What is depression in older adults?

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.

As in younger adults, depression in older adults is treated with medicine, counseling, therapy, or a combination of these. Treatment for depression also may help other medical problems that older adults have. And older adults may benefit from early, continuing, and long-term treatment.

Older adults may have special concerns when using medicine.

• Some of the medicines used for depression may not be good choices. This is because they may interact with medicine being taken for other health problems.
• The side effects of medicines may be more severe.
• Some antidepressants may take longer to start working in older adults than in younger adults.
• Older adults may need medicine for a longer amount of time than younger adults.

Many older adults don't take all the medicines they need for depression. A caregiver or family member may need to help the older adult remember to take the medicines.

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 exam.
• 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), or vitamin B12 deficiency 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.
• Older adults may not seek help for depression.
• They cannot afford the cost of doctor visits and treatment.

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.