Are Old People Depressed? Depression In Older Adults

Depression can be a serious mental health condition that often affects how you think, feel, and behave. It is also known as clinical depression or major depressive disorder. Many older people may experience depression, which can present differently than it does in younger people. Older adults living with depression may experience higher levels of anhedonia, cognitive changes, and sleeping pattern shifts than younger adults. Medical conditions may contribute to the development of depression in older adults more frequently than in younger adults as well. Therapy can be an effective treatment method for depression, no matter your age, and online therapy can provide a convenient alternative if in-person therapy isn’t available.

What is depression?

Depression is typically classified as a mood disorder, and it usually involves persistent feelings of sadness and an intense loss of interest or ability to take pleasure from the activities you used to enjoy, a symptom often called anhedonia. Depression can affect how you think, act, and feel, often leading to various physical, emotional, and mental complications if left untreated. 

Does depression occur more often in older adults?

As the CDC explains, “Depression is a true and treatable medical condition, not a normal part of aging. However, older adults are at an increased risk of experiencing depression. Depression is not just having ‘the blues’ or the emotions we feel when grieving the loss of a loved one. It is a true medical condition that is treatable, like diabetes or hypertension.” 

What does depression look like in older adults?

In general, the symptoms of depression in older adults, also called geriatric depression, tend to involve the same symptoms as those of other age groups. However, it can be essential to note that depression and other mental health symptoms can look different for everyone. 

Symptoms of geriatric depression may include the following:

• Feelings of sadness or worthlessness

• Irritability

• Persistent fatigue

• Apathy or inability to care about things

• Restlessness

• Difficulty concentrating or making decisions

• Social withdrawal and isolation

• Changes in eating habits

• Drastic shifts in sleeping patterns

• Physical aches and pains with no apparent cause, such as headaches, muscle tension, or stomachaches

• Crying spells

• Thoughts of suicide or suicidal actions

How does depression differ in older adults vs. younger adults?

The presentation, symptoms, and effects on mood and behavior caused by depression in older people can differ in various ways compared to younger people. 

Older adults tend to react to symptoms in different ways, and depression can also lead to or exacerbate other medical and mental health conditions. Depression is generally less prevalent among older adults, but it can severely affect mood, behavior, and cognitive ability. 

Onset and prognosis

More than half of depression diagnoses in older adults may result from an initial onset later in life. According to research published by Cambridge University, older adults with depression often have a poor long-term prognosis because the condition typically has a chronic course with higher relapse rates. 

Suicide rates

While recent figures show that suicide rates among older adults are generally declining, they are usually still higher than among younger adults and can be more closely related to depression symptoms. Researchers at the American Psychological Association report that older adults tend to have the highest suicide rates of any age group, especially among men.

Symptoms of depression in older adults

Depression in older adults is often linked to medical comorbidity, but that isn’t always the case. Many older adults experience difficulty falling or staying asleep, which can elevate other symptoms and contribute to physical, mental, and emotional impairment. 

Older adults with depressive disorders may be more likely to experience cognitive changes, sleep pattern shifts, and anhedonia (loss of interest) than younger adults.

Risk factors

While the risk factors for depression in older adults normally include the same ones younger people tend to face, some additional considerations may affect people in later life. 

Medical conditions often occur more frequently with age, and they can induce depression. In addition, genetics, stress levels, insomnia, social isolation, loneliness, lack of physical activity, functional limitations, and alcohol or substance use disorders can cause or worsen depression symptoms in older adults.  

Types of depression

There are several different types of depression that someone may experience, all of which apply to older adults. Examples include, but are not limited to, the following:

• Subsyndromal depression: This generally refers to depression symptoms that don’t meet the full criteria for major depression or another mood disorder. Subsyndromal depression can escalate to major depression if left untreated.  

• Persistent depressive disorder (Dysthymia): Dysthymia often consists of low-level depression symptoms that don’t interfere with your life as much as major depression. These symptoms generally must persist for at least two years. 

• Major depressive disorder: This can be a serious mood disorder involving persistent feelings of sadness or hopelessness and a loss of interest.

• Seasonal affective disorder (SAD): SAD typically involves depression symptoms tied to seasonal weather changes. SAD episodes often coincide with summer or winter and dissipate when the weather changes again.   

• Substance or medication-induced depressive disorder: Alcohol, substance use, and certain medications can induce depressive symptoms.  

• Depressive disorder related to a medical condition: Many medical conditions can cause depression symptoms, and the disorder can be a typical result of living with intense or chronic medical issues. 

Treating depression in older adults

Depression is a highly treatable mental health condition for most people. A comprehensive treatment plan generally involves talk therapy, medication, meaningful lifestyle changes, and an evolving set of coping skills that can adapt to your situation. 

Psychotherapy

Working with a licensed therapist can help you address your symptoms and the underlying causes with professional support and guidance. Many therapists use cognitive behavioral therapy (CBT) to help patients identify and reshape harmful or negative thought patterns and behaviors. You can also learn practical coping skills to manage your symptoms and stress, communication skills to explain your feelings and needs to people you're close to, and healthy emotional intelligence and awareness so you recognize and understand how you feel. 

Medication

Antidepressant medications may target depression symptoms by addressing the neurochemical imbalances often seen in patients. If you think medication could be an effective addition to your treatment plan, please talk to your doctor or healthcare provider to discuss whether it may be an option for you.

Electroconvulsive therapy (ECT)

This treatment is generally reserved for adults with severe depression who don’t find symptom relief or reduction with other treatment methods. Electroconvulsive therapy typically utilizes safe, mild electrical impulses to stimulate the brain. ECT is often highly effective at treating major depressive disorder symptoms. 

What can you do to avoid depression as you age?

While there may not be any conclusive methods to avoid developing depression as you age, you can take some preventative measures to reduce your risk. 

Maintain healthy sleep hygiene

Establishing and maintaining a healthy sleep schedule can be an excellent tool to benefit your self-care and overall health. 

Stay physically active

Physical activity can release beneficial brain chemicals that can counteract the effects of depression. Exercise can also be highly beneficial to your physical and mental health. 

Connect with your social network

Staying connected with friends and family can help you avoid social isolation and loneliness, both of which can contribute to whether someone develops depression. 

Eat a healthy, balanced diet

Eating a diet balanced with all the vitamins and nutrients your body needs to function properly can help you stay strong and healthy. 

When to reach out for help

If your depression symptoms cause you distress, interfere with your ability to function, or linger for more than two weeks, consider speaking to your doctor or a mental health professional about an assessment for depression or another mood disorder. If you’re an older adult dealing with symptoms of depression, it may be worthwhile to visit local primary care facilities. Physicians, therapists, and medical advisors at these healthcare centers can offer compassionate knowledge and support. Also, if you’re at risk of depression, appointments with a therapist may be worthwhile. They can help you to identify risk factors, while offering comprehensive depression treatment and support. Altogether, meeting with a therapist could improve your quality of life as you age. 

One convenient way to attend therapy may be online, through a virtual therapy platform like BetterHelp. With flexible appointment formats through phone, video call, or online chat, the support and guidance of a professional can be just a click away. Fitting therapy into your busy schedule can be simple, as there are often session times available outside of typical office hours. 

Effectiveness of online therapy for mental health treatment

A 2019 study by the National Institute of Mental Health evaluated the effectiveness of online therapy for treating depression and found that “depression symptom severity was significantly reduced after the use of the multimodal digital psychotherapy intervention.” Online therapy can be a valid option for the treatment of depression in older adults.