Dealing with Depression

More than seven million adults over the age of 65 suffer from a form of depression. Fortunately, there are ways you can help loved ones who may be experiencing more than just “the blues.”

We call them the “Golden Years.” Retirement means freedom—time to spend on hobbies, travel, and enjoying life’s milestones with children and grandchildren. So why is it that this time in life when wellbeing should be at a high, we find more than seven million Americans age 65 or older reportedly suffer from some form of depression?

Transitional moments in life can elicit feelings of uncertainty, anxiety, and loss. Leaving a job and co-workers behind. Experiencing mortality as close friends and life partners die.

Facing the reality of chronic ailments such as arthritis, dementia, heart disease, or cancer. Alisha Landes, executive director at The Lantern at Morning Pointe notes, “With age comes change that sometimes isn’t welcome.” Unfortunately, often times these unwanted changes can lead to forms of depression. And studies reveal suicide rates among older adults are higher than the national average (13.4 deaths per 100,000), with the Centers for Disease Control and Prevention reporting 14.9 deaths per 100,000 individuals 65 and up. (The numbers are even higher for men 85 and up, who have the highest rate of suicide in the country.)

Fortunately though, depression, even in severe cases, is treatable.

Defining Depression

According to the National Institute of Mental Health, depression is a common but serious mental health condition that impairs a person’s thinking, feeling, and physical activity level. Often, it leaves them unable to live life normally. Landes explains, “You may notice that the older adult is suddenly withdrawn more than usual. Normal activities that they used to enjoy are no longer appealing.”

For instance, maybe a loved one used to wake up at 6:00 a.m. sharp to have breakfast and go play a morning round of golf, but has recently lost interest and started sleeping more than normal, often missing regular meals and daily activities.

Or perhaps a loved one used to be a social butterfly, eating out with friends and taking in new restaurants each week, but now seems to have lost their appetite altogether and started keeping to themselves at home.

While depression can affect people in different ways, the types that most commonly affect older individuals are:

Major Depression, also known as clinical depression, which manifests through severe symptoms that interfere with a person’s ability to eat, sleep, work, and even concentrate.

Persistent Depressive Disorder (Dysthymia), also known as chronic depression, which is a state of sadness and depressed mood that lasts for at least two years, but has less severe symptoms than major depression.

Minor Depression which involves depression symptoms that are less severe than both major depression and persistent depressive disorder and don’t last as long.

Understanding the Signs

The scary truth? Depression in older adults can often be undiagnosed or misdiagnosed. Frequently, depression can be downplayed, with individuals assuming it’s a normal part of aging. Of course, it is common to experience grief or sadness over life’s changes. Dr. Jon Cohen, a psychiatrist with Behavioral Health Associates explains, “Grief is a very appropriate and expected emotional reaction to loss, whether of a child, family member, or other loved one.” It may come in stages and require help and support to get through, but it doesn’t instill a sense of hopelessness. Depression, on the other hand, can be a debilitating disorder that can lead to physical health issues if not appropriately treated.

Diagnosing clinical depression requires individuals to exhibit at least five out of the nine symptoms defined by the Diagnostic Criteria for Major Depressive Disorder and Depressive Episodes while those suffering from chronic or minor depression might only exhibit one or two. The symptoms include:

  1. Depressed mood or irritable most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful)
  2. Decreased interest or pleasure in most activities, most of each day
  3. Significant weight change (5%) or change in appetite
  4. Changes in sleep like insomnia (problems falling or staying asleep) or hypersomnia (excessive sleepiness; trouble staying awake)
  5. Changes in activity like psychomotor agitation (restlessness) or retardation (slowed functioning)
  6. Fatigue or loss of energy
  7. Feelings of worthlessness or excessive or inappropriate guilt
  8. Diminished ability to think or concentrate, or more indecisiveness
  9. Thoughts of death or suicide, or has suicide plan

Helping Loved Ones Cope

"If you are concerned your loved one might be suffering from a form of depression," Dr. Cohen shares. "It is important to visit a physician and get a complete assessment. Certain depressive symptoms can be linked to endocrine disorders, nutritional deficiencies, chronic medical problems, or medication side effects."

If you find that your loved one is exhibiting the signs of depression, there are ways to help. Dr. Cohen recommends, “Talk about the elephant in the room. Don’t be afraid to mention something that seems concerning, and let your loved one know you are worried.” A diagnosis and treatment plan, which may include psychotherapy, antidepressant medication, and lifestyle modification, are paramount.

He also suggests taking on a more proactive role. “Rather than saying ‘Let me know if there is anything I can do,’ say ‘I would like to take you out for lunch’ or even just show up for a visit instead of waiting for them to make the first move.”

Landes adds, “Help them get reconnected with the community. Encourage them to attend events, or even attend with them. Structure and activity are important for helping your loved ones feel purpose and meaning.”

The good news is: depression in older adults is treatable. Understanding what to look for, when to seek medical treatment, and how to provide support will help you ensure your loved one remains happy and healthy.

Picture of Alisha Landes

Alisha Landes

Executive Director, The Lantern at Morning Pointe

Picture of Dr. Joe Cohen

Dr. Joe Cohen

Psychiatrist, Behavioral Health Associates

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