Depression in Older Adults

May is mental health month, and the changes that often come in later life—retirement, the death of loved ones, increased isolation, medical problems—can lead to depression. Depression prevents you from enjoying life like you used to. But its effects go far beyond mood. It also impacts your energy, sleep, appetite, and physical health. However, depression is not an inevitable part of aging, and there are many steps you can take to overcome the symptoms, no matter the challenges you face.

Have you lost interest in the activities you used to enjoy? Do you struggle with feelings of helplessness and hopelessness? Are you finding it harder and harder to get through the day? If so, you’re not alone.

Depression is a common problem in older adults. The symptoms of depression affect every aspect of your life, including your energy, appetite, sleep, and interest in work, hobbies, and relationships.

Unfortunately, all too many depressed seniors fail to recognize the symptoms of depression, or don’t take the steps to get the help they need. There are many reasons depression in older adults and the elderly is so often overlooked:

  • You may assume you have good reason to be down or that depression is just part of aging.
  • You may be isolated—which in itself can lead to depression—with few around to notice your distress.
  • You may not realize that your physical complaints are signs of depression.
  • You may be reluctant to talk about your feelings or ask for help.

Recognizing depression in the elderly starts with knowing the signs and symptoms. Depression red flags include:

  • Sadness
  • Fatigue
  • Abandoning or losing interest in hobbies or other pleasurable pastimes
  • Social withdrawal and isolation (reluctance to be with friends, engage in activities, or leave home)
  • Weight loss or loss of appetite
  • Sleep disturbances (difficulty falling asleep or staying asleep, oversleeping, or daytime sleepiness)
  • Loss of self-worth (worries about being a burden, feelings of worthlessness, self-loathing)
  • Increased use of alcohol or other drugs
  • Fixation on death; suicidal thoughts or attempts

While depression and sadness might seem to go hand and hand, many depressed seniors claim not to feel sad at all. They may complain, instead, of low motivation, a lack of energy, or physical problems. In fact, physical complaints, such as arthritis pain or worsening headaches, are often the predominant symptom of depression in the elderly.

Older adults who deny feeling sad or depressed may still have major depression. Here are the clues to look for:

  • Unexplained or aggravated aches and pains
  • Feelings of hopelessness or helplessness
  • Anxiety and worries
  • Memory problems
  • Lack of motivation and energy
  • Slowed movement and speech
  • Irritability
  • Loss of interest in socializing and hobbies
  • Neglecting personal care (skipping meals, forgetting meds, neglecting personal hygiene)

Depression isn’t a sign of weakness or a character flaw. It can happen to anyone, at any age, no matter your background or your previous accomplishments in life. Similarly, physical illness, loss, and the challenges of aging don’t have to keep you down. Whether you’re 18 or 80, you don’t have to live with depression. Senior depression can be treated, and with the right support, treatment, and self-help strategies you can feel better and live a happy and vibrant life.

Causes of depression in older adults and the elderly

As you grow older, you face significant life changes that can put you at risk for depression. Causes and risk factors that contribute to depression in older adults and the elderly include:

  • Health problems – Illness and disability; chronic or severe pain; cognitive decline; damage to body image due to surgery or disease.
  • Loneliness and isolation – Living alone; a dwindling social circle due to deaths or relocation; decreased mobility due to illness or loss of driving privileges.
  • Reduced sense of purpose – Feelings of purposelessness or loss of identity due to retirement or physical limitations on activities.
  • Fears – Fear of death or dying; anxiety over financial problems or health issues.
  • Recent bereavements – The death of friends, family members, and pets; the loss of a spouse or partner.

Depression in older adults and the elderly is often linked to physical illness, which can increase the risk for depression. Chronic pain and physical disability can understandably get you down. Symptoms of depression can also occur as part of medical problems such as dementia or as a side effect of prescription drugs.

Medical conditions can cause depression in the elderly

It’s important to be aware that medical problems can cause depression in older adults and the elderly, either directly or as a psychological reaction to the illness. Any chronic medical condition, particularly if it is painful, disabling, or life-threatening, can lead to depression or make depression symptoms worse.
These include:

  • Parkinson’s disease
  • stroke
  • heart disease
  • cancer
  • diabetes
  • thyroid disorders
  • Vitamin B12 deficiency
  • dementia and Alzheimer’s disease
  • lupus
  • multiple sclerosis

It’s a myth to think that after a certain age you can’t learn new skills, try new activities, or make fresh lifestyle changes. The truth is that the human brain never stops changing, so older adults are just as capable as younger people of learning new things and adapting to new ideas. Overcoming depression often involves finding new things you enjoy, learning to adapt to change, staying physically and socially active, and feeling connected to your community and loved ones.

If you’re depressed, you may not want to do anything or see anybody. But isolation and inactivity only make depression worse. The more active you are—physically, mentally, and socially—the better you’ll feel.

  • Exercise. Physical activity has powerful mood-boosting effects. In fact, research suggests it may be just as effective as antidepressants in relieving depression. The best part is that the benefits come without side effects. You don’t have to hit the gym to reap the rewards. Look for small ways you can add more movement to your day: park farther from the store, take the stairs, do light housework, or enjoy a short walk. Even if you’re ill, frail, or disabled, there are many safe exercisesyou can do to build your strength and boost your mood—even from a chair or wheelchair.
  • Connect with others, face to face whenever possible. Getting the support you need plays a big role in lifting the fog of depression and keeping it away. On your own, it can be difficult to maintain perspective and sustain the effort required to beat depression. You may not feel like reaching out, but make an effort to connect to others and limit the time you’re alone. If you can’t get out to socialize, invite loved ones to visit you, or keep in touch over the phone or email. And remember, it’s never too late to build new friendships. Start by joining a support group for depression, a book club, or another group of people with similar interests.
  • Bring your life into balance. If you’re feeling overwhelmed by stress and the pressures of daily life, it may be time to learn new emotional management and emotional intelligence skills. Watch the short video clip and consider following Helpguide’s free Bring Your Life Into Balance toolkit.

Other self-help tips to combat and prevent depression in the elderly

  • Get enough sleep. When you don’t get enough sleep, your depression symptoms can be worse. Aim for somewhere between 7 to 9 hours of sleep each night.
  • Maintain a healthy diet. Avoid eating too much sugar and junk food. Choose healthy foods that provide nourishment and energy, and take a daily multivitamin.
  • Participate in activities you enjoy. Pursue whatever hobbies or pastimes bring or used to bring you joy.
  • Volunteer your time. Helping others is one of the best ways to feel better about yourself and expand your social network.
  • Take care of a pet. A pet can keep you company, and walking a dog, for example, can be good exercise for you and a great way to meet people.
  • Learn a new skill. Pick something that you’ve always wanted to learn, or that sparks your imagination and creativity.
  • Create opportunities to laugh. Laughter provides a mood boost, so swap humorous stories and jokes with your loved ones, watch a comedy, or read a funny book.

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