AgePage

National Institute on Aging

Depression

Everyone feels blue now and then. 

It’s part of life. But, if you no longer 

enjoy activities that you usually like, 

you may have a more serious problem. 

Being depressed, without letup, can 

change the way you think and feel. 

Doctors call this “clinical depression.” 

Being “down in the dumps” over 

a period of time is not a normal part 

of getting older. But, it is a common 

problem, and medical help may be 

needed. For most people, depression 

will get better with treatment. 

“Talk therapy,” medicine, or 

other treatment methods 

can ease the pain of 

depression. You do 

not need to suffer. 

There are 

many reasons why 

depression in older 

people is often missed or 

untreated. As a person ages, 
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the signs of depression are much more 

varied than at younger ages. It can appear 

as increased tiredness, or it can be seen

as grumpiness or irritability. Confusion or

attention problems caused by depression 

can sometimes look like Alzheimer’s 

disease or other brain disorders. Mood 

changes and signs of depression can be 

caused by medicines older people may 

take for arthritis, high blood pressure, 

or heart disease. The good news is that 

people who are depressed usually feel 

better with the right treatment.

What Causes Depression?

There is no one cause of depression. 

For some people, a single event can 

bring on the illness. Depression often 

strikes people who felt fine but who 

suddenly find they are dealing with a 

death in the family or a serious illness. 

For some people, changes in the brain 

can affect mood and cause depression. 

Sometimes, those under a lot of stress, 

like caregivers, can feel depressed. Others 

become depressed for no clear reason.

People with serious illnesses, such as 

cancer, diabetes, heart disease, stroke, 

or Parkinson’s disease, may become 

depressed. They may worry about how 

their illness will change their lives. They

might be tired and not able to deal

with things that make them sad. 
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Treatment for depression can help them 

manage their depressive symptoms 

and improve their quality of life.

Genetics, too, can play a role. Studies 

show that depression may run in families. 

Children of depressed parents may be 

at a higher risk for depression. And, 

depression tends to be a disorder that 

occurs more than once. Many older 

people who have been depressed in 

the past will be at an increased risk. 

What To Look For 

How do you know when you need 

help? After all, as you age, you may 

have to face problems that could cause 

anyone to feel depressed. Perhaps you 

are dealing with the death of a loved 

one or friend. Maybe you are having a 

tough time getting used to retirement, 

and you feel lonely. Possibly, you have 

a chronic illness. Or, you might feel like 

you have lost control over your life. 

After a period of feeling sad, older 

people usually adjust and regain their 

emotional balance. But, if you are 

suffering from clinical depression and 

don’t get help, your depression might 

last for weeks, months, or even years. 

Here is a list of the most common signs 

of depression. If you have several of 

these and they last for more than 

2 weeks, see a doctor. 
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F An “empty” feeling, ongoing sadness,

and anxiety 

F Tiredness, lack of energy

F Loss of interest or pleasure in

everyday activities, including sex 

F Sleep problems, including trouble 

getting to sleep, very early morning 

waking, and sleeping too much 

F Eating more or less than usual 

F Crying too often or too much 

F Aches and pains that don’t go away 

when treated 

F A hard time focusing, remembering, 

or making decisions 

F Feeling guilty, helpless, worthless, 

or hopeless 

F Being irritable 

F Thoughts of death or suicide or a 

suicide attempt 

If you are a family member, friend, 

or healthcare provider of an older 

person, watch for clues. Sometimes 

depression can hide behind a smiling 

face. A depressed person who lives 

alone may appear to feel better when 

someone stops by to say hello. The 

symptoms may seem to go away. But, 

when someone is very depressed, the 

symptoms usually come back. 

Don’t ignore the warning signs. 

If left untreated, serious depression 

can lead to suicide. Listen carefully if 
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someone of any age complains about 

being depressed or says people don’t 

care. That person may really be asking 

for help. 

Getting Help 

The first step is to accept that you 

or your family member needs help. You 

may not be comfortable with the subject 

of mental illness. Or, you might feel that 

asking for help is a sign of weakness. You 

might be like many older people, their 

relatives, or friends who believe that a 

depressed person can quickly “snap out 

of it” or that some people are too old to 

be helped. They are wrong. 

A healthcare provider can help you. 

Once you decide to get medical advice, 

start with your family doctor. Your doctor 

should check to see if your depression 

could be caused by a health problem 

(such as hypothyroidism or vitamin B12

deficiency) or a medicine you are taking. 

After a complete exam, your doctor 

may suggest you talk to a mental health 

worker, for example, a social worker, 

mental health counselor, psychologist, 

or psychiatrist. Doctors specially trained 

to treat depression in older people are 

called geriatric psychiatrists.

Don’t avoid getting help because you 

may be afraid of how much treatments 
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might cost. Often, only 

short-term psychotherapy 

(talk therapy) is needed. 

Treatment for 

depression 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.

Be aware that some family doctors 

may not understand about aging and 

depression. If your doctor is unable or 

unwilling to help, you may want to talk 

to another healthcare provider. 

Are you the relative or friend of a 

depressed older person who won’t go to 

a doctor for treatment? Try explaining 

how treatment may help the person feel 

better. In some cases, when a depressed 

person can’t or won’t go to the doctor’s 

office, the doctor or mental health 

specialist can start by making a phone 

call. A phone call can’t take the place 

of the personal contact needed for a 

complete medical checkup, but it might 

inspire the person to go for treatment.

Treating Depression 

Your doctor or mental health 

expert can often treat your depression 

successfully. Different therapies seem to 
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work for different people. For instance, 

support groups can provide new coping 

skills or social support if you are dealing 

with a major life change. Several kinds 

of talk therapies are useful as well. One 

method might help you think in a more 

positive way. Always thinking about the 

sad things in your life or what you have 

lost might have led to your depression. 

Another method works to improve your 

relations with others so you will have 

more hope about your future.

Getting better takes time, but with 

support from others and with treatment, 

you will get a little better each day. 

Antidepressant drugs (medicine to 

treat depression) can also help. These

medications can improve your mood, 

sleep, appetite, and concentration. There 

are several types of antidepressants 

available. Some of these medicines can 

take up to 12 weeks before you feel like 

they are working. Your doctor may want 

you to continue medications for 6 months 

or more after your symptoms disappear.

Some antidepressants can cause 

unwanted side effects, although newer 

medicines have fewer side effects. Any 

antidepressant should be used with great 

care to avoid this problem. Remember:

F The doctor needs to know about 

all prescribed and over-the-counter 
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medications, vitamins, or herbal 

supplements you are taking. 

F The doctor should also be aware of 

any other physical problems you have. 

F Be sure to take antidepressants in the 

proper dose and on the right schedule. 

If you are still very depressed after

trying different treatments, electroconvulsive therapy (ECT) may be an option. 

Don’t be misled by the way some movies 

and books have portrayed ECT (also 

called electroshock therapy). ECT may 

be recommended if medicines or other 

therapies do not work for you. ECT is 

given as a series of treatments over a few

weeks. Like other antidepressant therapies, 

follow-up treatment is often needed to 

help prevent a return of depression.

Help From Family and Friends 

Family and friends can play an 

important role in treatment. You can help 

your relative or friend stay with the 

treatment plan. If needed, make appointments for the person or go along to the

doctor, mental health expert, or support 

group.

Be patient and understanding. Ask 

your relative or friend to go on outings 

with you or to go back to an activity that 

he or she once enjoyed. Encourage the 

person to be active and busy but not to 

take on too much at one time. 
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Preventing Depression

What can be done to lower the risk 

of depression? How can people cope? 

There are a few steps you can take. Try to

prepare for major changes in life, such

as retirement or moving from your home

of many years. One way to do this is to

try and keep friendships over the years.

Friends can help ease loneliness if you 

lose a spouse. You can also develop a 

hobby. Hobbies may help keep your 

mind and body active. Stay in touch 

with family. Let them help you when 

you feel sad. If you are faced with a lot 

to do, try to break it up into smaller 

jobs that are easy to finish. 

Regular exercise may also help 

prevent depression or lift your mood 

if you are somewhat depressed. Older 

people who are depressed can gain 

mental as well as physical benefits 

from mild forms of exercise like 

walking outdoors or in shopping 

malls. Gardening, dancing, and 

swimming are other good forms of 

exercise. Pick something you like

to do. Begin with 10–15 minutes a

day, and increase the time as you are

able. Being physically fit and eating

a balanced diet may help avoid

illnesses that can bring on disability

or depression.
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Remember, with 

treatment, most 

people will begin

to feel better 

soon. Expect your 

mood to improve slowly. 

Feeling better takes time. 

But, it can happen.

For More Information

Here are some helpful resources:

American Association for 

Geriatric Psychiatry

7910 Woodmont Avenue, Suite 1050

Bethesda, MD 20814-3004

1-301-654-7850 

www.aagpgpa.org

American Psychological Association

750 First Street, NE

Washington, DC 20002-4242

1-800-374-2721 (toll-free) 

1-202-336-6123 (TDD/TTY) 

www.apa.org

Depression and Bipolar 

Support Alliance

730 North Franklin Street, Suite 501

Chicago, IL 60654-7225

1-800-826-3632 (toll-free) 

www.dbsalliance.org
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National Alliance on Mental Illness

3803 North Fairfax Drive, Suite 100 

Arlington, VA 22203

1-800-950-6264 (toll-free)

1-703-524-7600 

www.nami.org

National Institute of Mental Health

6001 Executive Boulevard, Room 8184, 

MSC 9663

Bethesda, MD 20892-9663

1-866-615-6464 (toll-free) 

1-866-415-8051 (TTY/toll-free) 

www.nimh.nih.gov

National Library of Medicine

Medline Plus

www.medlineplus.gov

Mental Health America 

2000 North Beauregard Street, 6th Floor

Alexandria, VA 22311

1-800-969-6642 (toll-free) 

1-800-433-5959 (TTY/toll-free) 

www.nmha.org

National Suicide Prevention Lifeline

1-800-273-8255 (toll-free/24 hours a day) 

1-800-799-4889 (TTY/toll-free)
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National Institutes of Health 

U.S. Department of Health and 

Human Services

May 2008

Reprinted November 2009

For more information on health and 

aging, contact:

National Institute on Aging

Information Center

P.O. Box 8057

Gaithersburg, MD 20898-8057

1-800-222-2225 (toll-free) 

1-800-222-4225 (TTY/toll-free) 

www.nia.nih.gov

www.nia.nih.gov/Espanol

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about new publications and other 

information from the NIA, go to 

www.nia.nih.gov/HealthInformation. 

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