1. Depression In The Elderly
Melvin L. Phillips, Jr., Ed.D.
Candidate, LCSW, CSAC

2. What is Depression?
• Depression (major depressive disorder) is a common
and serious mental illness that negatively affects how
you feel, the way you think and how you act.
• Depression is treatable.
• Depression causes feelings of sadness and/ or a loss of
interest in activities once enjoyed.
• It can lead to a variety of emotional and physical
problems and can decrease a person’s ability to function
at work and at home.

3. Depression symptoms can vary from mild to
severe and can include:
• Feeling sad or having a depressed mood
• Loss of interest or pleasure in activities once enjoyed
• Changes in appetite- weight loss or gain unrelated to dieting
• Trouble sleeping or sleeping too much
• Loss of energy or increased fatigue
• Increase in restless activity (e.g., hand-wringing or pacing) or
slowed movements and speech
• Feeling worthless or guilty
• Difficulty thinking, concentrating or making decisions
• Thoughts of death or suicide
• Symptoms must last at least two weeks for a diagnosis of
depression

4. Medical Conditions and Chronic Pain
• Medical conditions (i.e., thyroid, a brain tumor, or
vitamin deficiency) can mimic symptoms of depression
so it is critical to rule out general causes.
• Chronic pain can cause symptoms of depression in the
elderly (i.e., arthritis, back and neck pain, sciatica
problems, fibromyalgia, migraines, and multiple
sclerosis)

5. How Common is Depression in the Elderly?
• Estimates on the prevalence of depression among the
elderly vary.
• The American Psychiatric Association estimates that up
to 5 percent of people 65 and older suffer from
depression (APA, 2016).
• Other researchers believe the rate is even higher because
many of those who have a depressive disorder may be
diagnosed with illnesses such as dementia.
• Some older adults who have depression are not
diagnosed at all because many seniors accept their
symptoms as a part of the aging process.

6. How Common is Depression in the Elderly?
• Another concern is the elderly’s generational resistance
to the idea of emotional illness and the benefits of
seeking help.
• Many seniors are easily embarrassed by the stigma of
mental illness and are so ashamed of their symptoms
that they are unwilling or unable to discuss their feelings
with a professional.
• Others may be discouraged from seeking treatment
because of financial constraints.

7. How Common is Depression in the Elderly?
• Older people tend to deny feeling depressed and are
uncomfortable with the word “depression”.
• Many were raised in an era when people did not talk
about their feelings, and individuals with emotional
problems were perceived as having a character flaw but
“toughed it out”.
• Family members, friends, caregivers and professionals
who serve older adults should be alert to the changes in a
person’s appearance and behavior, rather than only
relying on what he or she says.

8. Suicide- The Risk of Unrecognized Depression
• Depression may be the cause of up to two-thirds of
suicides in older adults.
• Older Americans are considered the group most at risk
for suicide.
• Caucasian men, particularly those over the age of 65,
have the highest rate of suicide in the country, three to
four times greater than the general population.
• Feelings of worthlessness, helplessness and hopelessness
are major factors contributing to depression and suicide
in older adults.

9. Suicide- The Risk of Unrecognized Depression
• Warning signs are helpful for detecting suicidal behavior
include such verbal clues as, “ I want to end it all,” or
“My family will be better off without me,” or such
behavioral signs such as neglecting self-care, suddenly
putting personal affairs in order, giving away special
possessions, or sudden interest or disinterest in religion.
• Do not ignore these threats of suicide!

10. Depression is Different From Sadness or Grief
• The death of a loved one, loss of a job or the ending of a
relationship are difficult experiences for a person to
endure.
• It is normal for feelings of sadness or grief to develop in
response to such situations. Those experiencing loss
often might describe themselves as being “depressed”.
• Sadness and depression are not the same. The grieving
process is natural and unique to each individual and
shares some of the same features of depression.
• Both grief and depression may involve intense sadness
and withdrawal from usual activities.

11. Depression is Different From Sadness or Grief
• In grief, painful feelings come in waves, often intermixed
with positive memories of the deceased.
• In major depression, mood and/ or interest (pleasure)
are decreased for most of the two weeks.
• In grief, self-esteem is usually maintained. In major
depression, feelings of worthlessness and self-loathing
are common.
• For some people, the death of a loved one can bring on
major depression. Losing a job or being a victim of a
physical assault or a major disaster can lead to
depression.

12. Treatment
• Medication: Brain chemistry may contribute to an
individual’s depression and may factor into their
treatment.
• Antidepressants might be prescribed might be
prescribed to help modify one’s brain chemistry .
• These medications are not sedatives, “uppers” or
tranquilizers, and they are not habit forming.
• Antidepressants may produce some improvement within
the first week or two of use, but full benefits may be seen
for two to three months.

13. Treatment
• Psychotherapy, or “talk therapy”, is sometimes used
alone for the treatment of mild depression; for moderate
to severe depression, psychotherapy is often used in
along with antidepressant medications.
• Cognitive behavioral therapy (CBT) has been found to be
effective in treating depression.
• CBT is a form of therapy focused on the present and
problem solving.
• CBT helps a person recognize distorted thinking and
then change behaviors and thinking.

14. References
American Psychiatric Association. Diagnostic and
Statistical Manual of Mental Disorders (DSM-5), Fifth
edition. 2013.
National Institute of Mental Health. (Data from 2013
National Survey on Drug Use and Health.)
www.nimh.nih.gov
Kessler, RC, et al. Lifetime Prevalence and Age-of-
Onset Distributions of DSM-IV Disorders in the
National Comorbidity Survey Replication. Arch Gen
Psychiatry. 2005; 62(6): 593602.