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Depression - older adults
Depression is a mental health condition. It is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with daily life for weeks or longer.
Depression in older adults is a widespread problem, but it is not a normal part of aging. It is often not recognized or treated.
Depression in the elderly
In older adults, life changes can increase the risk for depression or make existing depression worse. Some of these changes are:
- A move from home, such as to a retirement facility
- Chronic illness or pain
- Children moving away
- Spouse or close friends passing away
- Loss of independence (for example, problems getting around or caring for oneself)
Depression can also be related to a physical illness, such as:
- Thyroid disorders
- Parkinson disease
- Heart disease
- Dementia (such as Alzheimer disease)
Overuse of alcohol or certain medicines (such as sleep aids) can make depression worse.
Many of the usual symptoms of depression may be seen. However, depression in older adults may be hard to detect. Common symptoms such as fatigue, appetite loss, and trouble sleeping can be part of the aging process or a physical illness. As a result, early depression may be ignored, or confused with other conditions that are common in older adults.
Exams and Tests
The doctor or nurse will examine you and ask questions about your medical history and symptoms.
Blood and urine tests may be done to look for a physical illness.
You may be referred to a mental health specialist to help with diagnosis and treatment.
The first steps of treatment are to:
- Treat any illness that may be causing the symptoms
- Stop taking any medications that may be making symptoms worse
- Avoid alcohol and sleep aids
If these steps do not help, medicines to treat depression and talk therapy often help.
Doctors often prescribe lower doses of antidepressants to older people, and increase the dose more slowly than in younger adults.
To better manage depression at home, you should:
- Exercise regularly, if your doctor says it is ok.
- Surround yourself with caring, positive people and do fun activities.
- Learn good sleep habits.
- Learn to watch for the early signs of depression, and know how to react if these occur.
- Drink less alcohol and do not use illegal drugs.
- Talk about your feelings with someone you trust.
- Take medications correctly and discuss any side effects with your doctor.
Depression often responds to treatment. The outcome is usually better for people who have access to social services, family, and friends who can help them stay active and engaged.
The most worrisome complication of depression is suicide. Men make up most suicides among older adults. Divorced or widowed men are at the highest risk.
Families should pay close attention to elderly relatives who are depressed and who live alone.
When to Contact a Medical Professional
Call your health care provider if you keep feeling sad, worthless, or hopeless, or if you cry often. Also call if you are having trouble coping with stresses in your life and want to be referred for talk therapy.
Go to the nearest emergency room or call your local emergency number (such as 911) if you are thinking about suicide (taking your own life).
If you are caring for an aging family member and think they may have depression, contact their health care provider.
Abbasi O, Burke WJ. Depression. In: Ham RJ Jr., Sloane PD, Warshaw GA, et al., eds. Ham's Primary Care Geriatrics: A Case-Based Approach. 6th ed. Philadelphia, PA: Saunders Elsevier; 2013:chap 18.
Ismail Z, Fischer C, McCall WV. What characterizes late-life depression? Psychiatr Clin N Am. 2013;36:483-496.
Reviewed By: Timothy Rogge, MD, Medical Director, Family Medical Psychiatry Center, Kirkland, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.