Depression among seniors gets little attention by the mental health community, even though their symptoms are often worse and longer-lasting.
Depression has been primarily considered a young person’s disorder, but the latest numbers say otherwise. This thinking has left one of the most vulnerable groups out of the conversation… older adults.
This oversight is even more glaring when a number of recent studies are considered. These studies appear to indicate that depression not only affects seniors, but often tends to hit them more severely and last longer, than depression in their younger counterparts.
In one recent study, researchers followed over a thousand adults (in a broad age range) with depression for two years and discovered that the disorder worsened steadily with age.1 The researchers tracked the following indicators:2
Rather unexpectedly, the study showed that people over the age of 70 were worst off in every indicator.3 The results of this major study were published in the prestigious Lancet Psychiatry. Moreover, it appears that from this and other studies, that depression can look different for older adults than other age groups.
Depression Symptoms
In Seniors Are Hard To Identify
When it comes to seniors, it can be difficult to spot depression symptoms. This is because many of their symptoms are often thought of as a natural part of enduring the life changes that come with age... such as divorce, retirement, losing a loved one or health struggles.4 Even mental health experts are often in the dark, as knowledge about depression in older adults is scarce and often controversial, according to a recent research article in Frontiers in Psychiatry.5
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.6
—— , co-chief of the Division of Geriatrics and Palliative Medicine at NewYork-Presbyterian/ Weill Cornell Medical Center.
This causes a good deal of unnecessary suffering, and can lead to a cascading effect. When older adults go undiagnosed, they don’t get the help they need. And when they don’t get timely support, they’re more likely to experience complications. And for seniors, depression’s reach goes beyond just mental and emotional health. Depression also dampens the immune system and can amplify other health issues and illnesses over time. It also gets in the way of other health treatments.7
As mental health experts learn more about depression in older adults, one thing is clear: Older adults with depression are falling through the cracks. They’re being left to figure things out on their own—if at all.
Similarly, choosing not to do something you haven’t been successful at before may help you avoid frustration, but it can deprive you of health perks, especially when it’s a habit like exercise. The CDC also notes that physical activity keeps your brain sharp, reduces anxiety, and boosts mood2 — all helpful for keeping unhelpful thoughts at bay. So avoiding trying a new physical, because of your negative inner dialogue, has consequences you may not have imagined.
The good news is that you have the power to change unhelpful thoughts, and in so doing, modify your behaviors to improve your physical and mental health.
How Is Depression Different In Older Adults?
Think you might have depression? Here’s what we know about how depression appears in younger and older adults, starting with the symptoms.
You might recognize some of the “classic signs” of depression. They include sadness, hopelessness, pessimism, irritability, changes in sleep and appetite, sluggishness, and loss of interest in hobbies.9 Younger adults with depression typically check a number of these symptom boxes.
In contrast, many older adults with depression may not show these classic signs of depression. They may have physical aches or pain. There can be personality changes. They typically prefer to stay home rather than go out to socialize.10 They may not express much emotion, much less talk about their feelings.11 And when their depression is long-lasting, memory and thinking problems can crop up, masking their underlying mood issues. 12
Add it all up, and you get a population that defies conventional understandings of what depression looks like.
What Causes Depression In Older Adults?
Just as older adults may have atypical depression symptoms, they also get depressed for unique reasons, that for many, comes with aging.
Health-Related Factors
One factor that increases the risk for depression is having a chronic health condition, such as heart disease or cancer.14 Roughly 80% of older adults have at least one chronic illness (50% have two or more), putting this age group at higher risk.15
In addition, aging adults typically take one or more prescription medications, many of which have depression listed as a potential side effect.16 Now, you can get this side effect from these prescriptions at any age, but older adults face a greater risk because their bodies don’t metabolize substances as well as when they were younger.17
Researchers have long known that many drugs can make us feel down or even depressed and that, as we age, changing body chemistries put us at greater risk for this side effect. But few doctors think to review the medications list when their patients have the telltale signs of depression.
—— wrote geriatric pharmacist
Some drugs, commonly taken by older adults, that have been linked to depression include medications for Parkinson’s disease, blood pressure medications, beta-blockers, calcium channel blockers and sleep aids.19
Lifestyle-Related Factors
Next up is retirement, which many look forward to as a time when they can finally travel or keep up with a favorite hobby. However, it often doesn’t work out that way, and when expectations go unmet, it can be a catalyst for depression.
Social Isolation and Loneliness
The reality of senior life can be so different from their previous life, that it can come as a shock. This makes sense considering how careers provide purpose, social connections and mental stimulation for most people. Often, career is one’s identity, and it can be tough to know how to cope once it’s all gone. Sadly, many retirees withdraw and become socially isolated after retirement, leading to depression.20
... [Social isolation] is often initiated as a consequence of not having a sense of meaning and purpose, so it might even be caused by lack of social engagement and meaningful engagement with others on a regular basis.
—— , an associate professor of sociology at Florida State University’s Pepper Institute for Aging and Public Policy.21
Depression can also be triggered by the death of a loved one. It’s true that everyone experiences grief at some point. However, the losses tend to pick up speed as we age. And while grief and depression aren’t mutually exclusive—meaning you can have one without the other—you can easily slip into depression following a death.22
But There’s More To The Story…
The newest findings, when it comes to seniors and mental health, have been quite revealing. One of the more surprising findings from that thousand person study in the Lancet Psychiatry is that factors that typically increase the odds of depression—including the ones we already mentioned—were only partly to blame for the worse outcomes in seniors. The study showed that old age in itself was a significant risk factor on its own.23
Researchers don’t yet know what that means. Lead author and researcher at VU University Medical Center in Amsterdam, Roxanne Schaakxs, said:
Old age really matters in the course of depression, and it really has to be investigated in more detail.24
In other words, other factors we don’t quite understand are putting older adults at risk for depression, and we won’t be able to fully fill in the blanks until we have more research on depression in seniors.
Don’t Lose Heart, Once Diagnosed There Are Solutions!
After reading this, you may think you’re doomed to be depressed during your golden years—but nothing could be further from the truth. If you think you might be depressed, contact your healthcare provider or a licensed mental health professional. Meanwhile, watch your inbox for future articles on proven Cognitive Behavioral Therapy (CBT) and other techniques created specifically for seniors struggling with depression, despair, or anxiety.
1 Loneliness and Social Isolation Linked to Serious Health Conditions. Centers for Disease Control and Prevention (CDC). Last updated April 29, 2021.
2 Benefits of Physical Activity. CDC. Last updated August 1, 2023.
3 What is cognitive behavioral therapy? American Psychological Association. 2017.
4 DeRubeis RJ, Siegle GJ, Hollon SD. Cognitive therapy vs. medications for depression: Treatment outcomes and neural mechanisms. Nature Reviews Neuroscience. October 2008.
5 Cognitive behavior therapy. StatPearls Publishing.
6 Thought Record. United Kingdom National Health Service.
7 Thought Record. United Kingdom National Health Service.
8 Depression - Ages 65+ in United States. America’s Health Rankings analysis of CDC, Behavioral Risk Factor Surveillance System, United Health Foundation.
9 Depression: What Is Depression? National Institute of Mental Health. Revised 2021
10 Depression (Major Depressive Disorder). Mayo Clinic. Last reviewed October 14, 2022.
11 Depression: What Is Depression? National Institute of Mental Health. Revised 2021.
12 Depression: What Is Depression? National Institute of Mental Health. Revised 2021.
13 Depression: What Is Depression? National Institute of Mental Health. Revised 2021.
14 Depression is Not a Normal Part of Growing Older. Centers for Disease Control and Prevention (CDC). Last reviewed September 14, 2022.
15 Depression is Not a Normal Part of Growing Older. Centers for Disease Control and Prevention (CDC). Last reviewed September 14, 2022.
16 What Causes Depression in the Elderly? Understanding Your Loved One’s Mental Health. Institute on Aging.
17 What Causes Depression in the Elderly? Understanding Your Loved One’s Mental Health. Institute on Aging.
18 Neel Jr., AB. 10 Types of Medications That Can Make You Feel Depressed. AARP.
19 What Causes Depression in the Elderly? Understanding Your Loved One’s Mental Health. Institute on Aging.
20 What Causes Depression in the Elderly? Understanding Your Loved One’s Mental Health. Institute on Aging.
21 Know a Senior With Depression? Here’s How You Can Help. Everyday Health. Reviewed January 13, 2022.
22 What Causes Depression in the Elderly? Understanding Your Loved One’s Mental Health. Institute on Aging.
23 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.
24 Bakalar N. Depression in Older People Tends to Be More Severe. The New York Times. June 7, 2018.