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

Published: May 18, 2022 Updated: June 23, 2022
Published: 05/18/2022 Updated: 06/23/2022
Headshot of Alicea Ardito, MSW, LCSW
Written by:

Alicea Ardito

MSW, LCSW
Headshot of Lynn Byars, MD, MPH, FACP
Reviewed by:

Lynn Byars

MD, MPH, FACP
  • What Is Geriatric Depression?Definition
  • Why Does Depression in Seniors Often Go Undiagnosed?Undiagnosed
  • Signs & Symptoms of Depression in Older AdultsSigns & Symptoms
  • Is It Grief or Depression?Grief
  • Dementia vs. DepressionDementia
  • What Are the Risk Factors for Geriatric Depression?Risk Factors
  • Self-help for Elderly DepressionSelf-Help
  • Treatment of Depression in Older AdultsTreatment
  • What Are the Consequences of Untreated Depression in Older Adults?Consequences
  • How to Help an Older Adult With DepressionHow to Help
  • Additional ResourcesResources
Headshot of Alicea Ardito, MSW, LCSW
Written by:

Alicea Ardito

MSW, LCSW
Headshot of Lynn Byars, MD, MPH, FACP
Reviewed by:

Lynn Byars

MD, MPH, FACP

Depression in older adults is common, but should not be considered a normal part of aging. Seniors with depression often feel sad or lose interest in things that they would typically enjoy. Other symptoms may include physical pain, fatigue, memory issues, and refusal of care. Ways to start feeling better include counseling, medication or a combination of the two.

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 some of the signs and symptoms of depression, it may be helpful to talk to a therapist.

Dealing with depression can be difficult, but you don’t have to do it alone. BetterHelp has over 20,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $60 per week. Complete a brief questionnaire and get matched with the right therapist for you.

Choosing Therapy partners with leading mental health companies and is compensated for referrals by BetterHelp

Visit BetterHelp

What Is Geriatric Depression?

Geriatric depression is a type of depression impacting adults aged 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 that can be impacted by depression in specific ways. Life changes such as death of a spouse, retirement, and personal medical issues can all 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 which occur, or psychosocial factors, such as maintaining social relationships, 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, such as cancer or heart disease. 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 or misdiagnosed. Depression in older adults may not present in the same way that it does in younger adults. When people think of depression, they think of feeling sad. Sometimes, in older adults, there are other symptoms that occur, such as 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 are a normal part of aging, but they are not.

Signs & Symptoms of Depression in Older Adults

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

Depression in older adults is common and there are several signs and symptoms which 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
  • Preoccupation with somatic symptoms
  • 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 is also aging, so we lose partners, siblings, and friends along the way. Depression and grief 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, over time it can develop into complex 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 two 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 geratirc depression, including issues like:

  • 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

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

  • Alzheimer’s Disease
  • Parkinson’s Disease
  • Dementia
  • Cardiac disease or Stroke
  • Cancer
  • Lupus
  • Multiple Sclerosis
  • Thyroid dysfunction
  • Diabetes
  • Vitamin B12 deficiency
  • Complicated grief or bereavement

Geriatric Depression as a Side Effect of Medication

There are side effects to medications which can lead to symptoms that mimic depression. Older adults are more prone to certain side effects as older bodies are not able to metabolize medications the same way. 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

If you’re struggling with depression as an older adult, these four tips can help:

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

It may take time for medication, talk therapy, and lifestyle changes to begin to work and for you to feel better. Improvement in your mood may be gradual. Keep your expectations realistic and acknowledge that it may take some time to feel better.

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, depression 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.

Psychotherapy for depression, also called talk therapy or counseling, is an effective treatment option. There are many evidence-based approaches that can be used, including Cognitive Behavioral Therapy (CBT), 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?

There can be serious consequences for 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 is also possible that the person does not recognize they are depressed. There may be fear of judgment or stigma associated with having a mental health issue and 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 reach out and get help if you think that you or your loved one may be depressed:

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 Are Feeling

It can be incredibly helpful to know that you have someone who will listen to you about how you are feeling. 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 may be a great option if you are not sure about counseling or have difficulty leaving your home.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for referrals by the companies mentioned below.

BetterHelp Online Therapy – BetterHelp has over 20,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $60 per week. Complete a brief questionnaire and get matched with the right therapist for you. Get Started

Talkspace Online Therapy – Online therapy is convenient with Talkspace. Get therapy for as little as $69 per week, or potentially much less if you have insurance from Cigna, Optum, or UHR. Try Talkspace

Choosing Therapy’s Directory – Find an experienced therapist who is committed to your wellbeing. You can search for a therapist by specialty, availability, insurance, and affordability. Therapist profiles and introductory videos provide insight into the therapist’s personality so you find the right fit. Find a therapist today.

Online Psychiatry & Medication – Answer a few questions and Talkspace will match you with an online prescriber and get schedule a video psychiatry session. Your online psychiatry prescriber will personalize your treatment, which may include psychiatric medication and follow-ups. Get started for $249 or see if your insurance is one of many Talkspace accepts. Learn More

Mindfulness & Meditation App – Headspace is an easy way to incorporate mindfulness and meditation into your routine. See for yourself how a few minutes each day can impact your stress levels, mood, and sleep. A monthly subscription for Headspace is only $12.99 per month and comes with a 7-day free trial. Try Headspace

Choosing Therapy partners with leading mental health companies and is compensated for referrals by BetterHelp, Talkspace, and Headspace

For Further Reading

  • Mental Health America
  • National Alliance on Mental Health
  • MentalHealth.gov
13 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • National Institute of Mental Health. (2020, November 13). Major depression. Retrieved from https://www.nimh.nih.gov/health/statistics/major-depression.shtml

  • National Institute of Mental Health. (2020, November 16). Depression. Retrieved from https://www.nimh.nih.gov/health/topics/depression/index.shtml<

  • American Psychological Association. (2020, November 13). Aging and depression. Retrieved from https://www.apa.org/topics/aging-depression

  • Allan CE, Valkanova V, Ebmeier KP. Depression in older people is underdiagnosed. Practitioner. 2014 May;258(1771):19-22, 2-3. PMID: 25065018.

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.

  • Almeida OP. Prevention of depression in older age. Maturitas. 2014 Oct;79(2):136-41. doi: 10.1016/j.maturitas.2014.03.005. Epub 2014 Mar 22. PMID: 24713453.

  • Depression in Older Persons Fact Sheet. (October, 2009). National Alliance on Mental Health. Retrieved from https://d2mkcg26uvg1cz.cloudfront.net/wp-content/uploads/Depression_Older_Persons_FactSheet_2009.pdf

  • Conner, K. O., Copeland, V. C., Grote, N. K., Koeske, G., Rosen, D., Reynolds, C. F., 3rd, & Brown, C. (2010). Mental health treatment seeking among older adults with depression: the impact of stigma and race. The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry, 18(6), 531–543. https://doi.org/10.1097/JGP.0b013e3181cc0366

  • Centers for Disease Control and Prevention. (2020, November 16). Depression is not a normal part of growing older. Retrieved from https://www.cdc.gov/aging/depression/

  • American Psychological Association. (2020, November 15). Geriatric depression scale (GDS). Retrieved from https://www.apa.org/pi/about/publications/caregivers/practice-settings/assessment/tools/geriatric-depression

  • Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of general internal medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x

  • Wang YP, Gorenstein C. Psychometric properties of the Beck Depression Inventory-II: a comprehensive review. Braz J Psychiatry. 2013 Oct-Dec;35(4):416-31. doi: 10.1590/1516-4446-2012-1048. Epub 2013 Dec 23. PMID: 24402217.

  • Patel, Dhaval et al. “Insomnia in the Elderly: A Review.” Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine vol. 14,6 1017-1024. 15 Jun. 2018, doi:10.5664/jcsm.7172

update history

We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.

  • Originally Published: December 21, 2020
    Original Author: Alicea Ardito, MSW, LCSW
    Original Reviewer: Lynn Byars, MD

  • Updated: May 18, 2022
    Author: No Change
    Reviewer: No Change
    Primary Changes: Updated for readability and clarity. Reviewed and added relevant resources. Added “What Is Geriatric Depression?”, “Depressed Older Adults Might Not Feel ‘Sad'”, “How Is Insomnia Related to Depression in Older Adults?”, “Is It Grief or Depression?”, “Dementia vs. Depression”, and “What Are the Risk Factors for Geriatric Depression?”. New material written by Silvi Saxena, MBA, MSW, LSW, CCTP, OSW-C and reviewed by Dena Westphalen, PharmD.

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Headshot of Alicea Ardito, MSW, LCSW
Written by:

Alicea Ardito

MSW, LCSW
Headshot of Lynn Byars, MD, MPH, FACP
Reviewed by:

Lynn Byars

MD, MPH, FACP
  • What Is Geriatric Depression?Definition
  • Why Does Depression in Seniors Often Go Undiagnosed?Undiagnosed
  • Signs & Symptoms of Depression in Older AdultsSigns & Symptoms
  • Is It Grief or Depression?Grief
  • Dementia vs. DepressionDementia
  • What Are the Risk Factors for Geriatric Depression?Risk Factors
  • Self-help for Elderly DepressionSelf-Help
  • Treatment of Depression in Older AdultsTreatment
  • What Are the Consequences of Untreated Depression in Older Adults?Consequences
  • How to Help an Older Adult With DepressionHow to Help
  • Additional ResourcesResources
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