Frequently Asked Questions - Seniors and Depression

Depression is more than being sad or feeling grief after a loss. Depression is a medical condition, just like diabetes or heart disease. Day after day, depression affects your thoughts, feelings, physical health and behaviours. It affects normal day-to-day activities. An episode must have a certain level of severity and a minimum duration of two weeks to be diagnosed as depression.

Depression is not a natural part of aging any more than it is a natural part of any other life stage. At any stage of life, depression is a condition that requires attention.

Current national statistics show the rate of depression in men and woman over age 65, who live in the community, to be under 2%. The figure rises to 10-15% if seniors suffering from all depressive symptoms are included.

There are differences by gender in rates of depression and suicide. According to a study in Edmonton, Alberta, the percentage of women suffering from depression (14.1%) is almost double that of men (7.3%) (Newman et al, 1998) Men over the age of 65 are at the highest risk for suicide among all age and gender groups (Health Canada, 2002). It is estimated that 30 to 40% of seniors living in long term care facilities live with depression (National Advisory Council on Aging, 1999).

• Those with a family history of depression
• Those with a personal history of depression – a past episode
• Taking certain medications
• Those with co-occurring health issues
• A recent loss or bereavement.

It’s unknown exactly what causes depression. There are a variety of potential factors for seniors:

• Loneliness and isolation
• Reduced sense of purpose
• Health problems
• Medications
• Fears
• Recent bereavements

Sometimes depression in older adults is difficult to pinpoint because it often shares symptoms with other medical conditions. In fact, older adults are more likely to complain about physical problems (aches and pains) than problems with their mood. The most common symptoms include:

• Sad mood
• Preoccupation with failures and inadequacies
• Loss of self-esteem
• Feelings of uselessness, hopelessness, excessive guilt
• Slowed thinking, forgetfulness, difficulty in concentrating and in making decisions
• Loss of interest in hobbies, people
• Social isolation
• Lethargy and/or low energy
• Agitation
• Changes in appetite and weight— eating too much or too little
• Oversleeping or insomnia
• Suicidal thoughts

Most often, seniors with depression will lose their appetites and develop insomnia.

Suicide is five times more likely in individuals over 60 than in younger age groups. It is also more likely to occur in those living alone. Bereavement from the death of a spouse, other family member or friend is highly associated with suicide. Loss of mobility, functionality and independence are related to higher suicide rates.

Suicidal talk should always be taken seriously and professional help sought immediately.

• Write down any symptoms you’ve had
• Write down key personal information
• Make a list of all medications you are taking
• Write down questions to ask your doctor
• Take a family member or friend along

Discuss all of your symptoms with your doctor and describe how they are affecting your life (e.g. slowed thinking that causes you to lack focus or not get things done). Your doctor can suggest or provide appropriate therapy. Make sure to discuss all of the available treatments and medications and their benefits and side effects before making any decisions.

If you are the adult child of a senior who you think might be depressed, be sure to tell your parent’s doctor about all the changes you have observed.

Depression in older people is sometimes harder to recognize than in younger people because it often co-occurs with medical, other psychiatric and substance abuse disorders. It is important to recognize that a diagnosis of depression is treatable. Research indicates that the best long term outcomes for the treatment of depression in older adults is medication, therapy and social support. Whether depression is caused by physical, psychological or social factors, the plan for treatment should address them all.

If you think you may be experiencing the symptoms of depression, talk with your family and friends about how you’re feeling, call your local mental health centre, and see your family doctor. The most common forms of treatment for depression are antidepressant medication and therapy. The most effective treatment is generally a combination of both. Some individuals suffering from depression may need a hospital stay or an outpatient treatment program until symptoms improve.

There are several types of antidepressant medication available, and they are categorized by how they affect the naturally occurring chemicals in your brain that affect your mood. Finding the right medication or medications will likely take trial and error. Patience is required, as some medications need eight weeks or more to take full effect, but don’t give up if you don’t find the right medication right away.

Complementary treatment, such as peer support groups or other support programs, may also be helpful.

Additional treatments, such as massage, mindfulness meditation, shiatsu, therapeutic touch, aromatherapy, tai chi, Pilates and yoga, can also help to improve wellness.

• Stick to your treatment plan. Don’t skip psychotherapy sessions. Even if you’re feeling well, continue to take medication as directed.
• Learn about depression. Empower yourself by learning about your condition.
• Pay attention to the warning signs. Find out what triggers your depression. Make a plan so that you know what to do if your symptoms get worse. Contact your doctor or therapist if you notice any changes. Ask friends or family to watch out for warning signs.
• Get exercise. Physical activity may help reduce the symptoms of depression. Consider walking, swimming, gardening, or any other physical activity.
• Avoid alcohol and illicit drugs. It may seem like they lessen your problems, but in the long run, they generally worsen symptoms and make the depression harder to treat.
• Get adequate sleep. This is especially important. If you’re having trouble sleeping, talk to your doctor about what you can do.
• Maintain an adequate diet. The Canada Food Guide is a useful reference in helping you choose to eat well. Choose more protein and Omega 3 and avoid simple carbohydrates.

A Life Worth Living: Practical Strategies for Reducing Depression in Older Adults, Moser-Ashley, M Pearl (1998)

Depression and Older People: Towards Securing Well-Being in Later Life, Mary Godfrey (2005)

Living Longer, Living Depression Free — A Family Guide to Recognizing, Treating and Preventing Depression in Later Life, Mark D. Miller, Charles F. Reynolds, The Johns Hopkins Press (2002)

Depression can be Prevented in Seniors

Geriatric Depression Rating Scale
(screening tool)

Healthy Me — Seniors and Depression

Seniors and Depression: Assessment and Management

Seniors and Depression