Condition Basics

What is depression?

Depression is a mental health condition that causes you to feel sad, lose interest in activities that you used to enjoy, withdraw from others, and have little energy. It's different from normal feelings of sadness, grief, or low energy. Depression can also cause people to feel hopeless about the future and to even think about suicide.

It is not a character flaw, and it does not mean that you are a bad or weak person.

Depression is very common. It affects people of all ages.

If you think you may be depressed, tell your doctor. Treatment can help you enjoy life again.

What puts older adults at risk for depression?

Both older and younger adults go through the same major life changes or challenges that may lead to depression. These include medical problems, life events, and having a family history of depression.

But some events are more common in older adults. This includes things like losing a spouse, living with a long-term health problem, or leaving a home you've lived in for years. And like others who experience a life change, older adults may feel sad and may grieve and recover, or they may develop depression.

Some older adults are more likely to be depressed than other older adults. Those who are more likely include:

• Older women.
• Those who are not married or who've lost their partner.
• Those who don't have friends or family to support them.
• Those who've had a medical problem such as a heart attack, stroke, or broken hip or who have chronic pain.
• Those who drink too much alcohol.

What are the symptoms?

Common symptoms of depression, such as sadness and loss of interest, occur in older adults just as they do in other adults. But older adults also may feel confused or forgetful and stop seeing friends and doing things. They may also have a hard time sleeping and may not feel like eating.

How is it diagnosed?

If your doctor thinks you are depressed, the doctor will ask you questions about your health and feelings. Your doctor also may:

• Do a physical examination.
• Do tests to make sure your depression is not caused by another medical problem. For example, your doctor may look for signs of a stroke, dementia, an underactive thyroid (hypothyroidism), vitamin B12 deficiency, or anemia.
• Ask you about thoughts of suicide.

But depression often is missed in older adults. This may be because:

• People may think that sadness or depression is part of aging.
• The symptoms of depression in older adults are sometimes like symptoms of other diseases. So depression may not be recognized.
• Many older adults take many medicines, and certain medicines may cause symptoms that are similar to the symptoms of depression. Think about having a medicine check-up with your healthcare provider.
• Older adults may not seek help for depression.

How is depression treated in older adults?

Depression is usually treated with supportive activities, counselling, therapy, medicine, or a combination of these. Treatment usually works.
For mild or short-term symptoms in older adults, first try supportive activities. This could include exercise, talking about memories, virtual visits, gardening, and social groups. For severe symptoms and those that last longer, sometimes antidepressant medicine may be used.

Older adults may have special concerns when using medicine.

• Some of the medicines used for depression may interact with medicine being taken for other health problems.
• The side effects of medicines may be more severe.
• In older adults with dementia, there is limited evidence to recommend antidepressant medicines for mild to moderate depression.
• Some antidepressants may take longer to start working in older adults than in younger adults.

A caregiver or family member may need to help the older adult remember to take the medicines.

How can you care for yourself?

You can try many things to help yourself when you feel depressed. These things may also help lower the chance of depression coming back.

• Get regular exercise. Even something as easy as walking can help you feel better.
• Eat a balanced diet.
• Get enough sleep.
• Avoid drinking alcohol, using drugs, or using medicines that have not been prescribed to you.
• Think positively. How you think can affect how you feel.
• Get support from others.

Taking good care of yourself is important as you recover from depression. Be sure to make and go to all appointments, including counselling. If your doctor prescribed medicines, take them exactly as they are prescribed. And call your doctor if you are having problems.