Depression in Older Adults: Know the Red Flags

Depression is common when you're over 65, but it can look very different than in younger folks. See who's more likely to have it and what signs to watch for.

 
Depression is common when you’re over 65, but it can be harder to spot. In part, it’s because it often shows up differently when you're older.
Even though it’s common, it’s not a normal part of aging. You can control your symptoms with the right treatment, and live a healthier, fuller life.

Who’s Most Likely to Have Depression Over 65?

Other things besides your age raise your chances of depression. You’re more likely to have it if you:
  • Have had depression before
  • Are a woman
  • Have a chronic illness like diabetes
  • Are disabled
  • Don’t sleep well
  • Spend a lot of time alone
  • Have other people in your family who've had depression
  • Take certain medications
  • Have a disease that affects your brain
  • Abuse alcohol or drugs
  • Are going through a stressful life event
Dependence also raises your odds. You’re far more likely to be depressed if you need in-home health care or hospital care than if you live in the community.
It’s common for depression to come with other health issues that often crop up after 65, like:
Sometimes it can be the medication for the above conditions that’s to blame for depression symptoms. Depression can often make these other health conditions worse, and vice versa. Getting your depression under control often improves other medical issues and your overall health.

Symptoms

Depression often gets overlooked or misdiagnosed in seniors. When you’re older, you may not have the sad or empty feeling that’s common with it. Instead, you may:
  • Feel tired
  • Have trouble sleeping
  • Be grumpy or irritable
  • Feel confused
  • Struggle to pay attention
  • Not enjoy activities you used to
  • Move more slowly
  • Have a change in weight or appetite
  • Feel hopeless, worthless, or guilty
  • Endure aches and pains
  • Have suicidal thoughts
Sometimes, depression can hit after the death of a spouse. It’s normal to grieve, but one-third of widows and widowers have symptoms of it in the first month after their partner dies, and half of them still struggle with it a year later.

Treatment

With the right plan, you can improve your quality of life. The first step is to talk to your doctor. You can see your general physician or a mental health specialist, like a psychiatrist or psychologist. They’ll examine you and take your medical history.
Different treatments work for different people. Doctors usually recommend a medication, some sort of therapy, or both.
The type of medication your doctor prescribes will depend on many things, including your:
  • Symptoms
  • Health
  • Other conditions you have and medications you're taking
Meds you may get include:
Selective serotonin reuptake inhibitors (SSRIs) like:
Serotonin and norepinephrine reuptake inhibitors (SNRIs) like:
Atypical antidepressants, such as:
Monamine oxidase inhibitors (MAOIs), like:
There's another class of antidepressants called tricyclic antidepressants, but they aren't used much in older adults because they have more side effects. Talk to your doctor about them.
All antidepressants come with side effects, so your doctor will want to monitor how you’re doing after you begin treatment. He may need to tweak your dosage or change your medicine altogether.
Studies show that psychotherapy, or “talk therapy,” works to treat mild to moderate depression in older adults just as well as medication. Counseling with a trained professional can help you work through some of the things that trigger your depression. It can also give you tools to deal with it.
Cognitive behavioral therapy (CBT) is a special form of psychotherapy that trains you to turn negative thoughts into positive ones.
When medication and psychotherapy don’t seem to make a difference in your symptoms, your doctor may recommend electroconvulsive therapy (ECT). It involves passing a brief small electrical current through electrodes placed on your scalp while you are under general anesthesia. This causes a brief seizure. That seizure causes a change to the chemistry in your brain. Researchers believe that change helps with your depression.

Doctors usually try medication and therapy for a while before trying ECT.
Healthy lifestyle changes can help ward off depression, too.
  • Eat nutritious foods.
  • Get enough exercise.
  • Work some relaxation methods like deep breathing or stretches into your schedule.
Together, the combination of medical treatment and a healthier lifestyle can help boost your mood and get you back to feeling like yourself.