According to America’s Health Rankings from the United Health Foundation, nearly 15 percent of people ages 65 and older have been diagnosed with depression by a health professional. And in August 2020, during the pandemic, 1 in 4 older adults reported having depression or anxiety — a marked increase from 1 in 10 adults with Medicare in 2018 — according to the Kaiser Family Foundation. Unfortunately, many seniors aren’t getting help for their symptoms. One reason: Depression in older adults hasn’t received the attention it deserves. In fact, despite the high incidence and impact of depression among seniors, knowledge about how to address the problem is limited, according to an article published in the May 2020 issue of Psychiatry.
They may assume their feelings are normal or they have a good reason to feel down.They could be isolated, which, in itself, may lead to depression. And if a senior lives alone, there may be no one around to notice their distress.They may not realize that certain physical symptoms they’re experiencing could be signs of depression.They may be reluctant to talk about their feelings or ask for help.
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What Does Depression Look Like in an Older Adult?
What’s more, depression can look a little different and therefore be harder to spot in an older person compared with someone younger, “since their everyday activities are different,” explains Dawn Carr, PhD, an associate professor of sociology at Florida State University’s Pepper Institute for Aging and Public Policy in Tallahassee. “For a [retired] person who doesn’t have a schedule that’s consistent, it’s easy to kind of get into a rut and for people to not be able to notice,” Dr. Carr says. Social isolation is a common trigger and sign of depression among seniors, she adds. “It’s often initiated as a consequence of not having a sense of meaning and purpose, so it might even be caused by lack of social engagement and meaningful engagement with others on a regular basis,” explains Carr. Depression may show up physically, too, says Sheila Babendir, PhD, a licensed professional counselor and the director of counseling at the University of Phoenix in Arizona. “Appetite lessens, they may want to sleep more, and they don’t have motivation,” Dr. Babendir explains. “They may not feel as sad or blue, but it might manifest as feeling less energized.” According to Mayo Clinic, in addition to other classic signs of depression — such as listlessness, difficulty sleeping, and recurrent thoughts of death or suicide — older adults also may experience:
Personality changesMemory problemsPhysical aches or painOften wanting to stay at home, rather than socializing or doing new things.
Research published in February 2017 in the journal International Psychogeriatrics also showed a relationship between depression and hoarding, characterized by difficulty discarding or parting with possessions regardless of their actual value, among older adults. RELATED: Detecting and Diagnosing Depression: It Can Look Different in Men and Women and in Teenagers, Too
How to Help an Older Adult Get Help for Depression
If you’ve noticed signs of depression in an older person who is close to you, try talking to them about your concerns. “The most important thing is to be able to develop a relationship where you can talk through and normalize the depression symptoms,” Carr says. Bozek agrees, adding that one of the biggest challenges to getting the conversation started may that the person grew up at a time when admitting to having a mental health problem was considered to be a character flaw. “It’s a huge taboo topic for our older population, and they still see behavioral health as you’re sick in your head and there’s a stigma associated with that thinking,” says Bozek. “And so, we have to really change that mindset.” With that in mind, avoid starting the conversation by asking directly, “Do you feel depressed?” Instead, Carr suggests asking about the person’s social interactions. “Essentially, speaking about the symptoms of depression is more accessible than simply saying, ‘You seem depressed,’ because that can be confrontational for some people,” says Carr. You might ask:
“Are you enjoying spending time with others?”What activities do you look forward to lately?”“You don’t seem like yourself today. What’s on your mind?”
Experts suggest that you also:
Let your loved one know that you want to help them to live as healthy, happy, and fulfilling a life as possible.Bring up delicate topics in private without distractions. “Timing is really important and maybe a conversation around a meal or a time of day where it’s a little bit easier for them to open up and be in a state of mind that they could be more accepting and able to hear what you’re having to say,” says Babendir.Encourage them to see their doctor. A health professional can rule out any underlying medical conditions that could be causing their symptoms, such as dementia, Parkinson’s disease, heart disease, or medication interactions.Talk about the potential benefits of therapy. A study published in November 2021 in the Journal of Affective Disorders shows that older adults may even respond better to therapy than working-age adults.Come prepared with a short list of possible therapists, along with their expertise and experience. Resources like the American Association for Geriatric Psychiatry, and the American Psychological Association have tools to help you to find local therapists.Offer to go to an initial therapy session if it will help them feel more comfortable.For seniors with limited mobility or who may prefer to connect with a health professional via Zoom or over the phone, consider helping them schedule a telemedicine.
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