New research shows that depression hits older adults more severely than other age groups, but because their symptoms are different, it can be hard to spot.
The word is out: Older adults get depression. Slowly, the world is recognizing that depression isn’t just a young-person problem. It's a mental health issue that can—and does—strike at any age.
Still, older adults with depression often go undiagnosed. Many don’t even realize they have depression, so they don’t know to ask for help. Others are too ashamed to admit they have a problem, and because many older adults don’t display classic depression symptoms, friends and family don’t catch on.
There’s a name for this phenomenon: Silent depression.
Unfortunately, staying silent doesn’t resolve depression. Depression—and all its unpleasant symptoms—typically sticks around until you take steps to get better. So, whether you’re puzzled by unexplained symptoms or hesitant to ask for help, chances are the status quo won’t change until you do.
The first step is to determine if you’re among those suffering from silent depression.
Depression Different For Older Adults
Depression in older adults is no laughing matter. According to research published in the prestigious journal The Lancet Psychiatry, not only do older adults experience depression more severely than younger adults, but their symptoms also last longer.2
Researchers followed over a thousand adults (of all ages) with depression for two years, discovering that people over the age of 70 were the worst off in every indicator, including:3
So, if depression hits older adults that hard, why can’t we tell? Even mental health experts don’t often recognize when an older adult is depressed, according to a recent research article in Frontiers in Psychiatry.4
A primary reason depression gets overlooked in seniors is… the symptoms look different from other age groups.5
Most of us picture depression as sadness or crying, but it’s a nuanced illness with a broader array of symptoms than we credit it with. Whereas younger adults display many of the emotions we tend to associate with depression (pessimism, sadness, irritability, and sleep and appetite changes), older adults with depression tend to exhibit a lack of emotions. Seniors with depression may also develop memory or thinking problems, have physical aches or pain, or avoid socializing.6
Depression can even look different depending on your cultural background. According to the National Institute on Aging, people from different cultures may express emotions and moods in different ways.7
Another reason seniors with depression often don’t get diagnosed is their healthcare provider mistakes their symptoms as just a natural reaction to illness or the life changes that occur as we age.8 So, they don’t see any reason to treat their depression—a belief many older adults may also share.9
For patients over 85, in particular, there tends to be a lot of stigma associated with depression. Often, patients have the sense that if they’re depressed, it means they don’t have the backbone that they used to have.
—— , co-chief of the Division of Geriatrics and Palliative Medicine at New York-Presbyterian/Weill Cornell Medical Center.10
Do I Have Silent Depression?
Recognizing depression in older adults can be tricky—even for the person who’s depressed. You may be wondering: how can I tell if I have depression? Start by reviewing the checklist below, comparing common symptoms in younger and older adults. See if any resonate.
Also, consider whether you have any depression risk factors. For example, the Centers for Disease Control and Prevention (CDC) notes that people with a chronic health condition like type 2 diabetes and heart disease face greater odds of developing depression.12
Other risk factors include undergoing a major life event, like a medical diagnosis or the death of a loved one. You can also get depressed if you’re lonely, or are the primary caregiver for someone with an illness or medical condition like dementia, cancer, or stroke.13 14 Some medications even list depression as a potential side effect, including medications for Parkinson’s disease, blood pressure medications, beta-blockers, calcium channel blockers and sleep aids.15
But you can also get depressed for no apparent reason, so don’t assume you’re in the clear if none of these risk factors apply to you.
It’s easy to think that depression results from life events, such as the loss of loved ones. But, even with loss and difficulties, life offers pleasure and happiness. Being ‘down in the dumps’ for a long time is not a part of normal aging. Older persons without depression are able to bounce back from hard times and find joy in life.
—— , professor of geriatric and palliative medicine at The University of Texas..16
The Consequences Of Missing Depression In Older Adults
Okay, you or someone you know is depressed—so what? No big deal, right?
Wrong.
It can be tempting to brush depression aside, to stay silent. But depression is a serious mood disorder that can affect the way you feel, act, and think.17 Leaving it unaddressed can carry severe consequences.
When an older person has untreated depression, he or she may lose interest in activities that previously held their interest, and retreat from social interaction and physical activities, which may eventually lead to loss of function. That’s one reason it’s important not to brush off any changes in behavior as simply part of ‘old age.’18
—— added.
It’s no fun dealing with depression symptoms such as sadness, irritability, hunger changes, and memory problems. And each of these symptoms can cause other issues. Irritability can strain relationships and make you unpleasant to be around, leading you to become alienated from friends and family. Hunger changes may cause unintended weight loss or gain or nutrient deficiencies. Meanwhile, memory problems can make everyday tasks more challenging than necessary, making you frustrated and embarrassed.
Plus, older adults with depression are at risk for a weakened immune system and complications from other health issues.19 It also gets in the way of other health treatments.20
Don’t Stay Silent—Speak Up About Depression!
There’s no shame in being depressed; it’s a common mental health illness that affects roughly 280 million worldwide.21 If you suspect you’re depressed, reach out to a mental health professional. (Your primary care doctor can give you names if needed.) There are many treatments that can help you feel better, including talk therapy, medications, self-care (e.g., exercise, meditation, music or art therapy, relaxation techniques), dietary supplements, and more.
We’ve got helpful articles coming to you that will provide plenty of effective tips and techniques for relieving depression.
1 Depression - Ages 65+ in United States. America’s Health Rankings analysis of CDC, Behavioral Risk Factor Surveillance System, United Health Foundation.
2 Schaakxs R, Comijs HC, Lamers F, et al. Associations Between Age and the Course of Major Depressive Disorder: A 2-Year Longitudinal Cohort Study. The Lancet Psychiatry. June 7, 2018.
3 Schaakxs R, Comijs HC, Lamers F, et al. Associations Between Age and the Course of Major Depressive Disorder: A 2-Year Longitudinal Cohort Study. The Lancet Psychiatry. June 7, 2018.
4 Aguera-Ortiz L, Claver-Martin MD, Franco-Fernandez MD, et al. Depression in the Elderly: Consensus Statement of the Spanish Psychogeriatric Association. Frontiers in Psychiatry. May 2020.
5 Depression: What Is Depression? National Institute of Mental Health. Revised 2021.
6 Depression: What Is Depression? National Institute of Mental Health. Revised 2021.
7 Depression and Older Adults. National Institute on Aging. Reviewed July 7, 2021.
8 Depression is Not a Normal Part of Growing Older. Centers for Disease Control and Prevention. Reviewed September 14, 2022.
9 Depression is Not a Normal Part of Growing Older. Centers for Disease Control and Prevention. Reviewed September 14, 2022.
10 How to Spot Depression in Seniors. Health Matters: NewYork-Presbyterian.
11 Depression: What Is Depression? National Institute of Mental Health. Revised 2021.
12 Depression is Not a Normal Part of Growing Older. Centers for Disease Control and Prevention (CDC). Last reviewed September 14, 2022.
13 Depression and Older Adults. National Institute on Aging. Reviewed July 7, 2021.
14 Caregiver Burnout. Cleveland Clinic. Reviewed August 16, 2023.
15 What Causes Depression in the Elderly? Understanding Your Loved One’s Mental Health. Institute on Aging.
16 Ask the Expert: Depression. Health In Aging. Updated July 2019.
17 Depression and Older Adults. National Institute on Aging. Reviewed July 7, 2021.
18 How to Spot Depression in Seniors. Health Matters: NewYork-Presbyterian.
19 Zenebe Y, Akele B, Selassie M, et al. Prevalence and Determinants of Depression Among Old Age: A Systematic Review and Meta-Analysis. Annals of General Psychiatry. 2021.
20 Zenebe Y, Akele B, Selassie M, et al. Prevalence and Determinants of Depression Among Old Age: A Systematic Review and Meta-Analysis. Annals of General Psychiatry. 2021.
21 Depressive Disorder (Depression). World Health Organization. March 21, 2023.