Depression in Older Adults

These fact sheets are brought to you through a joint partnership with the National Council on Aging. Mental Health America collaborates with the National Council on Aging (NCOA) My Medicare Matters campaign in support of our joint goal of assisting older adults to access mental health resources through Medicare.

Have you ever suffered from extended periods of sadness, loss of pleasure in everyday activities, poor sleep, or feelings of worthlessness or guilt? Have you quickly lost or gained weight, or lost all energy to complete everyday tasks? If so, you may be experiencing symptoms of depression.

Contrary to stereotypes about aging, depression is not a “normal” part of getting older. It is a medical problem that affects many older adults and can often be successfully treated. A recent study from the American Journal of Geriatric Psychiatry found that 27% of older adults assessed by aging service providers met the criteria for a diagnosis of major depression, and 31% had symptoms of depression that didn’t qualify as a diagnosable disorder, but significantly impacted their lives.

Identifying Risk Factors for Depression

Depression is often under-recognized and under-treated in older adults.

Without treatment, depression can impair an older adult’s ability to function and enjoy life, and can contribute to poorer overall health. Compared to older adults without depression, those with depression often need greater assistance with self-care and daily living activities, and often recover more slowly from physical disorders.

Use the checklist below to determine if you or someone you know may be at risk for depression.

Symptoms of Depression

• Depressed mood
• Loss of interest or pleasure in activities
• Disturbed sleep
• Weight loss or gain
• Lack of energy
• Feelings of worthlessness or extreme guilt
• Difficulties with concentration or decision making
• Noticeable restlessness or slow movement
• Frequent thoughts of death or suicide, or an attempt of suicide

Check for Risk Factors

Depression in older adults may be linked to several important risk factors. These include, among others:

• Medical illness (particularly chronic health conditions associated with disability or decline)
• Overall feelings of poor health, disability, or chronic pain
• Progressive sensory loss (i.e. deteriorating eye sight or hearing loss)
• A history of falling repeatedly
• Sleep disturbances
• Mental impairment or dementia
• Medication side effects (in particular from benzodiazepines, narcotics, beta blockers, corticosteroids, and hormones)
• Alcohol or prescription medication misuse or abuse
• Prior depressive episode, or family history of depression
• Extended mourning due to death of a friend, family member, or other loss
• Any type of stressful life events (i.e. financial difficulties, new illness/disability, change in living situation, retirement or job loss, and interpersonal conflict)
• Dissatisfaction with one’s social network

Screening for Depression

A quick, easy and confidential way to determine if you may be experiencing depression is to take a mental health screening.  A screening is not a diagnosis, but a way of understanding if your symptoms are having enough of an impact that you should seek help from a doctor or other professional. Visit www.mhascreening.org to take a depression screening.  If you don’t have internet access, you can ask your primary care doctor to do a screening at your next visit.

Treatment Options

The most common and effective treatment for depression is a combination of therapy and medication, but some people may benefit from just one form of treatment.

If you or someone you know is experiencing symptoms of depression, you should seek professional help immediately.

If you or someone you know is in crisis and would like to talk to a crisis counselor, call the free and confidential National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).

Depression and Anxiety

Older adults with mixed anxiety and depression often have more severe symptoms of both depression and anxiety. Learn more about the symptoms of anxiety by reading the “Anxiety in Older Adults” fact sheet.

Medicare Helps Cover Mental Health Services

Worrying about health insurance costs should never be a barrier to treatment. Visit the Medicare QuickCheck® on MyMedicareMatters.org to learn more about all of the mental health services available to you through Medicare.

Medicare Part A

Medicare Part A (hospital insurance) helps cover mental health care if you’re a hospital inpatient. Part A covers your room, meals, nursing care, and other related services and supplies.

Medicare Part B

Medicare Part B (medical insurance) helps cover mental health services that you would get from a doctor as well as services that you generally would get outside of a hospital, like visits with a psychiatrist, clinical psychologist or clinical social worker, and lab tests ordered by your doctor. Part B may also pay for partial hospitalization services if you need intensive coordinated outpatient care.

Medicare Part D

Medicare Part D (prescription drug coverage) helps cover drugs you may need to treat a mental health condition.

Need help figuring out mental health coverage through Medicare? Use the Medicare QuickCheck® to get a personalized report on the best options for your situation.

Other Resources

How to Recognize and Address the Signs of Depression in Your Aging Parent
By Nancy Kupka PhD, RN, Walgreens

Is Happiness the Secret to a Longer Life for Seniors?
By Nancy Kupka PhD, RN, Walgreens

Suicide Hotline
Phone: (800) 273-TALK (8255)
http://www.suicidepreventionlifeline.org/

Depression and Bipolar Support Alliance (DBSA)
800-826-3632
http://www.dbsalliance.org/

American Psychiatric Association
703-907-7300
www.psychiatry.org/

International Foundation for Research and Education on Depression
http://www.ifred.org/

National Institute of Mental Health
Phone Number: 301-443-4513
Toll Free Number: 1-866-615-6464
Fax Number: 301-443-4279
Email Address: nimhinfo@nih.gov
Website URL: www.nimh.nih.gov

Works Cited

1. U.S. Administration on Aging/Substance Abuse and Mental Health Services Administration. (2013). Older Americans behavioral health issue brief 6: Depression and anxiety: Screening and intervention. Retrieved April 2, 2015, from http://www.ncoa.org/improve-health/center-for-healthy-aging/content-library/IssueBrief_6_ DepressionAnxiety_Color.pdf
2. Medicare & Your Mental Health Benefits. (2014). Baltimore: Centers for Medicare and Medicaid Services. Retrieved April  2,  2015, from http://www.medicare.gov/publications/pubs/pdf/10184.pdf