Depression In Older Adults: What You Need To Know

Depression, or major depressive disorder, is categorized as a mood disorder often marked by feelings of sadness, anxiety, and loss of interest in usual activities. While it’s not uncommon for people of any age to experience these feelings, it’s often linked to a more serious medical condition when they last for a few weeks or even months. Depression often affects a person’s daily life—how they feel, act, think, and process the world around them. In some cases, it can affect their ability to perform tasks or live an everyday existence.

There are symptoms that are commonly associated with depression, including:

• Feelings of sadness, hopelessness, or despair

• Loss of interest in hobbies or connecting with others

• Loss of motivation or feelings of low/​no energy

• Feelings of low self-worth/self-esteem

• Difficulty sleeping/​sleep disturbances/​oversleeping

• Difficulty with memory

• Neglecting personal care/​hygiene

• Loss of appetite/​distinctive weight loss

• Unexplainable body aches and pains/​soreness

• Increase in using drugs/​alcohol

• Suicidal ideation/​thoughts of suicide/​heavy fixation on death

Depression in older adults, also referred to as ​“geriatric depression”, is certainly something to be aware of. However, while the risk is slightly higher, there are ways to help manage geriatric depression if it surfaces.

Given that older adults have an increased chance of major depression, it’s important to be aware of some of the potential causes and risk factors of geriatric depression.

Low Levels of Neurotransmitters

Chemicals in the brain, such as serotonin and norepinephrine, tend to have a significant effect on mood and mental health. If a person experiences low levels of these chemicals, it can potentially cause feelings of depression in older adults.

Life Changes

As adults age, plenty of life changes gradually take place. While some changes can be exciting, they can also contribute to feelings of depression, sadness, and hopelessness. Some examples of life changes include:

• Moving out of a home into a retirement facility
• Children or grandchildren moving far away
• Inability to care for themselves, leading to feelings of loss of autonomy
• Spouse or close friends/​relatives passing away

Chronic Pain/​Illness

In some cases, chronic medical conditions can contribute to depression due to a lack of mobility, constant physical pain, or other mental health side effects. Some examples of medical illnesses include:

• Stroke
• Cancer
• Heart disease
• Alzheimer’s disease
• Parkinson’s disease

Chronic conditions that affect the mind and cause a cognitive decline is also a cause or risk factor for depression in old age. Diseases such as dementia and Alzheimer’s can lead to someone feeling confused, distant, and disoriented constantly thus bringing them into a depressed mood. If someone is experiencing any sort of chronic condition, it’s important to talk with your doctor about how you’re feeling mentally and reach out for help if or when it is needed.

Substance Abuse

Substance abuse, such as alcohol or drugs, can contribute to depression. Some medications can also potentially have side effects that can worsen depression symptoms. It’s important to speak to a doctor or healthcare professional before taking any medications or if experiencing worsening symptoms of depression.

If you or a loved one is struggling with substance abuse, you can call the Substance Abuse and Mental Health Services Administration’s National Health Hotline at 1800–662-HELP (available 24/7, 365 days a year).

Financial Stress

Finances can also potentially contribute to depression in older adults. Certain circumstances can trigger feelings that are overwhelming, stressful, and hopeless. Some examples may include:

• Overwhelming debt due to healthcare costs
• Loss of income due to a spouse passing or an inability to work
• Lack of retirement savings

Lack of Social Community

As adults age, keeping a social circle can become difficult, and for some, nonexistent. Older adults can inadvertently end up in social isolation due to a lack of connection with family members, no close friends, or becoming widowed/​living alone. As a result, depressive symptoms can become more prevalent t in an adult without any type of community interaction.

Family History of Depression

Older adults whose family members have a history of depression may also be at risk of experiencing depressive symptoms themselves. It’s important to know your family medical history and discuss any past medical or mental health problems with a primary care physician so they can practice preventive care awareness.

Lack of Purpose

Some older adults may feel that they lack a sense of purpose, which can bring on feelings of apathy, hopelessness, and sadness. If a person has little to no social interaction, is unable to do daily tasks due to health issues, and doesn’t have hobbies or interests they engage in, a person can feel as though they have no actual purpose in the world.

For many, diagnosing geriatric depression can be difficult. Older adults may experience misdiagnosis due to a variety of factors, such as assumptions that the depressive symptoms are merely a side effect of a disease or medication. Additionally, the stigma for many that exists around mental illness can lead to a person refusing to get diagnosed. However, if symptoms appear, contacting a primary care provider can be a significant step in pinpointing geriatric depression. If a person lives in a retirement or assisted living facility, workers may also be able to help connect an older adult with the appropriate person to help if symptoms occur.

A mental health professional will need to assess the person with depression to determine symptoms, family history, recent life changes, and other factors associated with mental illness. Most commonly, a diagnosis is made based on the Diagnostic and Statistical Manuel of Mental Disorders (also referred to as the DSM‑5). A person must display symptoms for at least two weeks before they can be labeled depressed.

While difficult to diagnose, there are treatment options for clinical depression that can help alleviate or lessen the severity of symptoms. The American Psychiatric Association has a list of guidelines that can help with determining treatment options, which may be used by a mental healthcare professional. Some common treatment options for depressed older adults include:

• Psychotherapy: also referred to as ​“Cognitive Behavioral Therapy (CBT)” or ​“talk therapy,” involves a variety of treatments that can help a person become aware of and change troubling emotions, behaviors, or feelings. A mental health professional, such as a psychologist, psychiatrist, or social work counselor will take the lead with this treatment and it’s commonly known to treat depression effectively.
• Medications: medications, such as selective serotonin reuptake inhibitors, may be prescribed to alter hormones, which can help create balance and lessen depressive symptoms.
• Electroconvulsive Therapy (ECT): if other treatment options don’t improve the condition, ECT may be prescribed as an alternative. ECT involves placing electrodes on a person’s head and distributing a safe, mild electric current through the brain.

While there is no foolproof way to prevent depression from occurring, there are still a few things older adults can do to protect and improve their mental health. Some examples include:

• Staying active: it can be easy for older adults to avoid continuing to exercise or stay as active as they did when they were younger. However, older adults can still maintain a healthy lifestyle by engaging in exercise programs designed for older adults, taking walks, or doing light physical labor (such as basic yard work). Even those with physical illnesses and limitations can stay active. To learn more about exercising with limited mobility.
• Making healthy lifestyle changes: if a person is engaged in substance abuse, poor diet, or other self-sabotaging behaviors, making lifestyle changes can make a difference in their overall mental health.

Note: Oak Street Health partners with services such as Meals on Wheels that allow nutritious, healthy meals to be delivered at home for those with limited mobility or who are unable to care for themselves. To learn more about the Meals on Wheels program.

• Staying connected: finding a community to be part of and being social can significantly impact a person’s ability to protect their mental health. Joining a club, practicing hobbies, or making consistent plans to spend time with friends are all great ways to stay connected. Places such as community centers and senior centers can be great options for finding classes and communities to join. The U.S. Administration on Aging has this resource that helps older adults find senior centers and communities nearby.