Health Matters 5/14: Growing Older Does Not Mean Growing Depressed


By Arun S. Rao, MD

Depression is a common mental health condition that affects an estimated 18 million people throughout the United States, according to the Centers for Disease Control and Prevention (CDC).

And while depression can strike at almost any age, certain risk factors such as chronic health conditions, make older adults especially vulnerable to depression.

However, depression is not a normal part of aging.

If you or a loved one experiences signs of depression, it is important to talk with a doctor. Once diagnosed, depression can often be treated so that individuals can get back to feeling like themselves again.

Especially Vulnerable

Almost everyone – older adults included – feels sad or down every now and then, but when those feelings persist, it can interfere with the ability to enjoy daily life and may be a sign of depression.

Consider that, according to the CDC, 80% of older adults have at least one chronic health condition, and 50% have two or more, putting them at greater risk for depression.

Moreover, vascular changes that restrict blood flow to the brain and typically occur with aging can cause depression, as can certain medications.

At the same time, life changes, including the death of a loved one, moving to a new home or reduced independence, can also cause older adults to experience feelings of stress and sadness.

While many older adults are able to adjust to these changes after a period of time, some continue to struggle and may develop depression.

Additionally, older adults who experienced depression when they were younger are at greater risk for depression later in life than those who did not have depression at a younger age.

Recognizing Symptoms

Although many of the symptoms are the same, depression can look different in older adults than it does in younger people.

For example, as the National Institute of Aging notes, sometimes older people who are depressed appear to feel tired, have trouble sleeping, seem less motivated, or seem grumpy and irritable.

Depression can also cause confusion or attention problems in older adults that may mimic signs of Alzheimer’s disease or other brain disorders.

Other common signs of depression include:

Feelings of sadness or anxiety that last for weeks at a time
Feelings of hopelessness, or pessimism
Feelings of guilt, worthlessness or helplessness
Loss of interest in activities or hobbies
Change in eating habits, overeating, or appetite loss
Persistent aches or pains, headaches, digestive problems that do not get better, even with treatment
Frequent crying
Changes in hygiene and self care
Thoughts of death or suicide, or suicide attempts

In 2019, adults over age 85 had the highest suicide rate in the United States (an estimated 20 suicide deaths per 100,000 individuals), according to the American Foundation for Suicide Prevention. Statistics also show that older adults have the highest rate of suicide completion, and that suicide is more prevalent in men.

If you have symptoms of depression or are concerned about a friend or family member, seek help from a medical or mental health professional.

Treatment Can Help

Even though depression is a serious health condition, too often older adults choose to live with it rather than getting treatment.

Yet there are several safe and effective treatment options available that can alleviate symptoms of depression and restore quality of life.

According to the CDC, most older adults see improvement in their symptoms when treated with antidepressant medications, mental health therapy, or a combination of both. The combination of medication and therapy has been shown to be the most effective treatment approach.

Antidepressant medications typically take about two to four weeks to work and may need to be adjusted to meet an individual’s needs.

Therapy, which is confidential, can help older adults improve coping skills, strengthen connections and support, increase a sense of control over their life, and identify and change negative thoughts and behaviors that may worsen feelings of depression.

Preventing Depression

As you age, maintaining your mental health is just as important as maintaining your physical health.

To help lower the risk for depression, the National Institute on Aging offers these tips:

Try to prepare in advance for major changes in life, such as retirement or moving from your home of many years.

Stay in touch with family. Let them know when you feel sad.

Get regular exercise. Pick something you like to do to. Walking, biking, swimming, yoga, and tai chi are all good for your mind and body.

Eat a balanced diet, which can help you avoid illnesses that can bring on disability or depression.

In addition, studies show that older adults who have a strong social network and ties to their community have a lower risk for depression than others.

Most important, do not be ashamed to talk about depression and to seek help. With treatment, you can feel better and enjoy life.

To find a physician with Penn Medicine Princeton Health, call 888-742-7496 or visit”

Arun S. Rao, MD, is board certified in internal medicine and specializes in geriatric medicine. He is a member of the medical staff at Penn Medicine Princeton Health.