May 1, 2024

Recognizing and supporting an older adult at risk of depression

TELUS Health

Your mother hasn’t been eating well and is having trouble sleeping. Your father has been unusually irritable. Your aunt or an older friend seems to have lost interest in getting together and activities you used to enjoy sharing. These could be signs that someone you love is depressed.

Adults with untreated depression have a higher risk of many age-related conditions, including obesity, diabetes, and heart disease. But they often put off seeking treatment because they or their loved ones either don’t recognize the signs or don’t know where to find help. Here are important facts to know and steps to take if you think someone you love may be depressed.

Signs of depression in older adults

The signs of depression in older adults can resemble those found in the general population but diagnosing them can involve unique challenges. For many people over 65, sadness isn’t the first or clearest sign that something’s wrong. Older adults may have a constellation of smaller symptoms or may not see the value of talking about their feelings, so their doctors may miss important signs that may indicate depression.

In addition, depression can result from illnesses more common in people who are elderly, such as cancer, arthritis, Alzheimer’s, Parkinson’s, or heart disease. When this happens, doctors may focus on treating the disease and overlook the depression it’s triggered.

Among the most common symptoms of depression in older people are:

• experiencing a sad, anxious, or “empty” mood for two weeks or longer
• feelings of guilt, hopelessness, worthlessness, or helplessness
• irritability, restlessness, or having trouble sitting still
• loss of interest in activities the person used to enjoy
• fatigue or decreased energy
• moving or talking more slowly
• trouble concentrating, remembering, or making decisions
• sleep problems, including oversleeping or awakening too early
• eating more or less than usual; unintentional weight gain or loss
• thoughts of death or suicide or suicide attempts

Other signs may include:

• headaches, other aches or pains, or digestive problems for which doctors can’t find a medical cause
• frequent crying
• increased use of alcohol or other drugs
• neglecting personal care

Why is depression in older adults often overlooked?

Feeling depressed can greatly impair an older person’s quality of life. “Mental health conditions among older people are often underrecognized and undertreated, and the stigma surrounding these conditions can make people reluctant to seek help,” the World Health Organization says. Common reasons depression goes untreated include:

The mistaken belief that depression is “normal” in later life. Depression is common in people over 65, but it is never normal.

Isolation. The signs of depression may go unnoticed if an older person lives alone or has few friends in a new community or care facility.

Viewing depression as a sign of “weakness.” Some older adults may believe they should “tough it out” or “keep calm and carry on” in painful situations. If so, they may find it hard admit that they are struggling with painful feelings. Others may not want to be a bother to their family. Or they may fear that if they ask for help, their families will worry or think they need to enter a long-term care facility.

Related health problems that can mask signs of depression. Signs of depression can resemble those of other diseases. In such cases, older adults or their doctors may not at first recognize the different factors that contribute to the issue. Depression can also be a side effect of certain medications commonly prescribed for the elderly, including some blood-pressure and cholesterol-lowering drugs. The more medications the older person takes, the harder it may be to identify the root causes of a problem.

Ways to find help and support

At any age, depression is treatable with therapy, loving support, medication, or a combination of these. You can help older friends or relatives experiencing depression by taking these steps:

Talk and listen. Talk with the older adult about what you’ve noticed in a sensitive and nonjudgmental way. Remember, the older adult that you may be concerned about has a whole lifetime of knowledge about what has helped in the past and what their concerns are now. As much as possible, include the person when learning more about and actively seeking help—this is a time in life when many people feel less valued, less understood, and see more of their independence taken away from them. Listen carefully to the person’s concerns and offer to provide any information about depression that might help.

Get a medical checkup that includes screening for depression. A primary care doctor can screen for depression during a checkup and recommend a therapist or other specialist if needed.

Consider talking with a geriatrician. Encourage your friend or relative to see a geriatrician, a medical doctor who specializes in treating older people. A physician who has little experience with older patients’ mental health concerns may miss key signs of depression or confuse them with other health conditions.

Encourage good self-care. Do what you can to support the good health habits that may ease some symptoms. Offer to look into a home-delivered meal program for an older adult who isn’t eating well, or to take walks with someone who seems isolated. Regular exercise can in some cases ease depression as well as antidepressants, research suggests.

Get help right away for talk or thoughts of suicide. Call a doctor or 911, or go to a hospital emergency room, if an older person may be at risk for self-harm. Or contact the 988 Suicide Crisis Helpline by calling or texting 988 for 24/7 support.

Explore community resources. Most communities have a range of resources that can help people who are depressed. Houses of worship may provide free counselling by clergy members with special training in that field. Hospitals, clinics, and crisis or community centres may offer other treatment resources or recreation and social opportunities for older adults. And an older adult’s friends or neighbours may be able to call or visit more often if the person isn’t up for going out as much as usual.

Depression can be very frightening to older adults and their families. But with proper and timely treatment, most people can feel better and continue to lead rewarding lives at any age.