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Depression in Older Adults

Key information regaurding depression in seniors, including causes, symptoms, treatments, and more.

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Most people have days on occasion where you feel a little down or maybe even have the "blues." But clinical depression is more than that. Depression is a mood disorder that usually causes persistent feelings of sadness, hopelessness, and a loss of interest in activities. Symptoms may be severe enough to affect how a person thinks, feels, and handles everyday activities.

As reported by the National Council on Aging, up to 5% of older adults living in the general community have major depression. That number is even higher for adults who are hospitalized. About 11.5% of older adults who are hospitalized have depression. Adults who require home health also have an increased risk of depression. About 13.5% of older adults receiving home health care have depression.

It is vital to identify and treat senior depression. Untreated depression in older adults can lead to isolation and cognitive decline and may even increase the risk of dying. The article below provides a comprehensive guide to depression in older adults, including signs and symptoms, treatments, and prevention.

Signs and Symptoms of Depression in Older Adults

Depression in older adults may cause a variety of physical, emotional, and cognitive symptoms. According to the National Institute of Mental Health, symptoms must be present for two weeks for a diagnosis of clinical depression.

When someone thinks about depression in the elderly, they may not realize that in addition to emotional symptoms, it may also cause physical symptoms. Physical symptoms of depression in older adults may include:

  • Fatigue
  • Sleep problems
  • Chronic pain
  • Headaches
  • Changes in appetite, either eating less or more
  • Slower speech or movement
  • Digestive issues without a known cause

Emotional symptoms are often associated with depression and may include the following:

  • Sadness
  • Feelings of hopelessness
  • Isolation
  • Loss of interest in activities
  • Irritability
  • Feelings of guilt or worthlessness
  • Frustration

Cognitive symptoms may also develop, especially in older adults with depression. Cognitive symptoms may include:

  • Problems with memory
  • Difficulty concentrating
  • Trouble making decisions
  • Difficulty following directions

Older adults with depression may have specific behavioral symptoms, such as the following:

  • Increased substance abuse
  • Social isolation
  • Thoughts of suicide

Depression may be harder to identify in older adults since it may show up differently than when compared to younger people. For instance, older adults with depression may have cognitive changes more frequently than younger adults. Some of these symptoms, such as fatigue and memory problems, may be attributed to aging or dementia instead of depression in older adults.

Causes of Depression in Older Adults

The causes of depression in older adults may be varied and complex. Several things may play a role in the development of depression, including:

Biological factors

Biological factors may include hormonal imbalances, changes in brain chemistry, and health conditions. According to the World Health Organization, depression is closely linked to a person's physical health. Risk factors for depression include diabetes, cancer, and cardiovascular disease.

Psychological factors

Psychological factors that may affect an older adult and lead to depression can include stress, grief, and loneliness. It is not uncommon for older adults to lose family members such as a spouse or friend. In addition, their children may move away, which increases feelings of loneliness. Some people may also feel sad about getting older, which can contribute to depression.

Social factors

Senior depression can also be caused by certain social factors. For instance, an older adult no longer working may have financial difficulties or become isolated. A lack of social support and social connections may also increase the risk of depression.

Impact of Depression on Older Adults

If you have a loved one with depression, you may ask, can an elderly person die from depression? Depression can increase an older adult's risk of death for a variety of reasons. For instance, depression may lead to a suicide attempt.

Additionally, depression may harm an older adult's physical health. According to the National Institute of Mental Health, individuals who have depression are at an increased risk of developing certain diseases such as Alzheimer's disease, heart disease, and chronic pain.

Physical health may be impacted for several reasons. For example, someone who's depressed may not eat as well or exercise, which hurts their physical well-being. Additionally, their body may function differently due to depression, such as reduced blood circulation and abnormalities in stress hormones, which contribute to chronic diseases.

Depression may also have an impact on the cognitive function of an older adult. For instance, depression may cause a decline in memory or a decrease in problem-solving abilities.

An older adult's overall quality of life may also be negatively affected if they are suffering from depression. Depression can lead to social isolation, which makes the situation worse. It's common for someone with depression also to have decreased enjoyment of their life and reduced overall well-being.

Treatment for Depression in Older Adults

According to the American Psychiatric Association, there are different types of treatment available for depression and older adults that may be effective. Treatment may include the following:

An elderly woman sitting with a counselor

Psychotherapy

Psychotherapy is often an effective form of treatment for depression. It may take the form of cognitive behavior therapy (CBT), which focuses on the relationship between feelings, thoughts, and behaviors. The goal is to change the patterns that interfere with a person's ability to feel happiness or joy.

Interpersonal therapy involves improving relationships and circumstances that are causing problems and may be linked to the current depressive state.

Problem-solving therapy, which is a type of cognitive behavior therapy, may also be used. This type of psychotherapy focuses on helping a person cope with challenging circumstances and situations, which may help reduce the risk of depression.

An elderly man taking medication from a container

Medication

Medication can be an effective tool in treating depression in older adults. Different classifications of medications are available, including antidepressants and mood stabilizers.

Usually, second-generation antidepressants, including serotonin reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors, are recommended due to their reduced risk of side effects.

A group of seniors doing yoga in a park

Lifestyle interventions

Lifestyle interventions can also play a role in decreasing depressive mood in older adults. For instance, getting regular exercise has been shown to reduce symptoms of depression. A literature review published in the journal Medicine found that aerobic exercise can significantly improve depression in elderly patients.

Eating a healthy diet and finding healthy ways to manage stress, such as yoga, Tai chi, and meditation, are also helpful.

Staying involved in social activities is also vital for reducing symptoms of depression.

Preventing Depression in Older Adults

It's important to recognize there are ways to prevent depression in older adults. Steps to take include the following:

  • Maintaining social connections: Maintaining social connections is one of the most important ways to prevent depression. Encourage an older adult to spend time with family and friends and participate in activities in their community.
  • Engaging in hobbies and activities: Finding activities and hobbies a person enjoys is also an excellent way to prevent depression. It's helpful to have a purpose and do things you enjoy at any age and that includes seniors.
  • Managing stress and anxiety: Increased stress and anxiety can contribute to depression. Finding effective ways to manage stress and anxiety can help ward off depression. For instance, stress reduction techniques such as deep breathing and meditation are often effective relaxing methods.
  • Seeking help early: Seeking help early is critical in preventing depression from worsening. Treatment is available that can help reduce symptoms and help an individual develop symptom management skills.

Addressing Stigma and Misconceptions about Depression in Older Adults

To effectively deal with depression in older adults, it's vital to address the stigma and misconceptions associated with it. Because of the stigma that may still be related to mental health issues, some older adults may not seek help.

Understanding that mental health issues are not a character defect is vital. Becoming educated on mental health issues, such as depression in seniors, and educating others is also helpful in addressing misconceptions.

In addition to mental health issues, there are still misconceptions and stereotypes about aging that should also be addressed. Finding ways to help people understand that older adults are still competent is essential when changing misconceptions.

Encouraging older adults, caregivers, and mental health professionals to have open communication is also critical in providing the needed support to older adults with depression.

Conclusion

Depression in older adults may cause feelings of persistent sadness, hopelessness, and loss of interest in activities. Senior depression may hurt a person's cognitive ability, physical health, and overall quality of life.

Causes of depression in an older adult may be a combination of factors and can include biological factors, physical issues, and social factors. Identifying depression in older adults as early as possible is essential to get effective treatment and decrease the adverse effects it may have on a person's overall well-being. Treatment may include a combination of psychotherapy, medication, and lifestyle changes.

If you or a loved one are experiencing symptoms of depression, it is vital to seek help. Effective treatment is available to reduce symptoms and start you on the path to a more hopeful future. Talk to your physician or seek help from a local mental health agency. You can also contact The National Institute of Mental Health to find resources in your area.

About the Author

MaryAnn DePietro CRT

MaryAnn DePietro CRT is a licensed respiratory therapist with over 15 years of clinical experience in critical care, emergency medicine, and pulmonary rehabilitation. She is also an American Council on Exercise certified personal trainer and holds specialty certifications in orthopedics, senior fitness, and weight management. MaryAnn has a degree in Rehabilitation from Penn State University and a degree in respiratory therapy.

In addition to her clinical experience, she has written extensively about all things medical, as well as health, fitness, and aging for various websites, magazines, and newspapers.

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