Ask the Expert
Hello in There: Depression and Older Adults
By Nora Howley
Periodic doldrums are normal, but 6.5 million of the 35 million Americans over the age of 65 experience more than routine sadness. They’re depressed. Their feelings can represent a lifetime of depressive episodes, or be new. And when it comes to older adults, the dependency that can come with depression can be mistaken for normal aging. Either way, it is good to know the signs of this treatable condition.
What is depression?
It’s when sadness interferes with normal daily life and "causes pain for both the person with depression and those who care about him or her," according to the National Institutes of Health.
Alone, the changes that come from aging can cause disequilibrium, sadness, and grief. Retirement, the death of a loved one, changes in health, moving, or other major shifts can compound the problem. Many people process change and "bounce back." For others, the feelings become cemented, affecting their daily lives and those around them.
Women are more likely to be depressed, with evidence suggesting older women face the highest risk. Several factors could be responsible, including hormonal changes, family responsibilities, outliving friends and family, and other factors.
Symptoms of depression
Depression isn’t always easy to identify. A person who appears depressed may be unable to identify their feelings, and may deny feeling depressed. Common symptoms, according to The National Alliance on Mental Illness, include:
• Memory problems and social withdrawal
• Loss of appetite
• Physical ailments, such as headaches and digestive problems
• Insomnia and irritability
• Loss of interest in previously enjoyable activities
These symptoms may signal other health problems, or be a response to medication, so it’s sometimes difficult to discover whether another health-related issue is to blame.
The first step is a full medical exam by a physician or nurse practitioner specializing in geriatric medicine. In addition to certification in gerontology, these physicians are board certified in either internal medicine or family practice. Nurse practitioners are identified by the certification GNP-BC or Gerontological Nurse Practitioner-Board Certified.
Once physical ailments have been ruled out, the health care provider can provide a referral to a mental health professional—a psychiatrist, psychologist, or counselor—who can determine if the problem is depression and recommend treatment. Often, the ailment can be treated with psychotherapy and/or medication prescribed by a physician.
If medication is prescribed, health care professionals must be informed of all other medications to avoid adverse drug interactions. As a rule, older adults should bring a list of all medications to medical appointments and keep the list current and available at all times. A pharmacist should review the list as new prescriptions are filled, and provide information about any medicines that may have undergone a change.
Grief and sadness are normal reactions to the changes that come with age, but they shouldn’t interfere with life. When they do, it is wise to look for depression, treat it, and get back to living a full, active, and joy-filled life.