Depression in older adults is, unfortunately, more common than we realize. It is harder to diagnose as we age because the symptoms can be masked by or attributed to other illnesses, medication side effects, or simply signs of aging. Knowing what to look for and when to seek help for a loved one is the first step to helping them feel better.

Recognizing the Symptoms

Typical symptoms of depression include feeling sad and hopeless, a loss of interest in socializing and hobbies, and thoughts of death and suicide. Many of us have learned to spot these symptoms in ourselves and those around us. However, several symptoms specific to older adults make diagnosing depression much harder. People in this age group may not feel sad at all. Instead, they may report worsening headaches, arthritis pain, or low motivation. Other common signs include the following:

• Aggravated or unexplained aches and pains
• Feeling irritable or grumpy
• Weight loss, loss of appetite, and skipping meals
• Slow speech or movement
• Trouble focusing and memory problems
• Neglecting personal hygiene
• Forgetting to take medications
• Sleep disturbances

Identifying the Underlying Causes

The life changes and ailments commonly associated with aging play a unique role in the development and severity of depression in aging adults.

• Fears: Worrying over finances or health problems, fear of death, abuse, or neglect can trigger depression.
• Isolation and loneliness: Living alone, decreased mobility or losing one’s driver’s license, and losing friends due to relocation or death can contribute to depression.
• Lacking a sense of purpose: Retirement is a huge contributor to depression as individuals financial status, financial security, and identity change.
• Health problems: Any sickness or illness can bring on depression, but chronic conditions such as multiple sclerosis, diabetes, dementia, cancer, lupus, and heart or Parkinson’s disease can all worsen or trigger depressive symptoms.
• Medications: Our bodies become less efficient at processing medications as we get older. While depression may be a rare side effect for younger people, aging individuals may feel depressed after starting a new medication. A lower dose or a different drug may be a better choice. Talk to a doctor if you think medications may be contributing to depression.
• Loss of loved ones: Losing pets, friends, family, and especially losing partners or spouses are common causes of depression.

Is It Grief or Depression?

Older adults experience many losses: mobility, independence, careers, health, and loved ones. It is normal and healthy to grieve these losses. On the surface, depression and grief can look very similar, but there are a few ways to tell the difference.

1. Constant feelings of sadness, emptiness, or despair are good indicators of depression.
2. Those experiencing grief, however, will have good and bad days. Grieving individuals will still experience moments of happiness or pleasure while grieving.
3. If grief eliminates feelings of joy, it could turn into depression.

Could it be Dementia?

While doctors or loved ones may attribute memory problems to aging, they could be due to dementia or depression. These two conditions share similar symptoms such as decreased motivation, slower movements and speech, and memory issues.

If it is depression, the mental decline is more rapid, and language and motor skills may be slower but still intact. Older adults with depression may notice or worry about the memory problems, but they should be able to identify the correct time, date, and their location.

Mental decline is slower with dementia and less noticeable initially. Individuals may become lost in familiar locations and become disoriented and confused easily. Speaking or writing and motor skills will become impaired.

How to Prevent or Combat Depression

1. Find meaning or purpose by learning new skills, getting involved in your community, putting effort into how you look, traveling, and practicing art in whatever form you find enjoyable.
2. Get connected by volunteering, making social plans, joining a club or support group, or even taking care of your pet.
3. Practice self-care by eating healthy fats, complex carbs, and lean proteins every few hours to support your mood; move your body by walking, dancing, or formal exercise; foster healthy sleep habits with a set sleep-wake schedule; and spend at least 15 minutes per day in the sunshine.
4. Don’t be afraid to seek professional help. Support groups or supportive counseling and talk therapy have effectively treated depression in older adults. Doctors should prescribe antidepressants sparingly and closely monitor patients for side effects specific to older adults. Loved ones experiencing depression may also be eligible for transcranial magnetic stimulation with a Seattle area provider, a therapy for depression with little to no side effects.

The stigma of mental health issues and treatment is powerful among older adults. If you suspect your aging loved one may have depression, plan activities with them as often as you can or schedule social activities for them to get connected. Help them plan or prepare healthy meals. Encourage them to get help or treatment and watch for suicide warning signs. Depression is much harder to diagnose and more prevalent among older adults than many doctors realize. Knowing the risk factors and signs and symptoms goes a long way in caring for our loved ones.