Depression in Older Adults

Over six million Americans 65 and older are affected by late life depression but only 10% ever receive treatment. Why? Because many people think that depression is a normal part of aging. Due to the many health challenges older adults face, neither they nor their families recognize the symptoms of depression or mistake them as signs of other conditions that plague the elderly: Alzheimer’s and other forms of dementia; arthritis, cancer, heart disease, stroke, etc.

If depression goes untreated, older adults face increased risks of additional illnesses and cognitive decline. The elderly are much more likely to seek treatment for other physical ailments than they are for depression and the symptoms for depression for them can be different than for those who are younger.

The best way to determine if someone is depressed is with a physical exam which includes a review of all medications, plus a clinical and psychiatric interview. Blood tests and imaging studies, such as a CT scan, can eliminate other medical conditions that require different treatments.

Fortunately, treating older adults for depression does help. In fact, 80% of those who are clinically depressed can be successfully treated with medication, psychotherapy, electroconvulsive therapy or a combination of the three.

Risk Factors

• History of depression
• History of anxiety, eating disorders or PTSD
• Family history of depression, bipolar disorder, substance use disorder or suicide
• Diagnosed with a serious medical condition such as diabetes, cancer, heart disease, kidney disease, stroke, thyroid disorder, vitamin B12 deficiency, lupus, MS, Parkinson’s or substance use disorder
• Family history of vascular illness
• Recent traumatic or stressful event(s)

Signs of Depression in Older Adults

• Sadness or feelings of despair
• Unexplained or aggravated aches and pains
• Loss of interest in socializing or hobbies
• Neglecting personal care
• Weight loss or loss of appetite
• Feelings of hopelessness or helplessness
  Lack of motivation and energy
• Sleep disturbances
  Worries about being a burden
• Slowed movement and speech
  Increased use of alcohol or other drugs
  Fixation on death; thoughts of suicide
  Memory problems
• Confusion
• Irritability
• Delusions
• Hallucinations

Checklist: What To Ask…

• Are you basically satisfied with your life?
• Have you dropped many of your activities and interests?
• Do you feel that your life is empty?
• Do you often get bored?
• Are you in good spirits most of the time?
• Are you afraid that something bad is going to happen to you?
• Do you feel happy most of the time?
• Do you often feel helpless?
• Do you prefer to stay at home, rather than going out and doing new things?
• Do you feel you have more problems with memory than most?
• Do you think it is wonderful to be alive now?
• Do you feel pretty worthless the way you are now?
• Do you feel full of energy?
• Do you feel that your situation is hopeless?
• Do you think that most people are better off than you are?