Frank is a 74-year-old widower. He used to be quite active, volunteering his time at the local community center, playing golf with his buddies at least once a week, and enjoying frequent get-togethers with his grown children and grandkids. But since his wife Ruth passed away, he’s lost all interest in getting out or seeing anyone. It’s been nine months since his loss, but Frank shows no sign of feeling better.
To his friends and family, Frank seems like a different person. He’s not the lively man they used to know, always cracking jokes, telling stories, or starting a new project. Now he seems to walk and talk in slow-motion. He doesn’t even leave home most days and he avoids phone calls and visitors. Even more concerning is his rapidly deteriorating health. Frank’s diabetes used to be under control, but not anymore. Making matters worse, he often skips meals or forgets to take his insulin shots.
Although depression in the elderly is a common problem, most seniors don't get the help they need. Some assume seniors have good reason to be down or that depression is just part of aging. Elderly adults are often isolated, with few around to notice their distress. Physicians are more likely to ignore depression in older patients, concentrating instead on physical complaints. Finally, many depressed seniors are reluctant to talk about their feelings or ask for help.
The consequences of this oversight are high. Untreated depression poses serious risks for older adults, including illness, alcohol and prescription drug abuse, a higher mortality rate, and even suicide. So it’s important to watch for the warning signs and seek professional help when you recognize it. The good news is that with treatment and support, depressed seniors can feel better. No one, whether they’re 18 or 80, has to live with depression.
Signs and Symptoms
Recognizing depression in the elderly starts with knowing the signs and symptoms. Depression red flags include:
Sadness Fatigue Abandoning or losing interest in hobbies or other pleasurable pastimes Social withdrawal and isolation (reluctance to be with friends, engage in activities, or leave home) Weight loss; loss of appetite Sleep disturbances (difficulty falling asleep or staying asleep, oversleeping, or daytime sleepiness) Loss of self-worth (worries about being a burden, feelings of worthlessness, self-loathing) Increased use of alcohol or other drugs Fixation on death; suicidal thoughts or attemptsDepression without sadness
Older adults don't always fit the typical picture of depression. Many depressed seniors don’t claim to feel sad at all. They may complain, instead, of low motivation, a lack of energy, or physical problems. In fact, physical complaints, such as arthritis pain or headaches that have gotten worse, are often the predominant symptom of depression in the elderly.
Older adults with depression are also more likely to show symptoms of anxiety or irritability. They may constantly wring their hands, pace around the room, or fret obsessively about money, their health, or the state of the world.
Helping a depressed friend or relative
The very nature of depression interferes with a person's ability to seek help, draining energy and self-esteem. For depressed seniors, raised in a time when mental illness was highly stigmatized and misunderstood, it can be even more difficult—especially if they don’t believe depression is a real illness, are too proud or ashamed to ask for assistance, or fear becoming a burden to their families. With such roadblocks, assistance from others can mean the difference between suffering and recovery.
If a senior citizen you care about is depressed, you can make a difference by offering emotional support. Listen to your loved one with patience and compassion. Don’t criticize feelings expressed, but point out realities and offer hope. You can also help by seeing that your friend or family member gets and accurate diagnosis and appropriate treatment. Help your loved one find a good doctor, accompany him or her to appointments, and offer moral support.
Other tips for helping a depressed elderly friend or relative:
Invite your loved one out. Depression is less likely when people’s bodies and minds remain active. Suggest activities to do together that your loved one used to enjoy: walks, an art class, a trip to the museum or the movies—anything that provides mental or physical stimulation. Schedule regular social activities. Group outings, visits from friends and family members, or trips to the local senior or community center can help combat isolation and loneliness. Be gently insistent if your plans are refused: depressed people often feel better when they’re around others. Plan and prepare healthy meals. A poor diet can make depression worse, so make sure your loved one is eating right, with plenty of fruit, vegetables, whole grains, and some protein at every meal. Encourage the person to follow through with treatment. Depression usually recurs when treatment is stopped too soon, so help your loved one keep up with his or her treatment plan. If it isn’t helping, look into other medications and therapies. Make sure all medications are taken as instructed. Remind the person to obey doctor's orders about the use of alcohol while on medication. Help them remember when to take their dose. Watch for suicide warning signs. Seek immediate professional help if you suspect that your loved one is thinking about suicide.
