Know an Older Adult With Depression? Here’s How You Can Help

Find out how to spot depression in older adults, and learn what you can do if you know someone who needs help.

What Does Depression Look Like in an Older Adult?

Depression can look a little different and therefore be harder to spot in an older person compared with someone younger because their everyday activities are often different, says Dawn Carr, PhD, a professor of sociology at Florida State University’s Pepper Institute on 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 [other] people to not be able to notice,” Dr. Carr says.

Social isolation is a common trigger and sign of depression among older adults, she says. “[Depression is] 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,” says Carr.

Depression may show up physically, too, says Sheila Babendir, EdD, a licensed professional counselor and the dean of the College of Social and Behavioral Sciences at the University of Phoenix in Arizona. “Appetite lessens, they may want to sleep more, and they don’t have motivation,” Dr. Babendir says. “They may not feel as sad or blue, but it might manifest as feeling less energized.”

• Personality changes
• Memory problems
• Physical aches or pain
• Fatigue or sleep problems not connected to medication or illness
• Often staying at home and not socializing or trying new things

Why Depression May Be Overlooked in Older Adults

There are many other reasons depression may go unnoticed both by older adults themselves and the people closest to them, says Jessica Levin Bozek, a licensed professional counselor in Scottsdale, Arizona. She cites these examples:

• They may assume their feelings are normal or that they have a good reason to feel down.
• They could be isolated, which may lead to depression. And if an older adult 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.

What Are the Most Common Causes of Depression in Older Adults?

For older adults in particular, loss is another common challenge that can lead to or worsen depression. “Losses can also trigger adjustment reactions that worsen into major depressive episodes,” says David Merrill, MD, PhD, an adult and geriatric psychiatrist and director of the Pacific Neuroscience Institute’s Pacific Brain Health Center in Santa Monica, California.

Types of loss that commonly affect older adults, Dr. Merrill says, include:

• Loss of a spouse, an adult child, or other loved ones
• Loss of their role in the workplace
• Loss of previous personal health
• Loss of prior capabilities like running or playing sports or games that they used to love

How to Help an Older Adult With 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. Levin Bozek agrees, saying that one of the biggest challenges to getting the conversation started may be 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 [if] you’re sick in your head, and there’s a stigma associated with that thinking,” says Levin 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 these days?
• You don’t seem like yourself today. What’s on your mind?

How to Prevent Depression in Older Adults

• Staying physically active and maintaining a healthy diet, which can help reduce risk of other illnesses that could lead to disability or depression
• Getting seven to nine hours of sleep every night
• Staying connected with friends and family to avoid isolation
• Doing activities that make them happy
• Telling family, friends, or a healthcare provider if they’re developing depressive symptoms (depression is easier to treat before it escalates, says Merrill)

Additional reporting by Julia Métraux.