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The Life-Threatening Mental Illness in Older Adults No One Is Talking About

older man and caregiver sitting on couch with tablet

We’ve all experienced times in our lives when we’ve felt blue. But for some, those feelings can be intense and last for several weeks or longer, signaling a medical condition known as clinical depression.1

Although clinical depression affects people of all ages, adults over the age of 65 are at an increased risk, says Patrick Arbore, Ed.D., director and founder of the Center for Elderly Suicide Prevention and Grief Related Services, a program of the Institute on Aging in San Francisco.

“While depression is common in older adults, it’s not a normal part of aging,” says Arbore.

According to the Centers for Disease Control and Prevention, 80% of older adults have at least one chronic health condition, and depression is one of the most common complications of chronic illness.1

The prevalence of mental health disorders among older adults has only been exacerbated by the COVID-19 pandemic. In a 2020 analysis, the Kaiser Family Foundation reported that 1 in 4 older adults reported anxiety or depression during the pandemic, a significant increase over the 11% of older adults who reported depression and anxiety in 2018.2

On top of that, Arbore says life during the pandemic has made managing depression harder for many older adults. Living through uncertain times and losing loved ones to the virus can trigger feelings of anxiety, stress, and sadness. Increased rates of social isolation and loneliness during the pandemic have led to an uptick in symptoms of depression such as a sense of helplessness, loss of interest in daily activities, sleeping more or less than usual, and appetite or weight changes.1,2

All of these statistics add up to one upsetting fact: Millions of older adults are suffering needlessly. But there is hope, because depression can very often be treated effectively — if you know what to look for.

The importance of treating depression in older adults

Depression in older adults is often underdiagnosed and undertreated, says Arbore, in part because the signs of it can be misinterpreted.

“Rather than seeming sad, you may notice your loved one lacks motivation or makes excuses as to why they can’t participate in family activities, such as saying they’re too tired,” Arbore says.

Instead of brushing them off or making assumptions about their behavior, be more proactive about addressing your loved one’s feelings. By asking the right questions or making a mental note of repeated behaviors, you could identify symptoms of depression where you may not have believed it existed.

Identifying signs of depression and getting help for your loved one is essential, Arbore says. Untreated depression not only takes a toll on relationships, it can also make it difficult to overcome other serious illnesses. And in some cases, if left untreated, it can lead to death by suicide.3

According to the National Council on Aging (NCOA), suicide is a significant concern among older adults, especially men 65 and older. While older adults comprise just 12% of the population, they account for 18% of deaths by suicide. In 2017, among the more than 47,000 suicides that took place, the NCOA says 8,500 of those involved people 65 and older.3

How to help a parent or grandparent with depression

If you suspect your parent or grandparent is suffering from depression, there are a number of steps you can take to support them.

Talk with them.

Arbore recommends starting a conversation rather than confronting them.

“You might begin by saying something like, ‘You don’t go out anymore, I’d like to help you change that,’” Arbore says. “Be prepared to listen and to acknowledge what they’re feeling. Don’t tell them depression is something they’ll get over in time, because it doesn’t work like that.” (The website SeizeTheAwkward.com offers more tips on how to start a conversation about depression.)

Point them to the right clinician.

“See if your loved one is open to talking to their doctor about their depression,” Arbore says. “It’s best if their primary care doctor can provide a referral to a mental health professional who is trained in antidepressant medications and can also offer talk therapy.”

Their doctor could refer them to either a psychiatrist or psychologist, depending on their treatment needs. If medications are deemed appropriate for your loved one’s treatment, they most likely will see a psychiatrist. A psychiatrist is a medical doctor who specializes in mental health and can prescribe medication if needed.

While psychologists can prescribe medication in some states, their expertise largely revolves around non-pharmaceutical therapy. An example of this is psychotherapy, which is also commonly referred to as talk therapy. It can help older adults by teaching them new ways of thinking, processing grief, and addressing issues such as ageism and isolation that may be adding to their depression,4 Arbore notes.

It’s not uncommon for older adults diagnosed with clinical depression to be prescribed a few different types of antidepressants before discovering the one that works best for them.5

Fortunately, precision medicine practices like the ones offered through Genomind can reduce that trial-and-error period. By providing insights into your loved one’s genetic profile as it relates to drug metabolism and response, healthcare providers can then make more-informed decisions for individual treatment plans. This approach is designed to reduce risks and avoid dangerous drug combinations. Think Genomind’s precision health platform could help your loved one’s treatment? Get started today.

Check in regularly.

Check in with your loved one on a regular basis, either in person or by phone or through video calls.3 “If you give your loved one a smartphone or tablet, take the time to ensure they know how to use it,” Arbore says.

A related option: Arbore founded the 24-hour toll-free Friendship Line, the only accredited crisis line for adults 60 years and over that provides emotional support, well-being checks, grief support through assistance and reassurance, active suicide intervention, and information and referrals to isolated older adults, and adults living with disabilities (800-971-0016). Trained volunteers offer a caring ear and can have a friendly conversation with older adults.6

Encourage social activities.

Another idea to help your older loved one is to suggest activities that encourage their cognitive, as well as their social abilities. For individuals that are more tech-savvy, RoadScholar.org offers  free virtual learning lessons centered on travel, cooking, and history. Alternatively, Arbore says the Aging Mastery Program, which is run through healthcare providers, community centers, and nonprofits, in partnership with the National Council on Aging, focuses on aging well, health, personal involvement, and beating social isolation.7 (Aging Mastery starter kits are available for $30 on ncoa.org)

For loved one’s who may not be as adept at navigating technology, many local gyms and community senior centers offer fitness classes, board game nights and other in-person activities. Services like Yelp can help you find those in your area.8

Volunteer together.

Volunteering can help older adults feel as though they have a renewed purpose in life and provide them with a sense of accomplishment.9 The nonprofit VolunteerMatch offers in-person and remote volunteer opportunities, including pitching in on events, serving as a tutor, and helping low-income children learn to read.10

Bottom line: Identifying the warning signs of depression in older adults can be the first step in getting them the treatment they need. It begins and ends with their support system (in other words, you). Whether it’s being more attentive to your loved one’s feelings or needs, or just getting them in touch with the right clinician, a little can go a long way. If they’re diagnosed with clinical depression and need a prescription drug to treat it, go with them to the pharmacy when they pick it up, take notes for them, and make sure they’re taking it as prescribed. With the right support, the older adults in your life can thrive.

Sources: 

  1. Stat on depression in older adults: Depression is not a normal part of growing older (2021)
  2. 2020 analysis of older adults and depression: One in four older adults report anxiety or depression amid the COVID-19 pandemic (2020)
  3. Stat on suicide issue among older men: Suicide and Older Adults: What You Should Know (2021)
  4. Talk therapy: Older adults and depression (2022)
  5. Trial and error diagnosing antidepressant: Antidepressants: Selecting one that’s right for you (2019)
  6.  Friendship Line: Friendship line (2022)
  7. Info on Aging Mastery Program: Welcome to Aging Mastery (2021)
  8. Local senior center finder: Yelp (2022)
  9. Health benefits of volunteering: Helping people, changing lives: 3 health benefits of volunteering (2021)
  10.  Volunteer Opportunities: Find the Best Volunteer Opportunities (2022)

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