Depression in Older Adults

August 16, 2019
In this article, learn about the unique characteristics of depression in older adults and how social support can decrease the risk of psychological and physical disorders.

Depression is not a homogenous diagnosis. It changes according to the specific characteristics and context of each person. Things like age group, gender, and socioeconomic level affect how depression manifests itself. When children are depressed, for example, they tend to be more irritable or angry than sad. Children also tend to display more physiological symptoms of depression and trouble sleeping.

Epidemiological data shows that depression in older adults also has some unique characteristics. Consequently, offering a general treatment for all patients is ineffective.

Sometimes, people interpret the signs of depression in older adults as just a normal part of aging, which means said signs aren’t addressed. Not only that, but the drugs that are normally used to treat depression aren’t always the best choices for older adults.

Many older adults who live in nursing homes suffer from clinical depression. It’s difficult for many of them to explain their symptoms. They usually describe them as somatic complaints. Thus, older adults with depression often complain about having trouble sleeping, lack of energy, aches, and pains, etc. The overlap between physical illness and depression means that healthcare professionals often misdiagnose patients.

A worried older man.

Characteristics of depression in older adults

  • Longer depressive episodes that resist conventional medication.
  • Older adults with depression don’t express feelings of uselessness or guilt like middle-aged adults do.
  • Alexithymia, or the inability to verbally express emotions, is more common.
  • Older adults with depression often suffer from hallucinations and delusions.
  • Negative symptoms such as apathy, flat affect, lack of eye contact, or lack of reaction to their surroundings.
  • Physical symptoms that hide mental symptoms such as anorexia, phobias, hypochondria, and anxiety.
  • Higher risk of suicide, especially in men who live alone.
  • Psycho-motor agitation with intense anxiety or atypical inhibition.
  • Irritability.
  • Significant sleeping problems, particularly disorders such as insomnia or hypersomnia.
  • Frequent anxious somatizations.
  • Less variation in daytime mood.
  • Cognitive dysfunction, which is related to the intensity of the rest of the symptoms and tends to improve when mood improves. In older adults, executive functions and memory are the most affected.

The importance of a support network for older adults with depression

Preventing depression in elderly patients is crucial. To that end, researchers Lowenthal and Haven conducted a study that showed how it important it is for older adults to have a confidant. Having social support not only improved older adults’ mental health but also their physical well-being.

Older adults with a social support network have reduced mortality rates compared to those who are more isolated. Studies show that there’s a significant relationship between social support networks (marriage, interpersonal relationships, satisfaction with your surroundings, etc.) and a decreased risk for heart disease.

Not only that, but having a social support network means that older adults are more likely to take care of their own health and adhere to medical treatment plans. Satisfying relationships in old age increase immunocompetence and regulate stress.

Loneliness increases the risk of depression

In terms of psychological health, loneliness is also an important factor. Older adults who are alone or who feel alone are much more likely to suffer from depression. Thus, a social support network can protect senior citizens from stress and anxiety.

Studies show that pets can also help fight depression and anxiety in older adults.

An older woman looking sad.

A great way for older adults to fight depression is to create a network of friends with similar interests. Doing regular recreation or leisure activities with friends or a spouse make it much easier for senior citizens to adjust to retirement.

In conclusion, older adults who spend time with friends or a pet and aren’t lonely are less likely to suffer from depression. They generally enjoy better health and don’t have to use the health care system as much.

Since prevention is always best, it’s crucial to make sure that older adults have company and opportunities to improve their well-being and contentment.

  • Belloch, A., Sandín, B. y Ramos, F (2008). Manual de psicopatología. Volúmenes I y II. McGraw-Hill.Madrid