Understanding Causes & Symptoms Of Depression In Older Adults

Medically reviewed by April Justice, LICSW

Updated October 9, 2024by BetterHelp Editorial Team

Getting older: It is a natural part of life, sometimes considered a reason to celebrate, enjoy one’s later years, and spend time with loved ones. However, aging may not always be easy, particularly for those who experience mental health challenges later in life.

Depression in the elderly is one of those potential challenges, with the Centers for Disease Control reporting that depression affects up to 5% of older adults.

But what are the causes of depression among older adults? What are the warning signs, and what management strategies are available to those who are affected? Let us explore the answers to these questions in more detail in this article.

What is depression?

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Before getting into the reasons depression might affect older adults, it may be worth reviewing what depression is and how it may manifest.

Depression is a mental illness that can affect a person’s mood, in addition to the ways they view and interact with the world. According to the World Health Organization, depression “is characterized by persistent sadness and a lack of interest or pleasure in previously rewarding or enjoyable activities.” Individuals experiencing depression may find themselves with low levels of energy or motivation to do the things they once enjoyed. They might also experience changes in their appetite, sleeping patterns, ways of working or interacting with others, and other aspects of their daily life and functioning.

Depression may present with a variety of mental and emotional symptoms, such as:

A persistent feeling of sadness or emptiness
A loss of interest in previously enjoyed activities
Trouble concentrating, making decisions, or remembering things
Feelings of hopelessness or worthlessness
Feelings of restlessness or anxiety
Trouble fulfilling daily responsibilities

Individuals with depression may also experience physical or behavioral symptoms, which can include:

Insomnia or oversleeping
Changes in appetite, such as over- or undereating
Weight fluctuations
Muscle aches or unexplained pains
An increased use of alcohol or drugs

Those with depression may not experience all the above symptoms. However, the symptoms of depression that are present might persist for an extended period of time. According to the National Institute of Mental Health, “symptoms associated with depression interfere with day-to-day functioning and cause significant distress for the person experiencing them.”

What are the different types of depression?

A range of different types of depression exists, and these can vary in terms of intensity and symptoms. Subcategories of depression may include, but are not limited to:

Major depressive disorder: Commonly associated with the more general term “depression,” major depressive disorder refers to depression that persists for an extended period of time (typically two or more weeks) and can affect day-to-day functioning.
Postpartum depression: Sometimes referred to as PPD, postpartum depression is a form of depression that may affect new parents.
Seasonal affective disorder: Seasonal affective disorder, also known as SAD, is a form of depression that can cause mood changes based on the seasons, with depressive symptoms often occurring in the fall and winter months.
Persistent depressive disorder: Also known as PDD or dysthymia, persistent depressive disorder is a form of mild to moderate depression that may last for a prolonged period of time (typically two or more years).

Regardless of the type, depression can have a range of impacts on one’s mental and physical health. Because depression can impact a person’s lifestyle — for instance, their eating, sleeping, or exercise habits — it may have the potential to lead to weight gain or inflammation. This, in turn, can raise the risk of conditions like diabetes and cardiovascular disease. A long-term study published in 2020 also found an association between depression and dementia, a category of diseases that tend to be more common among older adults.

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Depression in the elderly: Why do older adults get depressed?

With all this in mind, it may be natural to wonder why depression might affect older adults. It is worth remembering that no two individuals are exactly alike, and the factors contributing to depression in one person might not be the same as in another.

A range of factors can play a role in the development of depression, some of which may be more common among the elderly. These might include, but are not limited to:

The loss of loved ones
Reduced self-reliance and independence due to lower mobility, strength, or balance
A lack of exercise (physical activity has been associated with a reduced risk of developing depression)
Stress, whether due to family matters, financial challenges, or other factors
Chronic pain, which has been associated with an increased risk of developing depression, or other health conditions such as heart disease

Other factors that may contribute to depression among older adults include elder abuse — whether by caregivers, relatives, or others — and a lack of social interaction. According to the National Institute on Aging, “loneliness and social isolation are associated with higher rates of depression.” These factors, among others, may all contribute to the development of depression or other mental illnesses later in life.

If you or a loved one is experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7.

Managing symptoms: Strategies for older adults

Given the prevalence of depression among the elderly, in addition to its possible effects on health and well-being, it may be important for older adults and their loved ones to take action to manage depression and mitigate its effects.

For those whose loved ones are experiencing depression at an older age, the following steps may be helpful:

Staying socially connected, whether through phone calls, video calls, or in-person visits
Offering social and emotional support
Participating in enjoyable activities alongside loved ones who are elderly
Encouraging elderly loved ones to seek treatment for concerning symptoms
Providing support in following treatment plans

Additionally, for older adults who are experiencing depression, the following strategies may be helpful for managing symptoms and tending to overall wellness:

Getting physical exercise, whether through walking, swimming, attending aerobics classes, or participating in other activities
Eating a healthy diet
Getting enough sleep
Staying connected with loved ones, either in-person or remotely
Engaging in social activities, such as group classes, community events, or volunteer work
Seeking treatment from a medical provider or mental health professional
Seeking support from friends, loved ones, or other trusted sources

Therapy for depression

For those who need extra support when it comes to managing the effects of depression on themselves or their loved ones or the different stressors that can be part of aging, therapy can also be a useful resource. A licensed therapist may be able to provide a safe space for discussing emotions or to offer suggestions for tending to one’s mental health and overall well-being.

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That said, commuting to a counselor’s office for in-person therapy may not always be practical — for example, for older adults who might be experiencing reduced mobility. In these cases, online therapy through platforms like BetterHelp may be a helpful alternative as it offers the option to attend counseling from the comfort of home via voice call, video call, or in-app messaging.

Online therapy has been found to be an effective form of treatment for a variety of mental illnesses, including depression. For example, a 2017 study found that internet-based cognitive behavioral therapy was useful for treating and managing depression, anxiety, panic disorder, phobias, and more.

Takeaway

Depression is a mental illness that may lead to symptoms like a low mood, a lack of energy or motivation, or changes to eating or sleeping habits, among others. Rates of depression among older adults are estimated to reach 5%, potentially due to factors like a lack of social connection, low physical activity, grief, stress, and chronic pain.

Strategies for managing depression later in life may include eating a healthy diet, getting regular exercise, socializing with others, and seeking treatment from a health care provider such as your primary care provider or a therapist. Therapy, either in-person or through an online platform like BetterHelp, can also be a helpful resource for those in need of additional support.

Frequently asked questions

Read more below for answers to questions commonly asked about this topic.

What is the most common cause of depression in the elderly?

While there can be a variety of causes for depression in the elderly, one of the main sources may be a decline in physical health. As we age, humans may experience more frequent short-term or chronic medical conditions. This may reduce a person’s ability to enjoy their day-to-day life and could result in pain, loss of independence, financial hardship, or frequent thoughts of one's own mortality. These effects, combined with the stress that older individuals may experience, may increase the likelihood that a person will develop depression.

What are the 5 depression symptoms in older adults?

The symptoms of depression can often be similar for individuals of all ages. For example, five depression symptoms in older adults may include:

Loss of interest in previously enjoyable activities
Chronic fatigue
Sleep disturbances
Poor appetite or overeating
Mood swings

These symptoms may also be experienced by younger people, including middle-aged adults, young adults, adolescents, and children. However, the causes of depression in older adults may differ from other ages. For instance, elders are often isolated, which may increase the risk of developing depression.

What are coping skills for elderly people with depression?

Older individuals who experience depression can cope through several activities, including:

Exercise: Physical activity, specifically exercise, has been shown to be an effective treatment for major depression in adults. While exercise can pose a risk of physical injury to the elderly, there are numerous low-impact activities (like walking and swimming) that may be beneficial.
Socialization: Elderly individuals may be at a higher risk of isolation, which is one of several risk factors for severe depression. Joining support groups and socializing with others can help to create more positive thought patterns, establish a sense of self-worth, and establish a healthy social network and enhance the community’s overall public health.
Adult Education: Older individuals experiencing depression may benefit from adult education courses, as these can provide mental stimulation and a sense of purpose. In addition, adult education can help these individuals improve their memory and maintain a functional level of cognition.

What is MDD within older people called?

Depression in the elderly is commonly referred to as geriatric depression, a mood disorder that may affect as many as 7 million adults aged 65 years and older. A number of lifestyle changes and situations experienced by older individuals can contribute to geriatric depression, including more frequent health conditions, increasing levels of social isolation, the death of partners or loved ones, and an overall lack of stimulation. While a different term is used, the symptoms of geriatric depression are typically similar to those of depression in other age groups. These symptoms may include fatigue, sleep disturbances, feelings of worthlessness, a lack of interest in previously pleasurable activities, and mood swings.

Is depression a serious problem for older people?

While it is possible for older people to develop depression, research may indicate that individuals over the age of 65 may have some of the lowest prevalence rates of depression at 14.2%. However, this doesn’t mean that depression isn’t a common and serious condition that can pose a risk to the well-being of the elderly. If you or a loved one are experiencing depression, it's essential to reach out for support. This may involve contacting a mental health professional, talking to your primary care physician, or speaking with friends and family members about depression-related struggles.

How common is depression in elderly?

The rates of clinical depression in older adults can vary based on their living situation, experiences, other mental health conditions, and economic status. According to the Centers for Disease Control and Prevention, anywhere from 1% to 5% of older people may be experiencing major depression. However, that number climbs to 11.5% for older individuals who are hospitalized, and as high as 13.5% for those who require home healthcare. In addition, the elderly may also be subject to a comorbid condition that could worsen their depression symptoms, such as substance use disorder (sometimes incorrectly referred to as “substance abuse disorder.”)

What is the best antidepressant for seniors?

According to the British Columbia Medical Journal, several classes of antidepressants are safely used to treat depression in the elderly. These include bupropion, mirtazapine, venlafaxine, moclobemide, and selective serotonin reuptake inhibitors (SSRIs). Of the SSRIs, sertraline, citalopram, and escitalopram are considered to have the best safety profile. This is due to their low potential for drug interactions when compared to other SSRIs such as paroxetine, fluvoxamine, and fluoxetine. However, it's important to note that the best antidepressant will vary based on the opinions of one's doctors and personal experience. It's also essential to speak with a doctor before changing or beginning any medication.

What is the first line treatment for anxiety in the elderly?

In many cases, the first-line treatment for anxiety in the elderly is antidepressant medications. These medications often include selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs). Both have been shown to be effective and well-tolerated by older individuals. Other medications like buspirone can be effective for the elderly, but more research may be required before they are considered a first-line treatment. In addition, therapeutic approaches like cognitive behavioral therapy can be effective for individuals of all ages, including the elderly.

What is a good anxiety medication to take daily?

Only a medical care professional can recommend what anxiety medications are effective or appropriate to take. It's essential to inform your doctor if you are taking any medications, whether they be for anxiety or any other other condition. Common medications prescribed for anxiety may include selective norepinephrine reuptake inhibitors (SNRIs) like Cymbalta and Effexor, selective serotonin reuptake inhibitors (SSRIs) like Lexapro and Paxil, and benzodiazepines like Xanax, Valium, and Ativan. However, not all of these medications are recommended for daily use, nor are they effective for everyone.

How can I treat anxiety without medication?

While it's important to see a medical professional in order to treat anxiety, there are several non-pharmacological approaches and healthy lifestyle changes that may help a person cope with their symptoms, including:

Therapy: Talk therapy approaches like cognitive behavioral therapy (CBT) can be an effective way to treat anxiety. With the help of a therapist, individuals may be able to address anxiety-associated thought patterns and learn healthy coping mechanisms to improve their quality of life.
Exercise: Physical activity and exercise can help to distract someone from negative thoughts, reduce stress, and overall lower the impact that mental and physical symptoms may have. One of the reasons that exercise is beneficial is due to its ability to release endorphins, which can positively affect mood.
Meditation: Meditation and mindfulness may help to clear your mind and stop the negative thought patterns often associated with anxiety. Meditation can also be an effective stress reliever and help to foster a more positive sense of well-being.

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