"My husband has lost interest in things he enjoys, and he's become grumpy. He's also lost weight and has trouble sleeping. Is he depressed?"

Everyone feels sad sometimes. But if people stay sad quite awhile and that sadness starts to affect their everyday life, they may be depressed. Depression isn't part of the normal aging process. It's a condition that can be treated. But for someone to get help, first they have to realize they are depressed, not just sad.

A range of senior depression

Depression is a general term for mood that ranges from grief to sadness to major depression. About 10 to 40 percent of elderly patients have major symptoms of depression.

People are more likely to get depressed when they get older. Depression can seriously affect a senior's health, making them more likely to get sick, making an ongoing disability worse or leading to suicide. Because doctors often overlook depression, family members and friends need to watch out for it and get their loved ones help. Treatments that were made just for elders can treat depression well. No one needs to stay depressed.

One out of every 10 seniors that has depression tries to take his or her life. Most are men (85 percent), and sadly, many of them succeed. Seniors who are divorced or widowed, live alone, and experience stressful events, such as money problems, drug or alcohol abuse, and chronic pain or other serious illness are more likely to try to kill themselves.

How to tell if someone might be depressed

Doctors consider people to be depressed if they have five of these symptoms nearly every day:

  • Feeling sad or worried most of the day
  • Caring less or losing interest in things they enjoy doing
  • Gaining or losing quite a bit of weight (more than 5 percent of total body weight in a month), or a drop or rise in appetite
  • Being unable to sleep or sleeping a lot
  • Unintentional and aimless motions (or tics), or a slowdown of movement and thought
  • Tiredness or loss of energy
  • Feelings of worthlessness or extreme or unfounded guilt
  • Difficulty with thinking or concentrating, or in making decisions
  • Repeated thoughts of death, dying or suicide

Symptoms of depression in elders

Older adults tell others that they are sad or depressed less often than younger people. Instead, older people feel anxious. They lose interest in normal activity. They may be grumpy and want to be left alone. They don't enjoy doing things that they used to like to do. They talk of losing hope and feel they can't do anything to change their lives. Most important, they have unexplained aches, pains, upset stomach, tiredness and headache. Doctors who see these older patients may focus on treating the symptoms rather than what is causing them: depression.

Because depressed people may be forgetful or just not care about their own health issues, they may not tell doctors about their symptoms. Friends or family members should come along with a possibly depressed senior to see the doctor. They should share their concerns so that the doctor can get a better picture about whether someone is depressed.

Be sure to bring all medications and any medical history to the doctor visit. These help the doctor find medical conditions that might be causing depression.

Many people, including seniors, get depressed during certain times of the year. These serious seasonal shifts in mood are called seasonal affective disorder (SAD). They most often happen in late fall to early winter and get better in summer. Bright artificial lights can treat SAD.

Treatment

Medication combined with therapy can treat most depression. Take antidepressant medications as directed (unless there are troubling side effects) because they need four weeks to start working and up to three months to take full effect.

Because depression in seniors comes back more often than with younger people, see the doctor more often to detect and prevent more depression.

Published on Feb. 12, 2013; updated on May 5, 2014.


Dr. Robert Herr

Dr. Robert Herr, M.D., M.B.A., practiced internal medicine and emergency medicine for more than 20 years prior to serving as a medical director at Regence. Dr. Herr frequently lectures and writes about health care issues affecting seniors.