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Depression in Older Adults

Tuesday 22 September 2020
Mental Health

Table of Contents


I. What is Depression?

II. Are Depression Symptoms Different in Older Adults?

a. Depression Symptoms

b. Depression Symptoms in Older Adults

III. What Causes Depression in Older Adults?

a. Isolation

b. Health Problems

c. Fears

IV. How is Depression Treated in Older Adults?


What is Depression?

Depression is a mental disorder that affects people of any age. While occasional feelings of sadness and despair are natural, lasting feelings are not a normal part of getting older. Depression is also known as clinical depression and major depressive disorder. It is a mental illness that affects the way that you think and feel.

There are several different types of depression. Older adults often suffer from subsyndromal depression. This form of depression is a less severe form, but if untreated can lead to major depression. [1]

Depression is a common condition in older adults and is thought to affect approximately six million Americans over the age of 65. However, only around 10 percent of these people receive treatment. [2] Depression is a medical condition and there is no shame in seeking treatment. Antidepressant medications such as Prozac (fluoxetine), Cymbalta (duloxetine), and Wellbutrin XL (bupropion) can be prescribed to treat the condition.

Depression can affect older adults differently than younger people. Often, the condition lasts for a longer period of time and may also occur alongside other mental illnesses. [2]

Keep reading to learn more about depression in older adults, including the symptoms, causes, and treatments available.

Are Depression Symptoms Different in Older Adults?

a. Depression Symptoms

Depression can cause symptoms that affect both your mind and body. The range of symptoms will depend on how mild or severe your condition is. Some or all of these symptoms must occur almost every day for two weeks or longer in order for depression to be diagnosed. [3] Common depression symptoms include:

  • Feeling sad, hopeless, or empty
  • Feeling guilty or worthless
  • Feelings of anxiety, pessimism or irritation
  • Finding it difficult to concentrate or make decisions
  • Restlessness
  • Changes in weight or digestion problems
  • Aches, pains, headaches and cramps
  • Suicidal thoughts or actions [4]

An older woman holding her head in pain

b. Depression Symptoms in Older Adults

Older adults that have depression are likely to have many of the same symptoms listed above. However, depression can affect older adults in some other ways as well. Often, sadness is not the primary symptom of depression for older adults. [5]

In addition to the previous symptoms, older adults may also have the following signs of depression:

  • Confusion
  • Forgetfulness
  • Sleeping difficulties
  • Loss of appetite
  • Physical aches and pains
  • Loss of interest in sex 
  • Fatigue
  • Social withdrawal [6] [7]

People that have depression rehabilitate from illnesses at a slower rate. Studies show that elderly adults with depression are more likely to pass away from illnesses than those without depression. [2] Suicide is another big concern with depression in older adults. For people aged between 80 and 84, the suicide rate is over twice the rate for the general population. [2] This is why it is important that even mild depression is diagnosed and treated promptly in older adults.

What Causes Depression in Older Adults?

Depression is caused by several genetic, psychological, and environmental factors. While the genetic and psychological factors are unlikely to be affected by age, getting older has a significant effect on the environmental factors.

Older women are more likely to be depressed than older men. [6] However, there are several other significant life changes or other causes that can occur during later life that can trigger depressive episodes.

a. Isolation

A key factor in elderly people developing depression can be feelings of isolation. A significant trigger can be the loss of a spouse, causing extreme loneliness. As people get older, they may also have to deal with the loss of siblings, family members, friends, and pets. [8] The lack of a close support group of friends and family may also increase the risk of depression. 

An older man sitting alone on a bench

b. Health Problems

As we get older, living with chronic conditions can become a real challenge. Around 85 percent of older adults have a chronic health condition, and around 60 percent have at least two chronic conditions. [9] There are several ways that chronic conditions can lead to depression. Living with severe pain, cognitive decline or a damaged body image can all contribute to developing depression. [8]

c. Fears

Older adults may have several fears that may trigger depression. Elderly adults may have an ever-increasing fear of their health issues worsening or of dying. Adults may also be anxious about financial troubles, either for themselves or for their families.

Getting older can also cause a fear of becoming useless or having a reduced sense of purpose after retirement. [8]

How is Depression Treated in Older Adults?

There are several different medications that are used to treat depression. It can often take time to find the most effective treatment option for each person. Antidepressants include:

Selective serotonin reuptake inhibitors (SSRIs):  These include Prozac (fluoxetine) and work by increasing the levels of serotonin, a chemical in the brain.

A mixture of medication pills

Serotonin-norepinephrine reuptake inhibitors (SNRIs): These include Cymbalta (duloxetine) and block neurotransmitters such as serotonin and norepinephrine.

Tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs): These are usually prescribed if other antidepressants are ineffective as they often cause severe side effects.

Atypical antidepressants: These drugs include Wellbutrin XL (bupropion). Atypical antidepressants are a wide group of medications that do not fit into other categories.

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis or treatment.