What Older Adults Need to Know About Depression

It’s normal to feel down in the dumps sometimes. But depression is not a natural part of aging. Here’s how to protect your mental health.

Life definitely has its tough moments, and those can take a toll on our mood. But emotions should come and go. If you’re feeling down for weeks, months, or even years, you may be experiencing depression.

Depression is a serious mental health condition. It can affect how you feel, think, focus, sleep, and more. It is not a normal part of aging, but rather a condition that requires treatment, according to the National Institute on Aging.

Fortunately, depression can improve with treatment. That’s why it’s helpful to know the signs, causes, and treatment options that might work for you. Understanding those things can start to help you feel like yourself again.

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What are symptoms of depression in older adults?

Senior citizens often have different symptoms of depression than younger people, according to the National Institute on Aging. For many, sadness is not the main one, and you may not even feel that way. That can make it hard to recognize that you have depression.

These are the symptoms you may be experiencing:

• Lack of interest in activities you once enjoyed
• Don’t want to talk about your feelings
• Feelings of hopelessness, guilt, worthlessness, or helplessness
• Irritability, annoyance, or being quick to anger
• Restlessness or having trouble sitting still
• Decreased energy, fatigue, and daytime sleepiness
• Difficulty concentrating or making decisions
• A shift in sleep schedule, such as waking up too early or oversleeping
• Eating more or less than usual, often with unplanned weight gain or loss
• Thoughts of death or suicide, with possible suicide attempts
• Physical symptoms like aches and pains, gastrointestinal upset, low back pain, headaches, and joint pain
• Low libido

Depression can affect people in different ways. You may have only one symptom from this list, or you could have others that aren’t listed here.

If you’re feeling any of these symptoms, pay attention to how long that has been happening. If it lasts for more than two weeks, the National Institute on Aging suggests you speak with your doctor.

Recommended reading: 3 Physical Signs of Depression You Might Not Know

What are potential causes of depression as you age?

People of all ages have depression, and many life events can be triggers for this disorder. But older adults experience different situations than younger people. The events below might lead to feelings of depression.

Retirement. Just because you’ve saved and planned for decades doesn’t mean the transition will be easy. A 2020 Healthcare study found that it’s common to feel unsettled, anxious, uncertain, and even depressed as a result of retirement. This is especially true if retirement is due to illness, disability, or unexpected layoffs.

Cardiovascular disease or event. According to the National Institutes of Health, at least a quarter of heart patients have depression. And those who have depression are at higher risk of developing heart disease. The risk goes both ways.

Chronic pain, such as osteoarthritis. There is a strong link between depression and chronic pain, especially in older adults. A 2017 Clinical Interventions study noted that 13% of older people have both conditions at the same time. This is partly because inflammation that causes pain can also affect brain function. Plus, limited mobility can lead to feelings of isolation.

Grief and loss. Losing a loved one can happen at any age, but older people may be overwhelmed by multiple types of loss. These can all add up to a more complicated grief process, which raises the risk for depression:

• Deaths of friends and family
• Having medical issues that result in disability
• Transitioning out of the workforce
• Moving to a new home, or into an assisted living facility

Previous history of depression. You may have struggled with the condition when you were younger and received treatment. Or maybe those emotions faded with time. If you’ve experienced depressioh before, you’re at higher risk of having it again as an older adult.

Genetics. People with a family history of depression may be more likely to have it too, so it’s helpful to know how prevalent depression is with your relatives.

Sleep problems. There’s a strong connection between depression and sleep issues like insomnia, sleep apnea, and sleep disruption. There’s also a good chance you’ve experienced sleep issues as you age. The National Institutes of Health notes that insomnia is common in older adults, due to factors like medication side effects, chronic pain, and restless legs syndrome.

Medication side effects. If your depression symptoms come on suddenly after starting a new medication, your medicine may be impacting your mood. Some prescriptions linked with depression that are prescribed to older adults include:

• anticonvulsants
• seizure medications
• beta-blockers
• calcium-channel blockers
• opioids
• statins
• shingles medication like Zovirax

There are several medications within these categories. So just because one type of statin is causing an issue, it doesn’t mean they all will. Often, a different drug may lessen or eliminate depression symptoms.

Recommended reading: 5 Surprising Causes of Depression as You Get Older

How is depression diagnosed?

It starts by seeing a doctor. There are some medical conditions that mimic the symptoms of depression, including thyroid issues and vitamin deficiencies. Because of this, your doctor should ask for your health history, review all your symptoms, and do a physical examination.

Your doctor may also do a blood test to rule out other health problems and also a depression screening exam that is geared toward older adults.

Recommended FREE SilverSneakers On-Demand Class: Exercises for Seniors to Relieve Anxiety

What are common treatments for depression in older adults?

Depression is one of the most treatable mental health disorders. Between 80% and 90% of people with depression eventually respond well to treatment. Almost all patients experience some relief from symptoms, according to the American Psychological Association (APA). Below are some of the more common treatments for depression:

Medication. Since brain chemistry may contribute to depression, antidepressants can be helpful for altering how the brain works. The APA notes that antidepressants may produce some improvement within the first week or two of use, but full benefits may take two to three months. If you don’t feel any better after several weeks, talk to your doctor about changing the dose of the medication, adding another antidepressant, or switching drugs.

If you’re prescribed an antidepressant, be sure to talk with your doctor or pharmacist and go over your list of current medications and supplements to make sure they work well with your new prescription. As you get older, your body may react differently to medications than when you were younger, and your risk of negative drug interactions is higher as you age.

Psychotherapy. Sometimes called talk therapy or cognitive behavioral therapy, this type of treatment is often used along with antidepressant medications. Psychotherapy involves identifying possible sources of depression and creating a care plan to change thoughts and behaviors in a more positive direction. The APA suggests that in many cases, significant improvement can be made in 10 to 15 sessions.

Electroconvulsive therapy. This type of treatment is usually reserved for people with severe, major depression that is resistant to other treatments. It involves brief, electrical stimulation to the brain while the patient is under anesthesia. A 2016 Current Psychiatry Reports study about this therapy in older adults concluded that it tends to be highly effective and safe.

Repetitive transcranial magnetic stimulation. This is a treatment that uses magnets to activate certain areas of the brain. It does not require anesthesia and can help reduce the side effects of depression, such as fatigue.

Are there lifestyle habits that can help reduce depression symptoms?

The same strategies that improve overall health can also be good for your brain:

• Being physically active, since exercise can have a major effect on emotional health
• Eating a nutritious, balanced diet
• Sleeping seven to nine hours every night
• Maintaining social connections with friends and family
• Participating in activities you enjoy

These habits can help with physical and mental health, but they’re not considered a substitute for treatment if you have depression. For comprehensive treatment, it’s important to see your healthcare provider.

Recommended reading: What Exercise Can and Can’t Do for Depression and Anxiety

When should I talk to my doctor?

Make an appointment with your doctor as soon as you notice that your emotional state is affecting your quality of life. Answering these two questions (known as the Whooley questions) honestly can help you decide if a call to a health care professional would help you:

1. During the past month, have you often been bothered by feeling down, depressed, or hopeless?
2. During the past month, have you often been bothered by little interest or pleasure in doing things?

Yes answers to either question doesn’t necessarily mean you have depression, but it’s a sign that you might be at risk. Talking to your doctor is the first step. If depression is left untreated, it can impact your sleep, appetite, self-esteem, and quality of life. Depression may also lead to physical problems, such as fatigue, chronic pain, and higher risk of heart disease.

Taking charge of your emotional health by asking for help is an essential step toward treating and managing depression and starting to feel more like yourself.

Press play to learn more about the importance of your emotional well-being and how to recognize the signs of depression:

See Our Sources:
General info/signs/treatment: National Institute on Aging
Retirement: Healthcare
Cardiovascular health and depression: National Institutes of Health
Depression and chronic pain: Clinical Interventions in Aging
Sleep disruption: National Institute on Aging
Physical symptoms: The Primary Care Companion
Treatments: American Psychiatric Association
Electroconvulsive therapy: Current Psychiatry Reports
Whooley questions: Whooley questions for depression screening

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