Short answer: depression in older adults often shows up as fatigue, aches, poor sleep, irritability or memory complaints rather than obvious sadness. It is common after health changes, retirement or loss, but it is not a normal part of aging, and it responds to treatment at any age.
Signs that may point to depression
- Losing interest in hobbies, friends or family events
- Unexplained aches, low energy or slowing down
- Changes in sleep or appetite, with weight loss
- Trouble concentrating or memory complaints
- Withdrawing, staying home more, neglecting self-care
- Comments like “I’m a burden” or “What’s the point”
Depression or dementia?
Depression can cause memory and attention problems that look like early dementia, and the two can also occur together. A careful evaluation, sometimes with input from the primary care doctor and cognitive testing, helps sort this out. When depression is treated, thinking often improves.
Treatment considerations
- Medication: chosen with attention to other medications, heart health, fall risk and kidney function, often starting at lower doses.
- Therapy: problem-solving therapy and CBT work well in later life.
- Social connection: senior centers, volunteering and regular family contact.
- Physical health: treating pain, hearing or vision loss and sleep problems supports mood.
Safety
Older men have among the highest suicide rates. Take any talk of hopelessness or suicide seriously and call or text 988, or call 911 in an emergency.
Common triggers in later life
- A new medical diagnosis or chronic pain
- Loss of a spouse, friends or siblings
- Retirement and loss of daily structure or purpose
- Moving from a long-time home
- Caregiving for a partner with illness
- Hearing or vision loss leading to isolation
Medication reviews matter
Older adults often take several medications, some of which can affect mood, sleep or thinking. A psychiatric evaluation includes a careful review of all medications, sometimes in coordination with the primary care doctor or pharmacist, to remove anything unnecessary and choose treatments with the fewest interactions.
How families can help
Regular contact, invitations to activities, help with transportation and gentle encouragement to see a doctor all make a difference. Offering to attend the first appointment, or helping set up a video visit, removes common barriers.
Frequently asked questions
Is telehealth practical for older adults?
Many older adults do well with video visits, often with a family member helping set up. Learn about telehealth appointments.
Can family attend the visit?
With the patient’s permission, family input is very helpful.
Psych Boston provides adult psychiatry and depression treatment in Lexington and across Massachusetts by telehealth. Request an appointment.
Related reading: Living With Chronic Illness and Depression · Genetic Testing for Psychiatric Medications: Does It Help?
This article is general information, not medical advice. If you are in crisis, call or text 988 or call 911. Psych Boston is an outpatient psychiatry practice at 35 Bedford St #17, Lexington, MA781-218-9550).