Understanding Depression in Seniors & Older Adults

Signs of Depression in Seniors

Signs of depression in older adults can have a few different qualities than they are in younger populations but are mostly similar. It’s important to know what to look for if you suspect a loved one may be experiencing symptoms of depression. 

Signs and symptoms of depression in older adults can include:

• Change in behavior
• Feeling more tired than usual
• Memory loss
• Increased irritability
• Confusion
• Moving more slowly
• Change in eating habits
• Hoarding, especially items that have no value or importance
• Physical symptoms like new aches and pains or dizziness
• Insomnia
• Weight loss
• Feeling worthless or hopeless
• Not wanting to leave home
• Lack of interest in things once enjoyed
• Giving away personal belongings
• Changing end-of-life instructions (like updating a Will or Trust)

Common Causes of Depression in Older Adults

Several things can cause depression. Failing health, social isolation, uncertainty around life changes,  and loss of friends or family members are significant factors that increase the risk of mental health conditions like depression and anxiety in seniors. 

Health issues and chronic pain

It’s a known fact that health issues increase as we age. Everything from poor eyesight to hearing loss can affect the quality of life and make the idea of aging gracefully feel near impossible. 

Any of these chronic health issues can leave an older person feeling discouraged and frustrated:

• Pain
• Changes in mobility
• Diabetes
• Osteoporosis
• Alzheimer’s disease
• Dementia

Loss of independence

Losing one’s independence can be a painful, demoralizing experience. Yet it’s a reality most people have to face one day. It might mean giving up the right to drive, downsizing from a larger home and moving into a facility that offers help, or no longer being self-sufficient when it comes to routine things like buying groceries, paying bills, or ordering medication.

Loss of independence is something many older individuals have a hard time accepting. It can lead to feeling depressed and fear about the next phase of life.  

Bereavement and social isolation

Losing someone or feeling socially isolated from friends and families can profoundly impact the emotional well-being of an older adult. Not only is there pain associated with loss, but grief often forces us to face our mortality, which can be frightening.

Social connections are crucial to maintaining a sense of community and support. Older people can begin to falter without them, feeling alone and like they don’t have much to live for. 

Genetic predisposition and biochemical factors

There’s a well-documented link between family history of depression and an increased risk of developing it. Some research estimates genetic predisposition might increase the likelihood of developing depression by as much as 40%. 

Likewise, biochemical factors like hormonal changes common with age and some autoimmune conditions can contribute to a higher risk of depression in older people. 

Diagnosis Challenges for Seniors and Depression

It can be difficult to diagnose depression in older adults. Some of the challenge stems from age-related factors — like cognitive decline or change in appetite or energy — that can be attributed to aging in general rather than being signs of depression. Another complication is that overlapping symptoms and comorbid conditions (conditions that exist simultaneously) can complicate getting an accurate diagnosis. 

Overlapping symptoms with other conditions

As we age, it’s common to experience things like sleep disturbances, increased fatigue, and cognitive decline. While these can be typical signs of aging, they can also be linked to other physical and mental conditions, including depression. Excessive tiredness can be the body slowing down a bit, a symptom of heart disease or thyroid issues, or a sign of depression. To further complicate things, it might also be a combination of these issues.  

Underreporting and misinterpretation of symptoms 

Signs of depression in older persons often go unnoticed or are misdiagnosed due to underreporting or misinterpretation of symptoms. Several factors contribute to the underreporting of depression among older individuals:

• Stigma and awareness: Many older adults may not recognize or admit to feelings of depression due to the stigmas surrounding mental health, especially prevalent in their generation, where such discussions were uncommon.
• Symptom overlap: Symptoms of depression can overlap with those of other age-related conditions, leading to misdiagnoses or oversight by healthcare providers.
• Lack of training for geriatric care: There is often a lack of specialized training in geriatric mental health among medical professionals, which results in inadequate care and attention to these critical symptoms.

Because of this, anyone 65 years or older should try to get regular, thorough medical and psychological evaluations by qualified, experienced health providers. Only a trained medical expert can distinguish late-life depression from other conditions in older individuals. 

Treating Depression in Older Adults

Like anything else, there’s no one-size-fits-all when it comes to treating late-life depression. It takes a holistic, combined approach that may involve therapy, medication, and lifestyle changes for the best results. 

Therapy for depression

Talk therapy, also known as psychotherapy, is a well-established, effective treatment for depression symptoms. Research supports that therapy can be most effective when tailored to an individual’s needs to address symptoms of depression and any comorbid medical condition. 

Talkspace is an online therapy platform that makes getting therapy for depression simple and convenient. Especially for older people who may have mobility or transportation concerns or where cost can be a barrier, Talkspace offers a way to seek therapy without adding additional stress. 

Depression medication

While medication can treat depression in some older adults, antidepressants aren’t always as effective with this population as they are for younger people. There are several reasons why medication might not be as beneficial for seniors, including: 

• Higher risk of side effects
• Increased risk of drug interactions with other medications
• Concern about poor adherence 
• Lack of willingness to take medication as directed

Studies show that less than half (44%) of older adults who use antidepressants have a positive response, and less than a third see symptoms resolve completely. 

Commonly prescribed depression medication for older adults can include:

• Selective serotonin reuptake inhibitors (SSRIs)  
• Serotonin and norepinephrine reuptake inhibitors (SNRIs) 
• Serotonin modulators and stimulators (SMS)  
• Atypical antidepressants 
• Monoamine oxidase inhibitors (MAOIs)

Talkspace makes getting therapy and medication easy with licensed, qualified mental health providers who understand how to treat depression best. 

Lifestyle modifications & social support

Sometimes, simple lifestyle modifications, along with the addition of social support, can be crucial in relieving symptoms of depression in the older population. Holistic approaches combined with therapy and medical interventions can provide the best results. 

Any of the following can help older adults dealing with depression:

• Walking
• Doing yoga
• Gardening
• Joining community groups
• Participating in religious events
• Volunteering
• Eating healthy
• Spending time with family and friends
• Keeping a healthy sleep habit

Complementary & alternative treatments

Several complementary and alternative treatments can be beneficial for a loved one experiencing depressive symptoms. When used in combination with more conventional therapies — like talk therapy, group therapy, or medication — these alternative tools can be very effective and offer significant relief.

• Mindfulness meditation
• Acupuncture
• Tai chi
• Massage therapy

Supporting Seniors with Depression

Family members, friends, and caregivers must know how to recognize the symptoms of depression in older people so they can offer adequate support. If you have an older person in your life who you think might be showing signs of depression, the following tips can help:

• Look for sudden changes in behavior
• Use active listening that encourages open communication
• Watch for physical symptoms like unexplained pain or fatigue
• Encourage social involvement
• Promote positive habits like exercise, healthy eating, and keeping a consistent sleep schedule
• Offer emotional support and connections
• Seek professional help if needed
• Be patient
• Stay involved and maintain consistent contact

Online Treatment Covered by Insurance

Talkspace offers affordable, convenient therapy for seniors with depression or other mental health conditions. The online platform accepts major insurance plans and will offers treatment for depression in older adults covered by Medicare in select states, with more to come. 

For accessible, affordable online therapy for depression, reach out to Talkspace today.