What Causes Depression in the Elderly? Understanding Your Loved One’s Mental Health

Since the death of his wife two years ago, George hadn’t been the same. He’d taken to sleeping most of the day, he withdrew from his cribbage club, and his appetite had all but disappeared.

Since the death of his wife two years ago, George hadn’t been the same. He’d taken to sleeping most of the day, he withdrew from his cribbage club, and his appetite had all but disappeared.
To his children, it seemed as though George was probably still grieving his wife. George and Maggie had been married for 65 years, and it only made sense that he would struggle with her death. But what they didn’t realize was that George was suffering from depression—and his wife’s death wasn’t the only contributing factor.
As we age, we face so many challenges that can cause extreme emotional stress—the death of a spouse is only one example of these challenges. We also undergo a plethora of physiological changes. We lose muscle mass, our heart and lungs slow, and there is a change in the levels of neurotransmitters in our brains.
Because of all of these significant emotional and physical changes, it is difficult to pinpoint what causes depression in the elderly. We can, however, better understand the mental health of our aging loved ones if we know the various risk factors for depression and identify them as potential triggers or contributing factors to this mental illness.

Causes of Depression in the Elderly: The Many Challenges of Aging

George’s kids weren’t wrong to assume that the changes in his mental and physical state were related to his wife’s death, but what they failed to consider was that it likely wasn’t the only contributing factor to George’s undiagnosed depression. The majority of the aging population experiences stressful or traumatic life events, and everyone undergoes physiological changes, yet only a small percentage (1 to 15%) become depressed. This fact is leading researchers to conclude that aging adults who develop depression seemingly as a direct result of a major life change are likely more vulnerable to developing depression for genetic or cognitive reasons.
Nonetheless, when trying to understand your aging loved one’s mental health, it helps to identify potential contributing factors of depression so that you can help them take a preventative approach to depression. Making sure they have the support they need when they face inevitable challenges can result in better mental health.
Below are some of the triggers or contributing factors of depression in aging adults:

  • Retirement: For many people, their work gives their life meaning. Not only does a career provide people with a sense of purpose, it’s also a highly social endeavor. When aging adults retire, they may miss the social and cognitive stimulation that work gave them. This can result in social withdrawal and isolation, which are common signs of depression.
  • Death of friends and loved ones: As we age, we experience the loss of those who are close to us. Grieving is a natural part of loss, but typically, this period of intense sadness is peppered with moments of joy and gratitude. In George’s case, he never felt relief from his sadness and slowly slipped into depression.
  • Health problems: We tend to experience a persistent decline in our physical health as we age, and many aging adults experience the onset of chronic or life-threatening disease. Diabetes, dementia, stroke, Parkinson’s, infections, and thyroid conditions have been identified as biological risk factors for depression in aging adults. There has been increasing interest in the connection between cancer and depression as well.

It is a normal human response to feel sadness or anxiety as a result of these difficult life changes—as with any period of change or transition in our lives. But typically, as we adjust, these feelings will normally dissipate. If they persist and worsen, however, to the extent that they negatively impact or interfere with your loved one’s daily living, it is possible that they are struggling with depression. And if this is the case, symptoms are likely to persist until they receive proper treatment.

Pharmaceuticals Can Be Part of What Causes Depression in the Elderly

While there are so many possible contributing factors to depression among older adults, certain pharmaceuticals can also increase one’s likelihood of depression. While these side effects can occur in anyone at any age, older adults are more prone to experiencing depression as a side effect to a drug because their bodies don’t metabolize as quickly and efficiently.
If you are noticing the telltale signs and symptoms of depression in your aging loved one, and you know that they are taking one or more types of medication, they could be experiencing drug-induced depression.
Below are some of the drugs commonly taken by older adults that have been shown to cause drug-induced depression:

  • Medication for Parkinson’s disease
  • Blood pressure medications
  • Beta-blockers (i.e. Lopressor)
  • Calcium channel blockers
  • ACE inhibitors
  • Sleeping pills
  • Steroids (i.e. prednisone)
  • Cholesterol-lowering drugs (i.e. Lipitor)

Those who take several medications, like many aging adults, are at greater risk for experiencing depression as a side-effect. Be sure to check with their doctor if you suspect your aging loved one is experiencing drug-induced depression.
While you may never know the exact cause of your aging loved one’s depression, it’s important to understand the contributing factors so you can get them the kind of professional help they need. Behavioral health services may be effective for someone who is grieving a loved one, while medical help may be needed to treat drug-induced depression. Whatever journey lies ahead, the most important thing you can do is show your aging loved one unconditional love, compassion, and support on their path to better mental health.  
Institute on Aging offers a variety of valuable and compassionate resources for caregivers and aging adults alike. Connect with us today at 415-750-4111 to learn more about our Psychotherapy program, Center for Elderly Suicide Prevention, and grief-related services.

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Dr. Patrick Arbore

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