Depression in seniors is a common problem. Our physical health, brain health, independence, and social life change as we age, which can put us at higher risk for depression. But that doesn’t mean it's normal to be depressed as we get older. You don’t have to suffer through it. 

Depression at any age is serious. It can affect memory, energy, appetite, sleep, and physical activity. Depression at older ages is linked to problems like falling, disability, frailty, low resistance to illness, and health problems getting worse. It’s also under-diagnosed. This means that many people don’t get help for their depression.

Depression is treatable. Knowing the symptoms of depression can help you understand when you need help. Treating depression can help you stay independent and healthy, with a higher quality of life.

If you’re dealing with any symptoms of depression, you are not alone. Keep reading to learn more about causes, symptoms, and treatment options.

What are the symptoms of depression in seniors?

Depression isn’t just feeling sad. It’s a mix of emotional, mental, and physical symptoms. These symptoms can vary widely from person to person. It’s important to talk to your healthcare provider to get a diagnosis. Depression can happen at any age. Older adults go through plenty of things linked to depression, such as:

• Losing loved ones
• Retiring
• Losing income
• Living with chronic health problems
• Social isolation

Depression is diagnosed when you have 5 (or more) of the following symptoms:

At least 1 major symptom:

1. Persistent sadness: This can mean feeling sad, down, hopeless, or just feeling "off" most of the time.
2. Loss of interest: When things you used to enjoy no longer seem fun or interesting (like hobbies or spending time with loved ones)

Other symptoms:

• Trouble sleeping enough or sleeping too much
• Fatigue or low energy
• Changes in appetite or weight
• Physical symptoms like headaches or body aches
• Trouble thinking clearly or making decisions
• Memory problems
• Feeling guilty or worthless
• Feeling hopeless about the future

Another very common symptom: Thoughts of dying, hurting yourself, or suicide. These thoughts can range from passive ideas like “I wish I weren’t here anymore” to more active thoughts of taking your life and planning to do so. If you have recurring thoughts about suicide or plans about taking your life, get help right away. You can:

• Call 911
• Call or text 988 (the National Suicide Prevention Lifeline)
• Visit 988lifeline.org
• Always let your doctor know

It’s completely normal to struggle with the challenges related to aging, retirement, or physical changes. And you don't have to deal with these feelings alone. Talk to your care team about how you are feeling. Your provider can help figure out your options to get help. 

When should seniors get help for depression?

Seniors should get help for depression if they notice:

• Symptoms lasting 2 weeks or longer
• Symptoms affecting their daily life, such as a low desire to get out of bed, go to work, do things around the house, socialize, and bathe or shower. 

The first step to getting help: Reach out to your health care team. The sooner you reach out, the sooner you’ll be able to feel better. Don’t let your symptoms worsen because it takes longer to get better the longer you are depressed.

Think about which symptoms you have. Tell your provider exactly how you’ve been feeling. They can help you make a plan to get help.If you have Medicare, talk to your provider about what’s covered. Most older adults have Medicare Part B, which covers one free depression screening every year and many treatment options.

What causes depression in seniors?

Depression doesn’t have one single cause. Instead, certain things are linked to a higher chance of getting it. These are called risk factors. Risk factors for depression include:

• Genetics: There’s no one “depression gene.” If depression runs in your family, your risk is higher (but it doesn’t mean you’ll definitely get depression).
• Health problems: Depression and physical health problems are linked. People with depression are more likely to develop:
• • Diabetes
  • Heart disease
  • Stroke
  • Obesity
  • Brain conditions

Having these medical conditions can raise your risk of getting depressed, especially in later life. Depression is also linked to hormone changes and brain chemistry. 

• Environmental factors (external influences). Triggers may include:
• • Loneliness
  • Financial problems
  • Discrimination
  • Health issues
  • Lack of sunlight
• Mental health issues can also contribute to depression:
• • Perfectionism
  • Low self-esteem
  • Negative thought patterns
  • Grief

Depression and other health problems

Depression often shows up alongside other health problems. Some of these health problems are more common with age, like: 

• Hearing loss and depression: Trouble hearing can lead to social isolation and a higher risk of depression (and declining brain health). People with hearing loss sometimes withdraw from social activities because they have difficulty participating in conversations, and this can lead to social isolation.
• Parkinson’s and depression: About 38% of people with Parkinson’s have depression.
• Dementia and depression: Many people with memory issues also feel depressed. Symptoms of depression (like memory trouble or slowed thinking) are very common in older adults. Sometimes, when depression is very serious in older adults, it can look like dementia. Many people with dementia (severe memory loss) are prone to depression, but their depression can still be treated to improve quality of life. 
• Chronic pain and depression: Pain makes it harder to sleep and socialize. This creates a cycle that can worsen mood.
• Other mental health problems: Depression and anxiety often happen together. People with post-traumatic stress disorder (PTSD) or a history of trauma or abuse are more likely to get depressed. 

What is late-life depression?

Late-life depression is when people older than 65 with no previous history of depression develop the condition. It can be linked to:

• Genetics 
• Health problems like diabetes, heart disease, high blood pressure, or obesity

For some people, late-life depression is linked to developing dementia (including Alzheimer’s disease).

How is depression in older adults treated?

There are lots of treatment options for depression in seniors. 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 about what’s going on and learn coping skills. There are therapies proven to work for depression, such as cognitive behavioral therapy (CBT). You can meet with a therapist in person or online.
• Medication: Antidepressants can support your brain chemistry and help you feel better. Some people may need other types of medications like antipsychotics, mood stabilizers. Ketamine and psychedelics are recent new options for some people. They usually are not first line treatments, and  these treatments must be monitored very closely by a psychiatrist. Your doctor or psychiatrist will help find the right option for you.
• Brain stimulation: When other treatments don’t work, there are options like electroconvulsive therapy (ECT) or magnetic pulses. These help your brain change and can improve your 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 alcohol use or cut out drinking altogether. 
  • Sleep: Stick to a regular 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.

The bottom line

Depression is common and treatable. Help is available, and you are not alone. If you’re struggling, reach out to your doctor to take the first step toward feeling better.  Don’t let depression get worse—reaching out sooner is better than waiting. Check if you’re eligible for Bold at no cost through your health plan to bring movement into your routine and boost your mood.