Depression in older people

What is depression in older people?

Depression is a mental health condition that can affect people of all ages. While it is normal to feel down sometimes, if you feel this way for 2 weeks or more, or your mood is affecting your ability to cope with everyday life, you may be experiencing depression.

Sometimes older people can think that symptoms of depression occur because of their age, poor health or dementia. Some older people prefer not to talk about depression, feel a sense of shame, or don’t like to admit that they’re not coping. Sadly, this can lead to their not seeking help, or delaying assessment and treatment for a long time.

People who develop depression when they are over 60 often have other medical conditions. It is unusual for someone in good health to develop depression for the first time when they are over 60 — but this can happen for some people.

This page is about depression in older people; however, many aspects and risk factors are not age-specific. Go here for more general information about depression.

How common is depression in older people?

More than 1 in 10 older people, and more than 3 in 10 people living in residential aged-care, experience depression.

It’s important to remember that not all older people become depressed, and just because you are older, you don’t need to accept that you will become depressed, or that your depression can’t be treated.

What causes depression in older people?

The 3 main causes of depression in older people are poor physical health, social isolation and loss in old age.

Poor physical health

Physical illness can cause depression both directly and indirectly. Medical conditions such as vitamin deficiencies, cancer, thyroid disease, and even infections can change the way your body works and so cause depression.

Other medical conditions that make it harder for you to manage by yourself — such as arthritis and reduced mobility — can mean that you need to ask for more help from other people.

Loss of independence and dignity can sometimes cause depression too. Sometimes the medicines you take can play a part in depression, especially blood pressure medicines, steroids, and pain medicines.

Social isolation

People can sometimes become isolated from their friends, family or communities as they age. This may be due to friends and peers passing away, or because they find it harder to get around to visit people.

The COVID-19 pandemic has caused disruption for many people, who may have been away from friends and family for a long time, leading to an increased risk of depression.

Loss in old age

Older people tend to experience intense periods of loss as they get older. This can be loss of family members or friends, and can also involve loss of their health, their pets or their home. While some people cope well with these difficult circumstances, the experience of repeated loss can sometimes cause depression.

What are the signs of depression in older people?

The signs of depression in older people are different from those seen in younger adults and children. Older people are less likely to talk about the emotional symptoms of depression, such as feeling down or uninterested in activities. This might be because of old stigmas around mental health or because people sometimes find it hard to admit that they are not coping by themselves.

Older people may experience physical symptoms, but you may not realise that your physical complaints are signs of depression. These might include dizziness, aches and pains, weight loss and difficulty sleeping or staying asleep (insomnia).

Memory loss can also be a sign of depression, and if this is the case, treatment for depression can help improve your memory.

Sometimes older people or people close to them notice changes in behaviour, which can be a sign of depression. These include:

• not leaving the house
• not enjoying the things they once enjoyed doing
• not eating
• drinking more alcoholic drinks than normal
• hoarding unimportant items

Another sign of depression is thinking a lot about the end of your life. You may find yourself giving away personal possessions, changing your will, or talking a lot about death. This can be a sign of suicidal thoughts and should be taken very seriously.

When should I seek help?

If you — or someone close to you — shows signs of depression for 2 weeks or more, or you are concerned that you may have depression, you should speak to your doctor. They will assess you for depression and build a mental health treatment plan together with you. This is a plan that maps out your treatment goals and includes the services and resources available to you.

If your doctor thinks that other health professionals should be involved — such as a psychologist or psychiatrist who specialises in treating older people — they will be able to refer you to someone who can help.

How can I help an older person with depression?

If you think an older person whom you know may be experiencing depression, you can help them by discussing it with them and supporting them.

Many older people feel a stigma attached to depression and may think that depression is a personal weakness rather than a medical condition. You can encourage them to speak to their doctor and explain to them that being older does not mean that their depression can’t be treated.

Loneliness is a major cause of depression for older people. Taking the time to chat with them or arranging a visit can help reduce their social isolation and prevent depression.

How is depression in older people treated?

Your doctor can help build a mental health treatment plan with you. This may include a variety of different treatment strategies and tools. Older age does not make treatments for depression less effective.

Your doctor may recommend physical treatments for depression. Some antidepressant medicines that work for older people can be very effective, especially for people with severe depression.

Electroconvulsive therapy (ECT) is only used to treat some types of severe depression if medicines have not helped or if your symptoms are severe.

Psychotherapy, such as cognitive behavioural therapy (CBT), is popular, proven and an effective intervention for depression. If you have hearing difficulties, are vison-impaired or have other needs, let your therapist know so they can adapt your treatment treatment.

Self-help, alternative and complementary therapies can also be useful for older people with mild or moderate depression, such as:

• spending time with friends, family or the community.
• being physically active, either alone or with a group.
• participating in music therapy designed for people with depression