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Posted: November 16th, 2022

Depression and Older Adults

Depression and Older Adults
Feeling down every now and then is natural, but if these feelings last for several weeks or months, you may be suffering from depression. Read on to learn about common signs and symptoms of depression, treatment options, and whether you or a loved one is at risk for depression.

On this page, you’ll find:

What exactly is depression?
What are the depression risk factors?
What are the symptoms of depression?
Depression support for friends and family
Suicide discussion with friends and family
How does depression get treated?
Depression in dementia patients
Can depression be avoided?
What exactly is depression?
Depression is a serious mental illness. It can have an impact on how you feel, act, and think. Although depression is a common problem among older adults, clinical depression is not a normal part of the aging process. Despite having more illnesses or physical problems than younger people, studies show that most older adults are satisfied with their lives. However, if you have had depression as a child, you are more likely to have depression as an adult.

Infographic: Four Things You Should Know About Depression and Older Adults Click here for the pdf and transcript.
Read and share this infographic to help raise awareness about depression in older adults.
Depression is a serious condition, but there are treatments available to help. Most people’s depression improves with treatment. Counseling, medication, or other forms of treatment may be beneficial. You do not have to suffer; help and treatment are available. If you suspect you have depression, consult your doctor.

Older adults may suffer from one of several types of depression:

Major Depressive Disorder – characterized by symptoms that last at least two weeks and impair a person’s ability to perform daily tasks.
Persistent Depressive Disorder (Dysthymia) – a depressed mood that lasts for more than two years, but the person may still be able to perform daily tasks, unlike someone with Major Depressive Disorder. Major Depressive Syndrome
Substance/Medication-Induced Depressive Disorder – depression caused by the use of substances such as alcohol or pain relievers.
Depressive Illness Depression as a result of a medical condition, such as heart disease or multiple sclerosis.
Psychotic depression, postmenopausal depression, and seasonal affective disorder are examples of other types of depression. The National Institute of Mental Health provides detailed descriptions of various types of depression.

If you require assistance, please contact someone.
If you are considering self-harm, notify someone who can assist you right away.

Avoid isolating yourself.
Contact a close family member or friend.
To get immediate assistance, dial 988 or go to a hospital emergency room.
Schedule a visit with your doctor.
Call the 988 Suicide & Crisis Lifeline at any time: 988 or 800-273-TALK (800-273-8255) or 800-799-4TTY (800-799-4889).

What are the depression risk factors?
There are numerous factors that may be risk factors for depression. Changes in the brain can affect mood and lead to depression in some people. Others may experience depression following a major life event, such as a medical diagnosis or the death of a loved one. Those who are under a lot of stress, especially those who care for loved ones with serious illnesses or disabilities, can become depressed at times. Others may experience depression for no apparent reason.

According to research, these factors are associated with the risk of depression but do not necessarily cause it:

Medical conditions like stroke and cancer
People with a family history of depression may be at a higher risk.
Stress, which includes caregiver stress
Sleep issues
Loneliness and social isolation
Lack of physical activity or exercise
Functional limitations that make participating in daily activities difficult
Substance-Induced Psychosis includes addiction and/or alcoholism. Depressive Illness
Social isolation and depression in the elderly
To survive and thrive, everyone requires social connections. However, as people get older, they tend to spend more time alone. Loneliness and social isolation have been linked to higher rates of depression in studies.

If you’re feeling socially isolated or lonely and can’t see your friends or family in person for whatever reason, try calling them or joining a virtual club. Discover ways to stay more connected.

What are the symptoms of depression?
An elderly woman suffering from depression peers out a window.
How do you know if you or a loved one is depressed? Is depression different as you get older? Depression in older adults can be difficult to identify because symptoms differ from those in younger people. Sadness is not the primary symptom of depression in some older adults. They may instead be experiencing numbness or a lack of interest in activities. They might be hesitant to express their emotions.

A list of common symptoms is provided below. However, because everyone experiences depression differently, there may be symptoms not listed here.

A persistently depressed, anxious, or “empty” mood
Hopelessness, guilt, worthlessness, or powerlessness
Irritability, restlessness, or difficulty sitting still
Loss of interest in previously pleasurable activities, such as sex
Reduced energy or fatigue
Slower movement or speech
Difficulties concentrating, recalling information, or making decisions
Sleeping difficulties, waking up too early in the morning, or oversleeping
Eating more or less than usual, resulting in unanticipated weight gain or loss
Suicide attempts or thoughts of death or suicide
If you experience several of these signs and symptoms for more than two weeks, consult your doctor. These could be symptoms of depression or another health problem. Don’t disregard the warning signs. Serious depression, if left untreated, can lead to suicide.

Ask an older person’s health care provider how they are feeling during their visits. According to research, intervening during primary care visits is extremely effective in reducing suicide later in life. Keep an eye out for clues if you are a family member or friend. If someone of any age says they have been feeling depressed, sad, or empty for an extended period of time, pay close attention. That person could be genuinely seeking assistance. Knowing the warning signs for suicide and how to get help. It can help save lives.

Depression can look different depending on a person’s cultural background
Signs and symptoms of depression can look different depending on the person and their cultural background. People from different cultures may express emotions, moods, and mood disorders — including depression — in different ways. In some cultures, depression may be displayed as physical symptoms, such as aches or pains, headaches, cramps, or digestive problems.

Depression support for friends and family
Depression is a medical condition that requires treatment from a doctor. While family and friends can help by offering support in finding treatment, they cannot treat a person’s depression.

As a friend or family member of a person with depression, here are a few things you can do:

Encourage the person to seek medical treatment and stick with the treatment plan the doctor prescribes.
Help set up medical appointments or accompany the person to the doctor’s office or a support group.
Participate in activities the person likes to do.
Ask if the person wants to go for a walk or a bike ride. Physical activity can be great for boosting mood.
Suicide discussion with friends and family
It’s important to watch for signs and symptoms of depression or suicide. Don’t shy away from asking if a family member or friend is feeling depressed or suicidal. It may be an uncomfortable conversation, but it is important. Asking if someone is having thoughts of suicide will not make them more likely to act on those thoughts. Your questions may help the person open up about how they’ve been feeling and encourage them to seek treatment.

How does depression get treated?
Depression, even severe depression, can be treated. It’s important to seek treatment as soon as you begin noticing signs. If you think you may have depression, start by making an appointment to see your doctor or health care provider. Older man talking to a therapist.

Certain medications or medical conditions can sometimes cause the same symptoms as depression. A doctor can rule out these possibilities through a physical exam, learning about your health and personal history, and lab tests. If a doctor finds there is no medical condition that is causing the depression, he or she may suggest a psychological evaluation and refer you to a mental health professional such as a psychologist to perform this test. This evaluation will help determine a diagnosis and a treatment plan.

Common forms of treatment for depression include:

Psychotherapy, counseling, or “talk therapy” that can help a person identify and change troubling emotions, thoughts, and behavior. It may be done with a psychologist, licensed clinical social worker (LCSW), psychiatrist, or other licensed mental health care professional. Examples of approaches specific to the treatment of depression include cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT) (IPT).
Medications for depression that may balance hormones that affect mood, such as serotonin. There are many different types of commonly used antidepressant medications. Selective serotonin reuptake inhibitors (SSRIs) are antidepressants commonly prescribed to older adults. A psychiatrist, mental health nurse practitioner, or primary care physician can prescribe and help monitor medications and potential side effects.
Electroconvulsive Therapy (ECT), during which electrodes are placed on a person’s head to enable a safe, mild electric current to pass through the brain. This type of therapy is usually considered only if a person’s illness has not improved with other treatments.
Repetitive transcranial magnetic stimulation (rTMS), which uses magnets to activate the brain. rTMS does not require anesthesia and targets only specific regions of the brain to help reduce side effects such as fatigue, nausea, or memory loss that could happen with ECT.
Medication and older adults
As you get older, body changes can affect the way medicines are absorbed and used. Because of these changes, there can be a larger risk of drug interactions among older adults. Share information about all medications and supplements you’re taking with your doctor or pharmacist.

Use this worksheet to help track your medications.

Treatment, particularly a combination of psychotherapy and medications, has been shown to be effective for older adults. However, not all medications or therapies will be right for everyone. Treatment choices differ for each person, and sometimes multiple treatments must be tried in order to find one that works. It is important to tell your doctor if your current treatment plan isn’t working and to keep trying to find something that does.

Some people may try complementary health approaches, like yoga, to improve well-being and cope with stress. However, there is little evidence to suggest that these approaches, on their own, can successfully treat depression. While they can be used in combination with other treatments prescribed by a person’s doctor, they should not replace medical treatment. Talk with your doctor about what treatment(s) might be good to try.

Don’t avoid getting help because you don’t know how much treatment will cost. Treatment for depression is usually covered by private insurance and Medicare. Also, some community mental health centers may offer treatment based on a person’s ability to pay.

Depression in dementia patients
Depression is common in people with Alzheimer’s and related dementias. Dementia can cause some of the same symptoms as depression, and depression can be an early warning sign of possible dementia. Suicide attempts may also increase in people recently diagnosed with dementia. It is important to have support systems in place to help cope with a dementia diagnosis and possible depression symptoms that follow. More research is needed to determine effective depression treatment options for people with dementia.

Can depression be avoided?
Many people wonder if depression can be prevented and how they may be able to lower their risk of depression. Although most cases of depression cannot be prevented, healthy lifestyle changes can have long-term benefits to your mental health.

Here are a few steps you can take:

Be physically active and eat a healthy, balanced diet. This may help avoid illnesses that can bring on disability or depression. Some diets — including the low-sodium DASH diet — have been shown to reduce risk of depression.
Get 7-9 hours of sleep each night.
Stay in touch with friends and family.
Participate in activities you enjoy.
Let friends, family, and your physician know when you’re experiencing symptoms of depression.

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