Depression

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Basic Facts

Depression is a mood disorder that affects daily life. People need to take their depression seriously and get treatment right away. Depression can cause:

  • Sleep problems
  • Long-term sadness
  • Anger and frustration
  • Feelings of hopelessness or loss
  • Low energy
  • Problems with work, relationships, and social life
  • Suicide

Common Types of Depression

Depression ranges from mild, temporary periods of sadness to severe, persistent depressed mood with problems carrying out daily activities. These are the most common forms of depression.

Major Depression

Major or “clinical” depression is the most severe and lasting type of depression. This depression occurs daily for at least 2 weeks. Most older adults have major depression for a long time before they know something is wrong and try to find treatment.

Up to 8 percent of people with major depression complete suicide.

If you have symptoms of major depression, call your healthcare provider right away. Signs you need to contact them include:

  • Frequent crying spells for little or no reason
  • Depression is harming your work or family life
  • Thoughts of suicide or harming yourself

Three forms of major depression are relatively common in later life.

  • Depression related to dementia. Some symptoms of major depression are similar to symptoms of dementia (brain diseases affecting thinking, learning, and memory).  Sometimes depression can mimic dementia. People with signs of either disease need to see a healthcare professional. 
  • Depression related to physical illness.  People with serious illness have a higher risk of depression. Medications to treat these diseases can cause side effects that lead to depression. Symptoms of physical illness can be the same as depression. So, when people have severe symptoms they need treatment.
  • Depression associated with death of family and friends.  As people age they are likely to lose family and friends. So, the risk of depression is higher. A major depression may happen when grief is extreme or lasts a very long time. This type of grief needs treatment from a healthcare provider.

Psychotic Depression

People with severe depression may have hallucinations, delusions, or paranoia.  

  • Hallucinations are when a person sees or hears things that are not really there. 
  • Delusions are when a person has difficulty with determining what is real.
  • Paranoia happens when people feel very suspicious, such as having feelings of worry that other people are trying to harm them. Often people may believe they are being poisoned.

Psychotic depression is most common in severe depression and towards the end of life.

Minor (sub-clinical) Depression

About 25 percent of older adults experience less severe symptoms of depression. This type of depression can cause problems like:

  • Poor health
  • More visits to the doctor
  • Problems with daily activities
  • Decreased social activity
  • Early death

Seasonal Depression

People who are very depressed during the winter may have seasonal depression. This is also called Seasonal Affective Disorder or SAD. This type of depression usually lasts about two months. If the pattern repeats for at least two years a healthcare professional may diagnose SAD.

Bipolar Disorder

Bipolar disorder (previously called “manic-depressive disorder”) involves periods of major depression that alternate with manic periods. During the manic periods, people may:

  • Be very high-spirited, talkative, and active for a week or more
  • Have feelings of inflated self-esteem, grandiosity (self-importance), and higher sexual desire
  • Sleep less than normal
  • Spend money wildly
  • Have racing thoughts or paranoid delusions

Older adults may be irritable or agitated rather than high-spirited and grandiose.

Suicide

If you have thoughts of suicide, a plan for suicide, or thoughts of harming yourself, immediately call 911, or the National Suicide and Crisis Lifeline at 998. The Lifeline is available for everyone, is free, and confidential.

Risks for suicide include:

  • Previous attempts at suicide, suicidal thoughts, or a wish to be dead
  • Recent losses and hopelessness
  • Not following treatment recommendations
  • Impulsive behaviors
  • Substance misuse
  • Feeling of being a burden to family or others
Two screening questions are used for depression and suicide. If a person answers yes to either of these questions, seek help immediately. 
  1. Over the past 2 weeks, have you felt down, depressed, or hopeless?
  2. Over the past 2 weeks, have you had thoughts of hurting or killing yourself?

How Common is Depression?

Up to two percent of older adults have major depression. More women than men report that they are depressed. Up to 15 percent of older adults have less severe depression.

About 75 percent of older adults who died as a result of suicide likely were clinically depressed. Widowed men age 70 or older are at highest risk of depression and suicide.

Many older adults are not likely to admit or even realize that they are depressed. So, they don’t get the treatment they need. People of color are less likely to use mental health services than White people.

 

Last Updated February 2023

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