Depression in Older Adults and the Elderly: Recognize the Signs and Find Treatment that. Page 1 of 6
Depression in Older Adults and the ElderlyRecognize the Signs and Find Treatment that Works
IN THIS ARTICLE:
problems—can lead todepression. Depressionprevents you fromenjoying life like you used
to. But its effects go far beyond mood. It also impacts yourenergy, sleep, appetite, and physical health. However, depressionis not an inevitable part of aging, and there are many steps youcan take to overcome the symptoms, no matter the challengesyou face.
Depression: a problem for many older adults and the elderlyHave you lost interest in the activities you used to enjoy? Do you struggle with feelings ofhelplessness and hopelessness? Are you finding it harder and harder to get through the day? If so,you’re not alone.
Depression is a common problem in older adults. The symptoms of depression affect every aspect ofyour life, including your energy, appetite, sleep, and interest in work, hobbies, and relationships.
Unfortunately, all too many depressed seniors fail to recognize the symptoms of depression, or don’t
take the steps to get the help they need. There are many reasons depression in older adults and the
You may assume you have good reason to be down or that depression is just part of aging.
You may be isolated—which in itself can lead to depression—with few around to notice your
You may not realize that your physical complaints are signs of depression.
You may be reluctant to talk about your feelings or ask for help.
Feeling good as you age
Depression isn’t a sign of weakness or a character flaw. It can happen to anyone, at any age, nomatter your background or your previous accomplishments in life. Similarly, physical illness, loss,and the challenges of aging don’t have to keep you down. Whether you’re 18 or 80, you don’t haveto live with depression. Senior depression can be treated, and with the right support, treatment, andself-help strategies you can feel better and live a happy and vibrant life.
Causes of depression in older adults and the elderlyAs you grow older, you face significant life changes that can put you at risk for depression. Causesand risk factors that contribute to depression in older adults and the elderly include:
– Illness and disability; chronic or severe pain; cognitive decline; damage
to body image due to surgery or disease.
Loneliness and isolation
– Living alone; a dwindling social circle due to deaths or
relocation; decreased mobility due to illness or loss of driving privileges.
Reduced sense of purpose
– Feelings of purposelessness or loss of identity due to
retirement or physical limitations on activities.
– Fear of death or dying; anxiety over financial problems or health issues.
– The death of friends, family members, and pets; the loss of a
Bereavement, loss, and depression in the elderlyAs you age, you experience many losses. Loss is painful—whether it’s a loss of independence,
Depression in Older Adults and the Elderly: Recognize the Signs and Find Treatment that. Page 2 of 6
mobility, health, your long-time career, or someone you love. Grieving over these losses is normaland healthy, even if the feelings of sadness last for a long time. Losing all hope and joy, however, isnot
Is it grief or depression?
Distinguishing between grief and clinical depression isn’t always easy, since they share manysymptoms. However, there are ways to tell the difference. Remember, grief is a roller coaster. Itinvolves a wide variety of emotions and a mix of good and bad days. Even when you’re in the middleof the grieving process, you will have moments of pleasure or happiness. With depression, on theother hand, the feelings of emptiness and despair are constant.
While there’s no set timetable for grieving, if it doesn’t let up over time or extinguishes all signs ofjoy—laughing at a good joke, brightening in response to a hug, appreciating a beautiful sunset—itmay be depression.
Other symptoms that suggest depression, not just grief:
Intense, pervasive sense of guilt.
Thoughts of suicide or a preoccupation
Inability to function at work, home, and/or
Seeing or hearing things that aren’t there.
Depression and illness in older adults and the elderlyDepression in older adults and the elderly is often linked to physical illness, which can increase therisk for depression. Chronic pain and physical disability can understandably get you down. Symptomsof depression can also occur as part of medical problems such as dementia or as a side effect ofprescription drugs.
Medical conditions can cause depression in the elderly
It’s important to be aware that medical problems can cause depression in older adults and theelderly, either directly or as a psychological reaction to the illness. Any chronic medical condition,particularly if it is painful, disabling, or life-threatening, can lead to depression or make depression
Prescription medications and depression in the elderly
Symptoms of depression are a side effect of many commonly prescribed drugs. You’re particularly atrisk if you’re taking multiple medications. While the mood-related side effects of prescriptionmedication can affect anyone, older adults are more sensitive because, as we age, our bodiesbecome less efficient at metabolizing and processing drugs.
Medications that can cause or worsen depression include:
Blood pressure medication (clonidine)
Ulcer medication (e.g. Zantac, Tagamet)
Beta-blockers (e.g. Lopressor, Inderal)
Steroids (e.g. cortisone and prednisone)
High-cholesterol drugs (e.g. Lipitor, Mevacor,
If you feel depressed after starting a new medication, talk to your doctor. You may be able to loweryour dose or switch to another medication that doesn’t impact your mood.
Alcohol and depression in the elderly
It can be tempting to use alcohol to deal with physical and emotional pain as you get older. It mayhelp you take your mind off an illness or make you feel less lonely. Or maybe you drink at night tohelp you get to sleep.
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While alcohol may make you feel better in the short term, it can cause problems over time. Alcoholmakes symptoms of depression, irritability, and anxiety worse and impairs your brain function.
Alcohol also interacts in negative ways with numerous medications, including antidepressants. Andwhile drinking may help you nod off, it can impair the quality of your sleep.
Signs and symptoms of depression in the elderlyRecognizing depression in the elderly starts with knowing the signs and symptoms. Depression redflags include:
Sleep disturbances (difficulty falling asleep
or staying asleep, oversleeping, or daytime
Abandoning or losing interest in hobbies
Loss of self-worth (worries about being a
Social withdrawal and isolation (reluctance
to be with friends, engage in activities, orleave home)
Increased use of alcohol or other drugs
Fixation on death; suicidal thoughts or
Depression in the elderly without sadness
While depression and sadness might seem to go hand and hand, many depressed seniors claim notto feel sad
at all. They may complain, instead, of low motivation, a lack of energy, or physicalproblems. In fact, physical complaints, such as arthritis pain or worsening headaches, are often thepredominant symptom of depression in the elderly.
Depression clues in older adults
Older adults who deny feeling sad or depressed may still have major depression. Here are theclues to look for:
Unexplained or aggravated aches and pains
Feelings of hopelessness or helplessness
Loss of interest in socializing and hobbies
Neglecting personal care (skipping meals,
forgetting meds, neglecting personal hygiene)
Dementia vs. depression in the elderlyNever assume that a loss of mental sharpness is just a normal sign of old age. It could be a sign ofeither depression or dementia, both of which are common in older adults and the elderly.
Since depression and dementia share many similar symptoms, including memory problems, sluggishspeech and movements, and low motivation, it can be difficult to tell the two apart. There are,however, some differences that can help you distinguish between the two.
Is it Depression or Dementia?
Symptoms of Depression
Symptoms of Dementia
Knows the correct time, date, and where he
Confused and disoriented; becomes lost in
Writing, speaking, and motor skills are impaired
Doesn’t notice memory problems or seem tocare
Whether cognitive decline is caused by dementia or depression, it’s important to see a doctor rightaway. If it’s depression, memory, concentration, and energy will bounce back with treatment.
Treatment for dementia will also improve you or your loved one’s quality of life. And in some types ofdementia, symptoms can be reversed, halted, or slowed.
Depression self-help for older adults and the elderlyIt’s a myth to think that after a certain age
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you can’t learn new skills, try new activities,
or make fresh lifestyle changes. The truth isthat the human brain never stops changing,
so older adults are just as capable as younger
people of learning new things and adapting to
control—even if your depression is severe and
physically and socially active, and feeling
connected to your community and loved ones.
If you’re depressed, you may not want to do anything or see anybody. But isolation and inactivityonly make depression worse. The more active you are—physically, mentally, and socially—the betteryou’ll feel.
. Physical activity has powerful mood-boosting effects. In fact, research suggests it
may be just as effective as antidepressants in relieving depression. The best part is that thebenefits come without side effects. You don’t have to hit the gym to reap the rewards. Lookfor small ways you can add more movement to your day: park farther from the store, takethe stairs, do light housework, or enjoy a short walk. Even if you’re ill, frail, or disabled, thereare many safe exercises you can do to build your strength and boost your mood—even from achair or wheelchair.
Connect with others
. Getting the support you need plays a big role in lifting the fog of
depression and keeping it away. On your own, it can be difficult to maintain perspective andsustain the effort required to beat depression. You may not feel like reaching out, but makean effort to connect to others and limit the time you’re alone. If you can’t get out to socialize,invite loved ones to visit you, or keep in touch over the phone or email.
Bring your life into balance
. If you’re feeling overwhelmed by stress and the pressures of
daily life, it may be time to learn new emotional management and emotional intelligenceskills. Watch the short video clip and consider following Helpguide’s free Bring Your Life IntoBalance toolkit.
Other self-help tips to combat and prevent depression in the elderly
Get enough sleep.
When you don't get
Learn to manage your emotions
enough sleep, your depression symptomscan be worse. Aim for somewhere
between 7 to 9 hours of sleep each night.
Maintain a healthy diet
. Avoid eating
too much sugar and junk food. Choosehealthy foods that provide nourishment and energy, and take a daily multivitamin.
Participate in activities you enjoy
. Pursue whatever hobbies or pastimes bring or used to
Volunteer your time
. Helping others is one of the best ways to feel better about yourself
Take care of a pet
. A pet can keep you company, and walking a dog, for example, can be
good exercise for you and a great way to meet people.
Learn a new skill
. Pick something that you’ve always wanted to learn, or that sparks your
Create opportunities to laugh
. Laughter provides a mood boost, so swap humorous stories
and jokes with your loved ones, watch a comedy, or read a funny book.
Depression treatment options for older adults and the elderlyDepression treatment is just as effective for elderly adults as it is for younger people.
However, since depression in older adults and the elderly is often the result of a difficult life situationor challenge, any treatment plan should address that issue. If loneliness is at the root of yourdepression, for example, medication alone is not going to cure the problem.
Also, any medical issues complicating the depression must be also be addressed.
Antidepressant treatment for older adults and the elderly
Older adults are more sensitive to drug side effects and vulnerable to interactions with othermedicines they’re taking.
Recent studies have also found that SSRIs such as Prozac can cause rapid bone loss and a higherrisk for fractures and falls. Because of these safety concerns, elderly adults on antidepressants
Depression in Older Adults and the Elderly: Recognize the Signs and Find Treatment that. Page 5 of 6
In many cases, therapy and/or healthy lifestyle changes, such as exercise, can be as effective asantidepressants in relieving depression, but without the dangerous side effects.
Alternative medicine for depression in older adults and the elderly
Herbal remedies and natural supplements can also be effective in treating depression, and in mostcases, are much safer for older adults than antidepressants. However, some herbal supplements maycause interactions with certain medications or occasionally carry side effects, so always check withyour doctor before taking them.
Omega-3 fatty acids
may boost the effectiveness of antidepressants or work as a
standalone treatment for depression.
St. John’s wort
can help with mild or moderate symptoms of depression but should not be
can help relieve symptoms of depression when combined with other treatments.
may be used in place of antideppresants to help regulate mood, but in rare cases can
Counseling and therapy for older adults and the elderly
Therapy works well on depression because it addresses the underlying causes of the depression,rather than just the symptoms.
includes religious and peer counseling. It can ease loneliness and
the hopelessness of depression, and help you find new meaning and purpose.
helps you work through stressful life changes, heal from losses, and process difficult
emotions. It can also help you change negative thinking patterns and develop better copingskills.
for depression, illness, or bereavement connect you with others who are
going through the same challenges. They are a safe place to share experiences, advice, andencouragement.
Helping a depressed seniorThe very nature of depression interferes with a person's ability to seek help, draining energy andself-esteem. For depressed seniors, raised in a time when mental illness was highly stigmatized andmisunderstood, it can be even more difficult—especially if they don’t believe depression is a realillness, are too proud or ashamed to ask for assistance, or fear becoming a burden to their families.
If an elderly person you care about is depressed, you can make a difference by offering emotionalsupport. Listen to your loved one with patience and compassion. Don’t criticize feelings expressed,but point out realities and offer hope. You can also help by seeing that your friend or family membergets an accurate diagnosis and appropriate treatment. Help your loved one find a good doctor,accompany him or her to appointments, and offer moral support.
Other tips for helping a depressed elderly friend or relative:
Invite your loved one out.
Depression is less likely when people’s bodies and minds remain
active. Suggest activities to do together that your loved one used to enjoy: walks, an artclass, a trip to the museum or the movies—anything that provides mental or physicalstimulation.
Schedule regular social activities.
Group outings, visits from friends and family members,
or trips to the local senior or community center can help combat isolation and loneliness.
gently insistent if your plans are refused: depressed people often feel better when they’re
Plan and prepare healthy meals.
A poor diet can make depression worse, so make sure
your loved one is eating right, with plenty of fruit, vegetables, whole grains, and some proteinat every meal.
Encourage the person to follow through with treatment
. Depression usually recurs
when treatment is stopped too soon, so help your loved one keep up with his or hertreatment plan. If it isn’t helping, look into other medications and therapies.
Make sure all medications are taken as instructed.
Remind the person to obey doctor's
orders about the use of alcohol while on medication. Help them remember when to take theirdose.
Watch for suicide warning signs.
Seek immediate professional help if you suspect that
your loved one is thinking about suicide.
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Dealing with Depression
– You can’t beat depression with sheer willpower,
but you can make a huge dent with simple lifestyle changes and other coping
tips.Helping a Depressed Person
– Learn how to avoid becoming depressed
yourself while caring for a loved one who is depressed
– Learn about the many effective ways of dealing
with depression including therapy, medication, and lifestyle changes.
– What you need to know about
antidepressants, including their benefits and risks, so you can make an
informed decision about what’s right for you.
– It may seem like things will never get better, but don't lose
hope. Suicide is not your only option–help is available.
– You can save a life. Suicide prevention starts with
recognizing the warning signs and taking them seriously.
Many people suffering from depression need to find ways to better
manage stress and balance their emotions. Building emotional skills
can give you the ability to cope and bounce back from adversity,
trauma, and loss. Helpguide’s free Bring Your Life Into
toolkit can teach you how to confidently deal with life’s
problems and make you more resilient to setbacks.
Authors: Melinda Smith, M.A., Lawrence Robinson, and Jeanne Segal, Ph.D.
Last updated: November 2012.
Helpguide.org. All rights reserved. This reprint is for information only and
NOT a substitute for professional diagnosis and treatment. Helpguide.org is
an ad-free non-profit resource for supporting better mental health and
lifestyle choices for adults and children.
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