Diagnosis, treatment, and lifestyle changes can help ease symptoms of depression in older adults and improve their quality of life.

It’s not uncommon for adults to begin experiencing symptoms of depression such as sadness or loss of interest in activities as they grow older.

Life changes, medications, or chronic health conditions can often trigger depressive symptoms in adults 65 years old and older. Symptoms can sometimes be overlooked because they can mimic the natural stages of life.

But depression is not a natural part of the aging process.

If you’re 65 years old or older, sharing your symptoms can be a crucial first step in getting an accurate diagnosis and a treatment plan that works best for you and any other conditions you may have.

Depression is one of the most common mental health conditions. The National Institutes of Mental Health (NIMH) estimates that 21 million (8.4%) adults in the United States will have at least one major depressive episode.

It’s estimated that less than 1% to 5% of older adults live with major depression, according to the Centers for Disease Control and Prevention (CDC). This number can increase to about 11.5% for hospitalized patients and about 13.5% for those who require home health assistance.

If you or an older adult you know live with depression, they may experience symptoms such as:

  • loss of pleasure
  • changes in eating habits
  • changes in sleeping habits
  • not feeling “up” to seeing people
  • feelings of worthlessness
  • extreme fatigue
  • poor concentration
  • forgetfulness
  • suicidal thoughts

These symptoms can range in intensity, from mild to severe, and last 2 weeks or longer.

While the symptoms of depression primarily look the same regardless of age, there are some differences.

According to the National Institute on Aging (NIA), sadness may not be the primary symptom in older adults.

An older adult may say they “feel numb” or show a lack of interest in activities they once enjoyed. Some may not show symptoms at all.

The American Psychological Association (APA) suggests that older adults may experience some symptoms — such as indecisiveness, memory loss, and slowed responses — more intensely than younger people.

Because these symptoms can interfere with daily life skills such as driving, it’s crucial not to ignore them.

Cultural influences

Cultural influences can also affect how depression is expressed in older adults.

  • In some cultures, it’s more acceptable to talk about physical symptoms, such as stomach aches, than to share emotional ones.
  • According to Mental Health America, Black Americans may not report symptoms if they view mental health conditions as “a personal weakness.”

Depression vs. dementia

Symptoms of depression, particularly memory loss and lethargy, are also symptoms of dementia. Depression can also be an early sign of possible dementia.

If you or an older adult is experiencing any of these symptoms, having an evaluation by a healthcare professional is crucial to getting an accurate diagnosis and treatment.

While there’s no exact cause of depression, there are factors that can contribute to the condition:

  • low serotonin and norepinephrine levels
  • traumatic childhood events
  • environmental triggers
  • genetics
  • family history

For folks 65 years old and over, the following factors may also play a role:

  • retirement
  • empty nest
  • isolation
  • decrease in physical strength or ability
  • bereavement or widowhood
  • substance use
  • low household income

Medical risks for seniors

People who also have chronic conditions such as heart disease or stroke have an increased chance of depression.

According to the National Council on Aging, about 80% of older adults have at least one chronic condition. Nearly 70% of those who receive Medicare — a government insurance provider — have two or more.

This makes older adults more likely to have symptoms of depression. Other contributing factors include:

  • decreased folate levels
  • specific heart medications such as beta-blockers and angiotensin converting enzyme (ACE) inhibitors

A 2022 study of people ages 55 to 75 years old found that long-term health conditions had a strong impact on depression in older adults and vice versa.

Researchers also found that a fear of worsening health associated with a long-term health condition decreased independence for some, making their depression symptoms even worse. Many reported withdrawing socially, which prevented them from seeking help and getting treatment.

This study was based on self-reporting so more research is needed.

You’ll likely see a healthcare professional for an initial diagnosis. They may ask you about your medical history and symptoms and get a list of medications.

They may also do laboratory tests to determine any underlying causes of your symptoms, such as medication or another condition.

You may then be referred to a mental health professional for a psychological evaluation.

If you’ve experienced symptoms of depression every day for over 2 or more weeks, you might meet the criteria for a diagnosis of depression based on guidelines from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).

Symptoms can look different from person to person. You might not experience the same symptoms, or the same intensity of symptoms, as someone else.

Treatment for depression often involves a combination of medication and therapy.

  • Medications, such as antidepressants, may be recommended to help regulate mood. Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for older adults. Research from 2019 supports SSRIs for Alzheimer’s disease and depression if you have both conditions. A healthcare or mental health professional will work with you to monitor any side effects or possible interactions if you’re taking other medications.
  • Psychotherapy, or talk therapy, provides a safe space for you to talk through factors related to depression, including how you relate to others, how to manage negative thoughts, and ways to release your emotions safely. A 2017 review suggests that talk therapy can be adapted to meet the particular needs of older adults. Virtual therapies can be effective for older adults who find it difficult to leave home.

As a caregiver or friend of an older adult with depression, you can be supportive by helping to facilitate a healthy lifestyle. You might try offering to:

  • take them to visit a healthcare professional
  • check out community centers for exercise programs geared toward older adults
  • keep track of medicines and medical appointments
  • ask them to go on a walk or a bike ride
  • facilitate virtual appointments and social gatherings
  • help with healthy meal prep
  • research ways to pay for healthcare

You may also find some helpful resources by checking out the following organizations:

You can also check out Psych Central’s hub on depression for more information and resources.

If you or a senior adult you know is living with depression, you’re not alone. Help is available.

Sometimes, it’s easiest to talk with a trusted friend or caregiver about your symptoms and then seek an evaluation from a healthcare or mental health professional.

Treatment can ease symptoms of depression and improve your quality of life, no matter your age.