in part by a grant from the Atlantic Philanthropies to the Gerontological Society of America. Nancy A. Stotts, EdD, RN, FAAN (, a John A. Hartford scholar, and Carole E. Deitrich, MS, GNP, RN (, are the series editors. The authors of this article have no significant ties, financial or otherwise, to any company that might have an interest in the publication of this educational activity.

© 2005 Lippincott Williams & Wilkins. All rights reserved.