10 Signs of Depression in Older Adults

1 in 4 older adults report
having depression or anxiety.

May is National Mental Health Awareness Month (MHAM). People don’t talk about the mental health of older adults much.

Discover the ten signs that indicate an older adult is depressed, common causes for depression and how you—as an involved family member or friend—can help.

“I’m not sad, my body just hurts.”

Depression in older adults is not a normal part of aging, but it is a common experience. Identifying and treating depression in an older adult can be complicated since the older adult may have a stigma attached to depression, seeing it as a taboo topic, a sign of mental illness or weakness. Additionally, the signs of depression in an older adult may not look like the signs that show up in other age groups. 

According to the National Institute of Mental Health, depression in an older adult may look like: 

  1. Persistent sad, anxious, or “empty” mood
  2. Being grumpy or irritable
  3. Feel confused or struggling to pay attention
  4. Loss of interest or pleasure in hobbies and activities
  5. Moving or talking more slowly
  6. Having a change in weight or appetite
  7. Feelings of guilt, worthlessness, or helplessness
  8. Difficulty sleeping, early-morning awakening, or oversleeping
  9. Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment
  10. Having suicidal thoughts
According to the NIMH, if these signs and symptoms show up most of the day, nearly every day, for at least two weeks it may be a sign of depression.

Depression can also be an early sign of dementia. To make things more complicated, dementia can cause some of the same symptoms as depression. It is also common for people with Alzheimers and related dementias to suffer from depression. So in short, depression may be a sign of the onset of dementia or dementia may be causing some symptoms that look like depression.

For those who love and care for older adults, these issues are particularly important to pay attention to since older adults have one of the highest suicide rates in the nation. In fact, white males 85+ years old complete suicide at 4 times the rate of the general population. We highlight this because we don’t believe it’s common knowledge, but important to know.

Three reasons why an older adult may be depressed

  1. People who are isolated or lonely are more likely to experience depression, cognitive decline, dementia and Alzheimer’s disease. In fact, prolonged isolation can be as bad for your health as smoking 15 cigarettes a day!
  1. Older adults frequently find themselves in a season of loss. It may be loss of independence, mobility, health, a long-time career, or someone they love. 
  1. Dealing with chronic medical conditions like: Parkinson’s disease, Stroke, Heart disease, Cancer, Diabetes, Dementia and Alzheimer’s disease, Multiple sclerosis (MS) among others, particularly when painful, disabling, or life-threatening, can lead to depression or make depression symptoms worse.

In a season marked by loss, it can be difficult to tell the difference between someone who is grieving and someone who is depressed. This article from helpguide.org provides some valuable information about grief vs depression, depression vs dementia as well as detailed self-help suggestions. 

What you can do if you think the older adult may be depressed or at risk of becoming depressed

  • Take this quiz (page 7&8) to determine the level of risk for social isolation.
  • Enlist the help of the older adult’s primary care physician and specifically ask them to do a screening for depression.
  • Explore the topic with them. Dawn Carr, PhD, an associate professor of sociology at Florida State University’s Pepper Institute for Aging and Public Policy says, “The most important thing is to be able to develop a relationship where you can talk through and normalize the depression symptoms”. 

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 lately?”
  • “You don’t seem like yourself today. What’s on your mind?”

There are many reasons for hope.

Depression, even the most severe cases, can be treated. The earlier that treatment can begin, the more effective it is. Depression is usually treated with medications, psychotherapy, or a combination of the two.

Treatment is usually covered by private insurance and Medicare. Also, some community mental health centers may offer treatment based on a person’s ability to pay.

Equally important is to remember to care for your own mental health. You must care first for YOU so that you can even begin to show up well for the people you love in your family circle.

Can I just say, “Good work!” to you? Here you are loving the older adults in your family circles, not only through a pandemic, but through the bumps and turns in your own life. Through it, you are paying thoughtful attention, caring and advocating well. 

This is dedicated to my Uncle Howard, whose huge heart matched his huge smile.

If you or someone you care about is in crisis, please seek help immediately.

  • Call 911
  • Visit a nearby emergency department or your health care provider’s office
  • Call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (4889) to talk to a trained counselor
  • Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.
  • Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.