Mental health: more numerous elders to take antidepressants

More and more Quebec seniors have recourse to antidepressants to treat their mental health, according to data from the Quebec Health Insurance Régie (RAMQ).

Through the province, more than 370,500 elderly people have prescribed such medications during the year 2024, which represents an increase of 8 % compared to the previous year.

This increase is part of a trend that has been taking shape in recent years, while the number of people aged 65 and over taking antidepressants increased by 34 % between 2020 and 2024.

The upward trend in the taking of antidepressants is also noticeable in other age groups of the Quebec population, but it is more particularly marked among elders and adolescents.

These data agree with the observations of Dr. David Boivin-Lafleur, doctor gerontopsychiatrist at Ciusss of the Capitale-Nationale. He notes an increase in consultations related to mental health issues in patients in the third age.

Requests for mental health services in older age groups are increasing. As we know, we feel it, we see it in our statistics here that the number of patients increases from year to yearindicates the gerontopsychiatrist met in his office at the University Institute in Mental Health in Quebec (IUSMQ).

Twice as many women

Recent data from Ramq Also demonstrate that elderly women are twice as many to prescribe antidepressants as men. In 2024, nearly 250,000 women over the age of 65 resorted to this medication, while a little more than 121,500 men did the same.

This great disparity does not surprise experts either, who argue that this proportion reflects the higher propensity of women to consult for mental health problems.

The men will delay the moment to go to consult. There is an even greater taboo among the male population.

Women are also more inclined to carry on their shoulders the burden of the loved one and support for their children, which can play a role in this phenomenon, according to Marie-Josée Richer, lecturer in psychoeducation at the University of Montreal and at the University of Quebec in Outaouais (UQO).

A plurality of factors

Difficult to put your finger on a particular cause to explain this increase in the taking of antidepressants in the elders.

The isolation and lifting of taboos surrounding mental health issues are in particular among the many factors that could play a role in this upward trend, as well as the effects of the pandemic, which are still perceptible today.

We had a wave of isolated, lonely people, who had to live mourning. […] It is certain that the recovery after that had an impact on their quality of life, on their social level, their level of interaction and their mobility. It has backdrops on their ability to socialize […] and put yourself in roles that are activeexplains Dr. David Boivin-Lafleur.

Health professionals are also more aware of the symptoms of a deterioration in mental health in seniors, who sometimes manifest themselves differently than for other age groups. The signs of melancholy, of sadness, the desires to die and the lack of energy are often less noticeable in the elder customers.

In the elderly, it is more atypical to see this great melancholy in a very defined way. Sometimes there is a certain ability to keep a social varnish and a smiling contact which can sometimes hide this depressive entity, while if we dig […] We can catch a little more easily this syndrome which is different in the younger personsupports the one who is also a researcher at the Cervo research center.

The aging of the population and the increase in life expectancy are also aspects to be taken into consideration in reading this data. In 2024, 65 and over represented 21 % of the Quebec population, according to the Quebec Institute of Statistics.

Do we prescribe too quickly?

The president of the Quebec Association for the Defense of the Rights of Persons Retired and Préretraitées (AQDR) in Quebec, Judith Gagnon, believes that the increase in the taking of antidepressants from the elders raises questions.

According to her, medication should not be the first solution put forward when an elder feels anxiety or depressive symptoms. Before taking antidepressants, there may be other ways to try. Like going outside, taking time for yourself, being part of a movement, like ours or others, and trying to improve your situationunderlines the president of theAqDR-Québec.

The prescription of antidepressants is generally done in a thoughtful way, after discussion with the patient, to whom the advantages and disadvantages of medication have been explained, recalls Dr. David-Boivin-Lafleur, which should however be important to ask this type of question.

Is the medication that increases is a good thing, because we diagnose better and that we treat effectively, or is it a bad thing because the diagnostic label is brought to too many people? Does it become a bit of the simplest easy solution? There are arguments that will support on one side and the otherhe underlines.

Lack of resources

The stakeholders encountered, however, agree on one thing: accessibility to other solutions, such as monitoring in psychotherapy, home support and psychosocial aid, is often difficult for this vulnerable clientele, due to a lack of resources.

Regardless of the figures Ramqit is necessary to enhance accessibility to all these other methods of social support and psychological support for older customers, because yes, the needs are there, the needs are large, and the population will continue to agenote the gerontopsychiatrist doctor.

The psychoeducator Marie-Josée Richer abounds in the same direction. According to her, more resources should be invested upstream with the eldest customers, in order to prevent the deterioration of their mental health.

There is distress, there is a lack of services. […] We may not have the resources to set up programs, whether to break social isolation or increase physical activity. These are things that we know, that are in the literature, which can have an impact to reduce depressive symptomsshe says.

Several initiatives set in motion to try to meet this need. For example, Marie-Josée Richer worked on the project I de -stress in wisdoman adaptation of a program of the Center for Studies on Human Stress which will be offered in training to dozens of health professionals this fall.

On the side of theAqDR-Québec, outdoor walking sessions followed by group discussions will be organized in the fall to help seniors get out of isolation and maintain healthy lifestyles.

The president of the organization believes that this type of opportunity can offer precious support to the elders who live a difficult situation which affects their mental health.

It is important not to always find yourself alone, to try to find links with other people to feel better. […] There are ways to counter loneliness. Everything is not always perfect in life, but we can always change everything, as long as we are alive. We may have more power than you thinkconcludes Judith Gagnon.