Help for Seniors With Depression

Although depression is common in seniors, it's not a normal part of aging. Here are ways to understand and treat depression in older people.

By Wyatt Myers

Medically reviewed by Farrokh Sohrabi, MD

Although not an epidemic,depression strikes people in the U.S. at a substantial rate — more than 9 percent of Americans have some form of it, according to the Centers for Disease Control and Prevention. The National Alliance on Mental Illness estimates that depression affects 6 million people age 65 and older.

Causes of Depression in Seniors

Contrary to what some people may think, depression is not a normal part of getting older, says Forrest Hong, PhD, LCSW, a psychologist and social worker in Los Angeles who specializes in elder care. But there are many reasons why it happens. “Often a decline in health and medical conditions contribute to depressed feelings,” Dr. Hong says. These may include physical pain and discomfort, incontinence, constipation, and loss of sensation.

“A decrease in physical activity due to lack of energy and motivation, or physical limitations such as poor balance and arthritis, can also be an issue,” he says. “Dependency on medications, especially pain medications on a daily basis over a long period of time, can also contribute to depression.”

Unique Challenges for Seniors With Depression

Although depression is more common in seniors than in the population at large, older people often don’t get the treatment they need. Part of the problem may be that no one recognizes the symptoms. Because of this, Hong says, it’s very important to look carefully for symptoms of depression in an older loved one, such as:

• A decline in short-term memory
• Inability to focus or concentrate
• Change in appetite
• Interruptions in sleep or sleeping too much
• Loss of energy or motivation
• Decrease in social interaction
• General feelings of sadness, helplessness, or hopelessness

“Some research suggests that depression without feelings of sadness may be more common in older populations,” says Marsha Lucas, PhD, a psychologist in private practice in Washington, D.C. “This may sound strange because we usually think of sadness as a hallmark of depression, but that’s not always the case.” In seniors in particular, depression often shows itself as increased complaints of feeling unmotivated or too tired to do things, or about physical concerns like headaches or pain from arthritis.

Depression in Older People: Treatment and Tips

The good news about depression in seniors is that once it's correctly diagnosed, it can often be treated successfully. In fact, a regular mental health checkup might be advisable for seniors to determine whether they're experiencing temporary grief — such as from the loss of a loved one — or full-blown depression.

“Grief and depression affect the nervous system in different ways, so often the clues to telling the difference can be seen by looking at behavior,” Dr. Lucas says. “For example, in grief there are ups and downs in your mood, with good days and bad days — and even in the middle of it all, you can still have those moments of laughter at a joke or feeling better with a hug. With depression, the feelings of despair and emptiness seem pretty permanent.”

Treatment for depression in older people is usually not that different from treatment for depression in younger people. Lucas notes that there may be some concerns about using antidepressant medication in seniors, so depression treatment is likely to include a combination of medication, psychotherapy, and group therapy.

Simple, everyday actions can also help in coping with depression in older people. Good strategies include:

• Focus on relationships. Rather than isolating yourself, Lucas recommends planting some new relationships and cultivating the ones you already have. For some, volunteering helps: Lucas says that "it's been shown to have positive effects on mood for the volunteer as much as for the one receiving the help.”
• Don’t go it alone. It’s sometimes more difficult for older people to acknowledge a problem and seek professional help, but many times that's exactly what’s needed to overcome depression.
• Focus on a healthy lifestyle. Even as you grow older, Lucas says, exercises like tai chi or yoga, or simply spending more time walking out in nature, can help maintain a positive outlook.
• Get a pet. “Pets lower the levels of stress hormones in your body that can exacerbate depression,” Lucas says. Getting a dog or another pet that needs regular outdoor exercise offers even more benefits.
• Get enough sleep. “Our sleep needs change as we age,” Lucas says. Older people generally need less shut-eye at night, but having a regular sleep routine — keeping to regular bedtimes and wake-up times, as well as sleeping while it’s dark and staying awake when it’s light — helps keep your body’s endocrine and nervous systems well-tuned, helping to fight off depression.

Remember: Depression doesn’t have to be part of getting older. If you think you might have depression or suspect it in a loved one, don’t wait to get help. You can enjoy life to its fullest again.