Depression In Older Adults: Signs, Treatments, & Ways to Cope

What Is Depression?

Depression is one of the most common mental health disorders in the United States. An estimated 17.3 million adults in the United States had at least one major depressive episode—that is 7.1% of all adults in the United States.¹ If you or a loved one is exhibiting depression symptoms and signs, it may be helpful to talk to a therapist.

What Is Geriatric Depression?

Geriatric depression is a type of depression impacting adults 65 and older. Due to their older age and likely lower quality of life due to illness, familial deaths, or decreased ability to function independently, older adults are a unique population. Life changes such as death of a spouse, retirement, and personal medical issues can contribute to an older adult experiencing depression.

How Many Older Adults Are Depressed?

Depression is not a normal part of the aging process, and the good news is that the majority of older adults are not depressed. Estimates of the prevalence of depression in the older adult population range from 1%-5% overall, but are higher in homebound older adults (13.5%) and in hospitalized older adults (11.5%).⁹

Older adult women are at higher risk for depression, and this may be due to biological factors, such as hormonal changes or psychosocial factors, such as maintaining social relationships and caregiving. Widowed and unmarried older adults are also at a higher risk for depression.⁷

Older adults are at increased risk for depression because depression is more common in people who have other illnesses (e.g., cancer & depression). Chronic illness & mental health are also connected. Approximately 80% of older adults have at least one chronic health condition, and it is estimated that 50% are affected by two or more.⁹

Why Does Depression In Seniors Often Go Undiagnosed?

Depression in older adults is often undiagnosed/misdiagnosed. Depression in older adults may not present the same as in younger adults. When people think of depression, they think of feeling sad, although there’s a difference between depression and sadness.

Sometimes, in older adults, other symptoms occur, like refusing care, pain, or weight loss, that suggest depression but may be thought to be a result of other ailments or life events.⁴ Many people, even physicians, can mistake symptoms of depression for symptoms of other illnesses.

Another reason depression often goes undiagnosed in older adults is because there is the false belief that the symptoms of depression are a normal part of the aging process. For example, a depressed older adult may feel aches and pains and have difficulty remembering things. These symptoms may seem like they’re a normal part of aging, but they are not.

Signs & Symptoms of Depression In Older Adults

Depression is a mood disorder that affects how you feel, think, and behave. Signs of depression include hopelessness, irritability, and losing interest in previously-enjoyable activities. Depression symptoms are serious and can be debilitating. It can occur once or multiple times, and it can be chronic and persistent.

There are depression signs and symptoms that are more prevalent in older adults:^{3, 4}

• Weight loss/geriatric anorexia
• Memory impairment
• Insomnia
• Slowed reaction times/psychomotor retardation
• Difficulty paying attention and focusing
• Somatic symptom disorder
• Change in functioning
• Refusal of care

Depressed Older Adults Might Not Feel “Sad”

It’s common for those with depression to experience bouts of sadness as part of their symptoms; however, that is not necessarily true for the elderly. Their symptoms may be related to physical symptoms such as aches, pains, and low energy.

How Is Insomnia Related to Depression In Older Adults?

Those struggling with insomnia are more likely to struggle with depression, and this is very true in the elderly population. In one study, nearly half of the elderly participants with insomnia continued to have depression for 6 months compared to less than a quarter of elderly participants without insomnia. Depression and insomnia have a cyclical relationship and insomnia is also linked to higher suicidal ideation.¹³

Is it Grief or Depression?

The prevalence of loss as we age increases as our peer group also ages, so we lose partners, siblings, and friends along the way. Grief & depression can sometimes be intertwined. However, given the prevalence of depression, it’s important to consider how they differ: Those in grief are still able to recall and enjoy activities; however, if grief symptoms continue, it can develop into complicated grief or depression.

Dementia Vs. Depression

There can be similarities between dementia and depression for the elderly population; however, it’s important to consider that depression and dementia are distinct conditions. Dementia leaves individuals with short-term memory issues. For those with depression, memory issues are typically more related to concentration and recalling a memory. Dementia develops over time, while depression can be a more sudden noticeable difference.

What Are the Risk Factors For Geriatric Depression?

There are a number of risk factors that can lead to geriatric depression, including issues like isolation, low quality of life, and lack of purpose.

Here are geriatric depression risk factors:

• Social isolation
• Death of loved ones
• Health issues
• Low quality of life
• Lack of purpose
• Fear about mortality
• Complicated grief

Medical Conditions That Can Cause Elderly Depression

Medical conditions can also cause elderly depression, including cancer, heart disease, diabetes, and more.

Examples of medical conditions that can lead to elderly depression include:

• Alzheimer’s and depression
• Parkinson’s & depression
• Dementia
• Cardiac disease or stroke
• Cancer
• Lupus
• Multiple sclerosis & mental health
• Thyroid dysfunction
• Diabetes
• Vitamin B12 deficiency
• Complicated grief or bereavement

Geriatric Depression as a Side Effect of Medication

Medication side effects can lead to symptoms that mimic depression. Older adults are more prone to certain side effects because older bodies are not able to metabolize medications the same way as younger bodies. If you started a new medication or are on a variety of medications and experiencing depression symptoms, consider discussing this with your physician.

Self-help For Elderly Depression: 4 Tips

If you’re an older adult with depression, it can help to stay connected, exercise, eat well, be patient, and never give up.

Here are four tips for dealing with elderly depression:

1. Stay Connected

Continue to engage socially with friends, family, or others in the community. Maintaining social ties, even when you’re feeling sad, can be helpful to elevate mood.

2. Exercise & Eat Well

Physical activity and eating nourishing foods can help with mild and moderate depression.

3. Give it Time

If you’re wondering how long it takes for antidepressants to work, just know it may take some time. Truthfully, medication, talk therapy, and lifestyle changes all may take a moment to begin making you feel better. Improvement in your mood may be gradual. Keep your expectations realistic and acknowledge that it may take time.

4. Don’t Give Up

There is no one-size-fits-all treatment for depression. It could take time to find the right medication, or figure out the best approach in psychotherapy. It may take a few tries to find a good connection with a mental health provider. Stay focused on small, achievable goals and don’t give up hope.

Treatment of Depression In Older Adults

Even in severe cases of depression, it can be highly treatable. There is no one-size-fits-all method of treatment for depression because people are affected by depression differently. Medication, talk therapy, or a combination of the two are the most common treatments for depression.

Depression therapy, also called talk therapy or counseling, is an effective treatment option. There are many evidence-based approaches that can be used, including CBT for depression, solution-focused treatment, and acceptance and commitment therapy (ACT).

It is important to seek professional assistance if you or your loved one are experiencing some of the signs and symptoms of depression and functioning is impaired. A professional, such as a primary care physician or mental health provider can help by assessing, providing formal diagnosis, and providing recommendations for treatment.

What Are the Consequences of Untreated Depression In Older Adults?

Does depression go away on its own? There can be serious consequences of untreated depression in older adults. Untreated depression may lead to cognitive decline and physical illness.⁷ Depressed older adults may have changes in eating habits, overeating or not eating enough, which can lead to other health issues, and they may experience higher rates of insomnia and memory impairment.³

Untreated depression can affect behavior and may put an older adult at a greater risk of self-neglect. Depression in seniors is common, and it is associated with negative health outcomes, disability, and costs.⁶ It may complicate or exacerbate existing mental or physical health problems, or create new issues.³

The Stigma of Depression Among Seniors

Older adults are more likely to seek help for other medical issues than they are for depression.⁷ This may be due to a perceived stigma associated with mental health issues. Older generations may still perpetuate incorrect stereotypes and discriminate against people with mental health issues.

They may believe people with mental health issues are “crazy,” “dangerous,” or “insane,” and older people with mental health issues as “incompetent” or “weak.”

The stigma associated with mental health continues to negatively influence older adults’ willingness to seek treatment. Some research indicates this is the number one reason why older adults do not seek help for mental health issues, including depression.⁸

How to Help an Older Adult With Depression

Getting help for depression is often difficult because a person who is depressed may lack the energy or motivation to be able to seek support. It’s also possible that the person doesn’t recognize they are depressed. They may fear judgment or stigma associated with having a mental health issue. It may be perceived as a sign of weakness. There might be worry about being a burden on loved ones.

Here are four ways to help an older adult with depression:

1. Consult a Trusted Physician

A medical professional can assess symptoms and provide recommendations for treatment. You may also receive information about possible medications that can help and/or a referral to a mental health professional.

2. Talk to Someone Who Is Supportive About How You Feel

It can be incredibly helpful to know that you have someone who will listen to you about how you feel. This person may also be able to help you in other ways, for example, they could make calls on your behalf to schedule an appointment, or accompany you to an appointment.

3. Learn More About Depression

Understanding the causes, symptoms, and treatment of depression can help to eliminate any stigma and misunderstanding, which are common barriers to receiving treatment.

4. Talk to a Mental Health Professional

Psychologists, psychiatrists, licensed professional counselors, and licensed clinical social workers are all trained to assess and treat depression. Typically, therapy has been done in an office setting.

However, there is now the option to meet virtually, and online therapy for depression may be a great option if you are not sure about counseling or have difficulty leaving your home.

How to Find a Therapist

If you’re ready to find a therapist for online or in-person sessions, start your search in a free online therapist directory. This will allow you to narrow your search based on key details such as cost, location, and expertise.

Final Thoughts On Depression In Older Adults

Depression is difficult to deal with at any age, but if you or a loved one are dealing with depression there is hope. Contact your doctor to start talking about what treatments might be a good fit for you.