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Interpersonal Psychotherapy and Alcohol Addiction

Interpersonal psychotherapy (IPT) is a highly adaptable approach to treating an array of disorders, and it has been used to address the needs of various patient groups. In the beginning, IPT was designed as a brief intervention to use as primary care; later on, it was tailored to treat adolescents and individuals with major depressive disorder (Markowitz & Swartz, 2011). When the first alternations in the approach were made, the adapting process accelerated and reached more distinct social groups and conditions. The primary adaptations laid the foundation for practitioners and researchers in the domain to investigate the approach’s further prospects on the basis of the primary IPT model (Markowitz & Swartz, 2011). Alcohol-dependent senior citizens suffering from the major depressive disorder is a category that has been covered partially in different IPT adaptations; nonetheless, seemingly, a model focused specifically on their conditions is not designed.

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Solitude is one of the most salient problems that contemporary societies have to find methods to manage, as it may result in a number of mental illnesses, including major depressive disorder. Presently, its aspects regarding senior citizens, seemingly, necessitate additional exploration in the domain of psychotherapy. A decent amount of research is dedicated to children, adolescents, and adults, which reveals an inherent societal bias and its priorities. However, adaptation to the new social status that a person faces after retirement may not be efficient and lead to the augmented sense of emptiness, uselessness, and rejection from one’s community. These factors have negative consequences on the psychological state of the senior population.

The significance of IPT for this specific demographic group comes from limitations that aging poses to the use of antidepressants. Appropriate drug prescription is obscured by the risk of collateral symptoms that it may entail. An array of health problems common among senior citizens, such as dementia and Parkinson’s disease can be worsened by certain drugs (Heisel et al., 2015). Nonetheless, the combination of IPT with antidepressants reduces substance abuse and the severity of major depressive syndrome symptoms (Heisel et al., 2015). Hence, the shortcoming of certain types of medication used to treat depressive disorders among the elderly accentuates the benefits of IPT.

Major depressive disorder and alcohol abuse seem to be two coinciding factors. With the global population increasingly aging, the scale of research dedicated to this specific population group needs to be augmented. The higher risk of suicide resulting in death is associated with alcohol abuse, the rate of which is elevated among the elderly. It has been shown that senior citizens that suffer from chronic depression are more likely to have drinking problems as senior citizens without it (American Addiction Centers, 2020). Taking into consideration that the processes associated with aging lower resistance to the substance and increase the time an organism processes it, the issue deteriorates the life quality of this population group significantly. Alcoholism is a significant disease that affects numerous citizens and leads to especially severe consequences for people over sixty years old, among who it is the most frequently abused substance (American Addiction Centers, 2020). Hence, the adaptation of IPT for this particular category of the population could potentially reduce suicide and death consideration and increase their mental well-being.

Depression is not considered an integral part of aging, and the suicide rates among older adults demonstrate that the problem needs to be addressed more widely. Focused psychotherapeutic attention and psychological interventions are shown to impact older adults with suicidal ideation positively – still, only one concentrated clinical study has been implemented (Heisel et al., 2015). A limited trial of IPT concentrating on suicidal elderly citizens was designed by Heisel et al. (2015), revealing that the approach led to a reduction in thoughts about ending one’s life and morbid sentiments. The researchers (Heisel et al., 2015) state that “findings from a secondary analysis of data from three treatment studies of late-life depression in mental health care setting demonstrated significant reduction or the resolution of suicide ideation with standard IPT and/or antidepressants” (p. 88). The discussed studies suggest that the intervention is secure and effective for the elderly. Moreover, the focus of IPT on social support and interpersonal problems, and functioning in combination with the risk of increased loneliness for senior citizens, render this model particularly suitable for this population.

Treating substance abuse with IPT received a decent number of adaptation suggestions. Nevertheless, the specific combination of aging, substance abuse, and major depressive disorder, and the scope of IPT influence is, seemingly, not researched sufficiently. Abstaining from alcohol use for the elderly may not be the ultimate solution, as it results in higher depression rates – this finding may be related to the social aspect of alcohol consumption (Gibson et al., 2016). Diagnosing the problem for senior citizens is complicated by the fact that they are even less likely to disclose the substance abuse in medical records. Moreover, the psychological aspect of treatment may be combined with a medical one, as detoxification is one of the critical steps in the healing process (Gibson et al., 2016). In this way, the principles on which IPT is based make it the optimal option for treating the alcohol dependent elderly who endure societal abandonment, resulting in isolation.

Taking into account the motives that push senior citizens to abuse alcohol, and subsequently result in primary depressive syndrome, certain adjustments to the standard model should be added so it could function effectively. Case conceptualization for this type of patient needs to account for substance abuse and suicide risks. The middle treatment sessions may need to include, if possible, a relative or a person from the immediate environment. This approach cannot be considered a family-based adaptation as a parental conflict is not the central point of such sessions. Extreme psychological pain stemming from isolation and abandonment may be mitigated through the examination of the relationships between a patient and a relative, for instance. Role-playing in similar circumstances would facilitate the demonstration of affect, which may endorse facultative conjoint sessions at the latter stages. This format, potentially, helps to recognize possibilities for increasing social connection and engaging in purposeful interactions, and open communication.

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In the context of contemporary society, the increasing longevity and aging of the population accentuate the issues of ensuring and maintaining the mental health of the older generations. The negative manifestations of loneliness are demonstrated in the violation of a person’s internal integrity, which may serve as a psychological defense mechanism. IPT is a feasible, efficient, and safe method to treat several adverse effects that aging entails in current social circumstances. Adapting IPR for alcohol-dependent senior citizens suffering from major depressive disorder is a potentially valuable undertaking as it overarches a growing demographic category.

References

American Addiction Centers (2020). The invisible epidemic: Senior citizens and alcoholism. American Addiction Centers.

Gibson, R. C., Waldron, N. K., Abel, W. D., Eldemire-Shearer, D., James, K., & Mitchell‑Fearon, K. (2016). Alcohol use, depression, and life satisfaction among older persons in Jamaica. International Psychogeriatrics, 29(4), 663–671.

Heisel, M. J., Talbot, N. L., King, D. A., Tu, X. M., & Duberstein, P. R. (2015). Adapting interpersonal psychotherapy for older adults at risk for suicide. The American Journal of Geriatric Psychiatry, 23(1), 87–98.

Markowitz, J. C., & Swartz., H. A. (2011). Case Formulation in Interpersonal Psychotherapy of Depression. In T. E. Eells, Handbook of Psychotherapy Case Formulation (221–249). Guilford Press.

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