When you think of grandma or grandpa, you may notice that their behavior is changing, but your first assumption may not be that they are struggling with depression. You may attribute their lower mood to getting older, slower, or less attentive. However, aging is not always the default reason for personality changes, slight mental decline, or physical ailments.
It’s important to remember that the elderly can develop depression as well. There are many unique challenges that the elderly face, which can contribute to experiencing depression. With proper intervention, geriatric depression is treatable and fulfilled living in later life is possible.
Here’s a breakdown of what depression in the elderly looks like, potential causes, and treatments to put your older loved ones on the path to sustained emotional wellbeing sooner.
Understanding Depression in the Elderly: Aging and Mental Health
When older adults start to experience depression, symptoms may manifest differently than those of typical depression. It is important to note the subtle differences in mood may be considered as a side effect of aging. Noticing mental decline characterized by forgetfulness, irritability, sleep disturbances, fatigue, weight fluctuations, or the inability to accurately remember recent events are all side effects of aging.
However, symptoms of depression in the elderly are characterized by persistent and long-lasting feelings of sadness and loneliness, as well as self-isolation and loss of joy in activities. These symptoms can dramatically impact your elderly loved one’s quality of life, which is why it’s imperative to notice them promptly and assess if they could benefit from therapy.
Research shows that about 14% of adults 60-years-old and older struggle with at least one mental health condition 1. An even more concerning statistic demonstrates that the suicide risk in adults aged 75 and older is the highest of any age group, perhaps attributed to the fact that many feel they are at the end of their lives or want an end to the chronic pain that comes with the various physical ailments that they may be experiencing 2.
Struggles with age-related physical health conditions can impact quality of life, ability to live independently, and pain-free daily functioning. All those changes can deeply affect a person’s happiness — especially if their chronic condition is physically painful like arthritis or diabetes.
Common types of depression in the elderly
There are different types of depression that people experience, but some mood disorders and depression-related conditions common in the elderly include:
- Major depressive disorder (MDD): This normally affects a person’s ability to perform basic tasks, and lasts at least two weeks.
- Persistent depressive disorder (PDD): Otherwise known as high-functioning depression or dysthymia, this condition is characterized by a depressed mood that persists for more than two years. People experiencing PDD may be able to still complete tasks and go about their lives, even while struggling with these feelings.
- Vascular depression: This type of depression can occur due to the blood vessels weakening in the brain, which can happen after a stroke or similar neurological diseases.
- Health or medication-induced depression: Depression that develops due to medical issues or health-related problems is common among older adults. Various health problems tend to come with older age, which can affect mental health when you notice your mobility and mind do not function as they once did.
These different types of depression can go unnoticed for long periods of time, especially since most elderly people focus on the physical complaints, often dismissing the emotional ones. This is especially true considering symptoms of depression often coincide with those of certain physical health conditions, shifting the focus away from assessing emotional issues that could be the cause.
Additionally, cognitive changes can make assessment more difficult, especially if patients cannot recall past mood disruptions or changes in their behaviors. Communication barriers between older adults and healthcare professionals further complicate accurate diagnosis.
Overcoming generational stigma about mental health
The older generations’ view on mental health can be a big barrier for seeking help. Younger adults in the Millennial, Gen X, and Gen Z generations are much more open and accepting to the idea of therapy. Younger people also have a better grasp on the importance of mental health as it relates to your overall wellness.
When today’s seniors were young adults, mental health was generally considered a taboo subject, and anyone who needed mental health help was looked down upon or seen as unstable. Over time, many seniors may not have progressed past these beliefs, which is why breaking down these barriers for treatment can be beneficial.
Additionally, cultural or religious factors can prevent the elderly from seeking help, despite the fact that a mentally healthy mind is just as important as a physically healthy body. Mental health is often stigmatized in various cultures and religious communities, and many older adults tend to seek support from someone who’s a part of the same cultural community. Working to destigmatize mental health support in those communities can go a long way and help elderly individuals understand that seeking care is a courageous act of self-care.
Related: Navigating Depression Diagnosis and Treatment
Root Causes of Depression in the Elderly
Causes for mental illness can rarely be attributed to a singular factor. However, understanding the unique challenges that older people face that may trigger depressive symptoms in those vulnerable can help to provide clarity on geriatric depression.
Medication-induced depression in older adults
As different health complications arise, taking medication is commonly used to treat symptoms and make daily functioning more manageable. However, medications come with side effects and can affect mood, potentially causing reactions in your brain chemistry that may be linked to depression 3. Additionally, metabolism tends to influence medication efficacy as older bodies break down chemicals at a slower rate, affecting the timing of side effects and how fast they can act.
Social and environmental depression triggers in later life
Many people become depressed in later life due to becoming increasingly isolated from loved ones and spending more time alone than ever before. What’s more is that they may not isolate on purpose — it could be because their support groups are preoccupied with busy schedules, and with retirement comes more time to focus on loneliness.
Additionally, elderly adults may isolate to protect loved ones from witnessing them in physical pain or struggling with the side effects of medications. Moving — especially to retirement homes — can exacerbate these feelings as well due to logistical stress and feelings of isolation if they are not visited regularly.
Relocation can trigger anxiety, confusion, loneliness, and a sense of lost independence, as disruptions often impact cognitive functioning and provoke sadness, anger, and stress. These stress reactions can often resemble symptoms of depression. For seniors, maintaining socialization is important to prevent mental decline, as time with loved ones can help elevate mood and support cognitive function.
Related: Psychiatrist for Depression
Symptoms of Depression in the Elderly
Spotting symptoms of depression is critical to support your elderly loved ones. Symptoms of depression that may manifest in the elderly and should be identified include 4:
- Sleep changes — either too much sleep or not enough — or extreme, persistent fatigue.
- Memory problems or decline in cognitive function — symptoms that can often be confused with dementia.
- Constant complaints of body pains, such as aches and digestive issues.
- Appetite loss or unintended, dramatic fluctuations in weight.
- Neglect of personal hygiene or self-care.
- Withdrawal from previously enjoyed activities.
- Isolation from loved ones or relationships.
- Abnormal financial behaviors, like excessive spending.
- Frequent conversations about having too many possessions.
Although these symptoms can show up differently for everyone, having the knowledge on what they can potentially look like will help you urge your loved one to seek help.
When to seek immediate help: warning signs of suicide risk
Learning to pinpoint high risk behaviors for suicide can be life-saving. These behaviors include:
- Giving away possessions.
- Putting affairs in order.
- Writing a will.
- Mentioning death frequently.
These warning signs are serious and might signal that an elderly loved one is considering suicide, which is especially true if they suffer from a painful physical illness.
If you or someone you love is considering suicide, please call the Suicide and Crisis Hotline at 988.
Related: Understanding and Supporting Depression in Men
Evidence-Based Treatment for Depression in the Elderly
Effective treatment for depression in older adults often requires a specialized approach that addresses both biological and psychological factors. Treatment typically combines appropriate medication with depression therapy interventions designed for the unique challenges of aging.
Medication management for geriatric depression
If your psychiatrist decides a medications are appropriate, prescriptions can be written to manage mental health needs. Although medication management is an effective approach to treating mood disorders, there are certain types of antidepressants that the elderly should carefully consider the pros and cons of taking. These include tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) 5.
These antidepressants have side effects that particularly affect the older population, such as confusion, blurred vision, and increased risk of falling. Additionally, elderly individuals have a slower metabolism, which affects how the body interacts with various medications and can come with risky drug interactions if they are already taking prescriptions for other health issues. This highlights the importance of medication management — contact Neuro Wellness Spa today to talk to a psychiatrist who can provide more information.
Psychotherapy for older adults
In one-on-one talk therapy, a mental health professional will offer a safe and judgment-free setting for older people to discuss their struggles with mental health and guide them through the difficult life transitions. Whether those struggles are coming to terms with the reality that they are not as able-bodied as before, grieving the loss of a loved one, changing role dynamics, or accepting their mortality, therapy can help. Additionally, a therapeutic modality known as cognitive behavioral therapy (CBT) can help shift negative thought patterns to more constructive ones that will help them manage their ruminating tendencies and live a less stressful life.
TMS therapy for geriatric depression
If you’re an older adult, there might be a moment where you feel like you’ve tried everything to improve and sustain your mental wellbeing. When medication and talk therapy have shown little results, it may be time to consider seeking a treatment-resistant depression (TRD) diagnosis and turn to other options — especially considering the risk factors of antidepressants for the elderly.
Exploring things like transcranial magnetic stimulation (TMS) therapy — a non-invasive and medication-free treatment that targets underactive areas of your brain — presents promising results. Treating treatment-resistant geriatric depression with TMS therapy has shown to be effective, but research shows that more sessions may be required for optimal efficacy 6.
Related: TMS for Parkinson’s Disease Treatment
Lifestyle interventions for the elderly
Making sure to modify physical activity — like daily walks or weight lifting exercises to strengthen muscles — can help with long-term depression relief and improved mood. Encouraging older people to focus on holistic approaches such as proper nutrition and supplementing with vitamins that they may not be receiving from their diet can not only benefit their overall health, but give them energy that will sustain them throughout the day. Dedicating time for social connections is essential as well, and carving out time to connect with friends and family can reduce feelings of isolation and loneliness.
Supporting an Elderly Person with Depression
When a senior close to you is struggling with depression, it’s important to provide ample support during this time. Have conversations about how they feel, as some may feel frustrated, shameful, or embarrassed to communicate their need for help. Opening up a space for dialogue can make them more comfortable sharing their struggles, but it’s important to remember that not every older adult will be receptive to the idea of seeking mental health treatment. Destigmatizing depression treatment can reduce their resistance to psychotherapeutic interventions.
Additionally, offering help to implement an exercise routine, modify their environment, or simply visiting them in a senior home can provide valuable support to alleviate their depressed mood. Getting them involved in purposeful activities like volunteering or meaningful hobbies that help them find fulfillment in later life.
Related: Understanding and Supporting Depression in Women
How Neuro Wellness Spa Specializes in Elderly Depression Treatment
At Neuro Wellness Spa, we have a compassionate, knowledgeable care team that can treat you or your elderly loved one’s depression and set you up with an appropriate therapist. During our talk therapy sessions, they will be guided in a goal-oriented fashion throughout 13 sessions to learn effective coping techniques for their depression. Should they decide, therapists can also collaborate with the family and others to provide enhanced support. They will be taught valuable socializing skills, adapted physical exercises to improve cognitive function, and be provided meaningful volunteer opportunities with later-life limitations in mind.
With a mental health professional present to support their struggles and support their journey to a more fulfilling life, we can help manage your senior loved one’s depression symptoms. If needed, we offer services that include medication management, TMS therapy, CBT, and dialectical behavior therapy (DBT) — all of which can effectively manage mental health. Call Neuro Wellness Spa today to get back to feeling like yourself again sooner.
References
- World Health Organization: WHO. (2023, October 20). Mental health of older adults. https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults
- Fu, K., & Fu, K. (2025, February 25). Older adults at highest risk for suicide, yet have fewest resources. Harvard Gazette. https://news.harvard.edu/gazette/story/2025/02/older-adults-at-highest-risk-for-suicide-yet-have-fewest-resources/
- Ganzini, L., Walsh, J. R., & Millar, S. B. (1993). Drug-Induced Depression in the aged. Drugs & Aging, 3(2), 147–158. https://doi.org/10.2165/00002512-199303020-00005
- World Health Organization: WHO. (2023, October 20). Mental health of older adults. https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults
- Lindsey, P. L. (2009). Psychotropic medication use among older adults: What all nurses need to know. Journal of Gerontological Nursing, 35(9), 28–38. https://doi.org/10.3928/00989134-20090731-01
- Study finds TMS Treatment can be Effective for Older Adults. (2022, August 16). https://www.hebrewseniorlife.org/news/study-finds-tms-treatment-can-be-effective-older-adults