You're worried, but you don't know why. "Maybe she's just tired," you explain it to yourself, questioning your instinct that something's wrong. But if you're concerned that an older parent, loved one, or family member might be depressed, it's important to look a little deeper. Serious depression among older adults is more common than most people realize; 6 percent, or 15 out of every 100 adults over 65, are clinically depressed. And many more hover on the brink, suffering silently because they don't know what's wrong with them.
Unfortunately, if depression isn't recognized and treated, it can have tragic consequences. According to the American Psychological Association, older adults have the highest rate of suicide of any age group in the U.S. -- and the highest suicide rate of all is among older white men. What's more, these rates are underestimated due to the stigma associated with suicide, says the Centers for Disease Control. Depression can also compromise an older adult's health; it's associated with higher rates of many health issues, including heart disease and diabetes.
It's important to know that depression doesn't necessarily look the same in an older adult as it does in a younger person. While some people with depression appear sad or express their unhappiness directly, many experience a different set of symptoms that aren't as clear. And because seniors have a great deal of pride, they may be reluctant to admit they are suffering. Even when you ask your loved one how she feels, you may not get much insight -- previous generations weren't raised to talk about their feelings the way we do now.
Here are 5 signs to watch for that can let you know that someone you love is depressed.
More than a quarter of all Americans over 65 -- and almost half of all women -- live alone. Of course, many older adults who live alone have plenty of friends and interests and lead active, busy lives. But others find their world begins to shrink as they get older. Friends may die or move away, and they may have less energy to get out and about. Physical limitations and disabilities contribute to isolation, and transportation poses obstacles, especially once someone stops driving. According to one recent study, fostering a sense of connectedness is one of the key ways you can help an older adult who's suffering from depression. That may mean finding social activities, improving access to transportation, or changing their living situation.
2. Chronic Health Problems
Statistics show that older adults who commit suicide are often suffering from chronic pain or have a worsening health problem they feel hopeless about. If your parent or loved one feels her physical condition and abilities declining, she may see the situation as unresolvable and have a great deal of fear about the future. Suffering from several conditions can also make someone feel overwhelmed and hopeless. And if your loved one has arthritis, back problems, or any other painful condition that makes it harder to get around, the lack of physical activity can exacerbate depression.
Another factor linking health and depression is medications. Many medications include depression among their side effects, and medications can cause fatigue, dizziness, digestive problems, and other symptoms that can contribute to isolation. Then there's the issue of medication abuse, which is rising among seniors, according the Substance Abuse and Mental Health Services Administration (SAMSA). If you suspect your loved one is overly dependent on painkillers, sleep aids, or other drugs, it's important to intervene and get professional help.
Are you noticing your parent is crankier, complains more, or seems dissatisfied with everything? These kinds of changes can signal depression, even though your loved one doesn't seem sad. It makes sense; feeling unhappy tends to make us find fault with everyone and everything around us. Inflexibility can play into this problem as well. If you notice your parent or loved one is having a harder time adapting to change, this can be both a sign of and a trigger for depression. Because of course life is all about change, and a failure to accept this is going to make someone frustrated, annoyed, and generally grumpy. While you can try to address the causes of your loved one's irritability, it's going to be an exercise in futility and frustration unless you address the underlying issue of depression.
4. Weight Loss and Loss of Appetite
Losing interest in the things around you is a primary sign of depression, and that can include food. Meal preparation is a hassle for all of us, and it can become increasingly daunting for seniors, particularly those living alone. If you see your parent or loved one taking a "Why bother?" attitude toward cooking and preparing healthy meals, this might let you know something's up. Eating poorly also contributes to depression, because the brain needs proper nutrition to function right, so this can easily become a vicious cycle. Helping your parent or loved come up with a plan for food preparation that's realistic and doable, whether this means preparing precooked portions she can heat up easily or getting some in-home help, is one step in getting her on the road to recovery.
5. Fatigue, Low Energy, or Sleep Problems
While the stereotype of someone who's depressed is that they sleep all day, this is not necessarily the case with older adults. What you're more likely to notice is listlessness, lack of energy, and a tendency to say "no" a lot. Depression saps motivation, so anything you suggest may seem like too much trouble. You also might notice your loved one moving more slowly or having a more hunched posture. Another red flag is if your parent says she has insomnia, or if she seems to be sleeping at odd hours. Unfortunately, this one is another vicious cycle; disrupted sleeping patterns can signal depression, but lack of sleep also contributes to depression. Start by addressing anything that's clearly interfering with your parent's sleep, such as outside noise, too much light, or digestive issues. Then bring up the issue of depression when the obvious sleep issues have been resolved.
If, based on your observations, you suspect that your parent or loved one is depressed, you'll need to get professional help, even if she's reluctant. Anything you can do to relieve the stigma will help. Make sure she understands that depression is a disease, not something someone can "snap out of," and that it requires professional treatment. The risks of depression are too great to ignore.