Depression in the Elderly

A 74-year-old woman with hypertension that is well controlled with hydrochlorothiazide is brought by her daughter for an evaluation. The daughter states that her mother is withdrawn, often tearful, and at times appears to have memory problems but has no history of psychiatric illness. The patient is a retired teacher who is widowed and has lived independently for several years. During the last few months, she has stopped going to church and visiting friends. The patient's symptoms include irritability, anhedonia, fatigue, a 4.5-kg (10-lb) weight loss over a period of 3 months, and difficulty sleeping. She feels like a burden to her family. How should she be treated?