Depression and aging: Signs, causes, and treatment

Some people think depression is a normal part of getting older, but this isn’t true. Normal means something is expected, and depression is not an expected part of aging. Aging and depression are often related due to changes in health, cognitive abilities, independence, or social life, but that doesn’t mean it's normal. Rather, depression is a growing health problem worldwide, affecting on average, about 31% of older adults.

Depression at any age is serious. It can disrupt several aspects of life, including memory, energy, appetite, sleep, and physical activity. Depression at older ages is associated with serious consequences, including, falls, disability, increased use of medical services, frailty, and the worsening of health problems.

Depression in later life is underdiagnosed, so many people do not receive treatment. If left untreated, depression may resolve, but most of the time, it can become more severe. It’s important to understand the symptoms and seek help to maintain independence, health, and quality of life.

If you’re experiencing symptoms of depression, you are not alone. Depression is treatable, so reach out to your healthcare provider to talk through options such as medication, therapy, and lifestyle changes.

What are the symptoms of depression in seniors?

Depression doesn’t just mean feeling sad. Instead, depression is a combination of emotional, mental, and physical symptoms.

Depression symptoms can vary widely from person to person. It’s important to talk to your healthcare provider in order to receive a diagnosis.

According to the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-5), depression is diagnosed when 5 (or more) of the following symptoms are present:

At least 1 major symptom:

Persistent sadness: This can mean feeling sad, down, hopeless, or just feeling "off" most of the time.
Loss of interest: Things you used to enjoy, like spending time with friends or family, or hobbies, no longer seem fun or interesting.

Other symptoms:

Trouble sleeping or oversleeping
Fatigue or low energy
Changes in appetite or weight
Physical symptoms like headaches or body aches
Difficulty thinking clearly or making decisions
Memory issues
Feelings of guilt, worthlessness, or self-blame
Thoughts of death or suicide
- These thoughts can range from passive ideas such as “I wish I weren’t here anymore” to more active thoughts of taking your life and devising a plan for this (e.g. overdosing), and having the means to carry out the plan (collecting pills). If you experience suicidal ideations, such as thoughts and plans of taking your life, it's important to seek help right away.
- Talking about feelings of suicide is not going to make you hurt yourself—this is a myth. Talking about your feelings can save your life. Reach out to a trusted friend, let your primary care doctor know what is going on. If you need urgent help, call or text 988 (the National Suicide Prevention Lifeline), visit 988lifeline.org, or call 911 for immediate assistance.

Many people ask, at what age does depression start? The truth is, it can happen at any age. Older adults may experience specific circumstances that are known to be associated with depression, such as loss of loved ones, retirement and other life transitions like loss of income, chronic health problems, and social isolation.

If you’re depressed about aging, retirement, or physical decline, these feelings are valid, but you don’t have to deal with them alone. Talk to your healthcare provider about how you are feeling. Your provider can determine if you should be diagnosed with depression and discuss treatment options with you.

When is it time to get help?

If symptoms last more than 2 weeks and affect your daily life, it’s time to reach out to your healthcare provider. If you are feeling suicidal, reach out immediately. Depression rarely gets better without support. The sooner you reach out, the sooner you’ll be able to feel better especially because it takes longer to recover when symptoms are severe or longstanding.

Think about which symptoms you have. Tell your healthcare provider exactly how you’ve been feeling. They can point you in the right direction to begin a treatment plan. If you have Medicare, talk to your provider about what’s covered. Most older adults have Medicare part B, which offers one free depression screening every year. Many counseling and treatment services and medications are covered by Medicare too. Seek help through your health plan or provider.

What leads to depression?

Depression doesn’t have a single cause. Instead, certain factors, known as risk factors, are linked to a higher chance of developing it. These factors don’t cause depression on their own, but they’re often associated with depression. Risk factors for depression include:

Genetics: Research shows that multiple genes are associated with depression, but no single gene has been identified as the cause. If depression runs in your family, your risk is higher, but this does not necessarily mean you will develop depression.
Biological changes: Depression and physical health problems influence each other. People with depression are more likely to develop obesity, diabetes, heart disease, stroke, and brain conditions. At the same time, these medical conditions can raise the risk of becoming depressed, especially in later life. Hormonal changes and imbalances in brain chemistry also play a role in depression.
Environmental factors can lead to depression. Triggers may include:
- Loneliness
- Financial problems
- Discrimination
- Health issues
- Lack of sunlight
Psychological factors: Low self-esteem, perfectionism, or negative thought patterns can contribute to depression. Aging-related changes, like retirement or grief, social isolation, can also increase risk.

Depression and other conditions

Depression often shows up alongside other medical problems which can be more common with age. These include:

Hearing loss and depression: Trouble hearing can lead to social isolation, which can lead to higher risk of depression. Hearing loss, depression and social isolation can also contribute to cognitive decline.
Parkinson’s and depression: Changes in the brain caused by Parkinson’s disease can lead to symptoms of depression— about 38% of people with Parkinson’s experience depression.
Dementia and depression: Many people with memory issues also feel depressed. Cognitive symptoms of depression (like memory trouble, poor reasoning, or slowed thinking) are especially common in older adults. Sometimes, when depression is very severe in older adults, it can mimic dementia.
Chronic pain and depression: Pain makes it harder to sleep and socialize, creating a cycle that can worsen mood.
Other mental health problems: Depression and anxiety often occur together. Depression may also occur in the context of post-traumatic stress disorder. People with a history of trauma and abuse are also more likely to become depressed.

The special case of late-life depression

Late-life depression happens in people older than 65 with no previous history of depression. It can be linked to genetics, aging, and health problems like inflammation, diabetes, heart disease, high blood pressure, or obesity, many of which start in mid-life. These conditions can raise the risk of depression. For some people, late-life depression is associated with developing dementia including Alzheimer’s disease.

How is depression in older adults treated?

Your healthcare provider can help you find a treatment plan, so you can start to feel better. Common treatments include:

Psychotherapy (talk therapy): Meet with a trained therapist to talk through challenges and learn coping skills. There are specific therapies for depression that are highly effective, such as cognitive-behavioral therapy. Psychotherapy can happen in person or online.
Medication: Antidepressants can help balance brain chemicals that affect mood. Some people benefit from other types of medications such as antipsychotics, mood stabilizing medications, or psychedelics. Your doctor or psychiatrist will help find the right option for you.
Brain stimulation: When other treatments don’t work, options like electroconvulsive therapy (ECT) or magnetic pulses can help the brain change and improve mood.
Lifestyle changes:
- Exercise: Moving your body boosts mood and energy. Try a short walk or an online exercise class with Bold.
- Nutrition: Eat regular, balanced meals with fruits, vegetables, fiber, and lean protein. Limit sweets and do not use alcohol to soothe how you feel.
- Sleep: Stick to a consistent sleep schedule. Avoid screens, caffeine, and alcohol late in the day. Try to get 7 to 9 hours of sleep daily.
- Stay connected: Reach out to friends or loved ones, even if you don’t feel like it.
- Mindfulness and relaxation: Try meditation, breathing exercises, or gentle yoga like with Bold’s relaxation classes.

Remember that you are not alone. Reach out to your doctor, ask about a screening, and take the first step toward feeling better. Check if you’re eligible for Bold at no cost through your health plan to bring movement into your routine and boost your mood.