Low Mood in Later Life: How to Spot Depression in Older Adults

Key Takeaways

• Depression is common but often overlooked in older adults because symptoms can differ from younger people and are frequently mistaken for ageing.

• Older adults may show less sadness and more fatigue, anxiety, memory issues, appetite changes, and withdrawal from daily activities.

• Barriers such as physical illness, communication difficulties, misconceptions about ageing and limited GP appointment time mean depression is often underdiagnosed.

• Treatments include CBT, talking therapies, exercise, antidepressants, and in severe cases ECT, which remains safe and effective for many older adults.

• Persistent low mood is not a normal part of ageing. Seeking help early makes recovery more likely and improves overall wellbeing.

Depression doesn’t discriminate. It can affect people of any age, but did you know the symptoms of depression may be different in older adults?

In this article, we’ll talk about what depression is, how it affects older adults, signs to look out for, and how you can help yourself or a loved one deal with low mood.

What is depression?

It’s normal to feel down every once in a while, but depression is more than feeling a bit unhappy. With depression, you may feel low for weeks or months rather than a few hours or days.

Although many people think of depression as feeling sad, there’s more to it than that. Both psychological and physical symptoms can be a sign of depression.

Common psychological symptoms to look out for include feeling:

• hopeless

• low or sad for a prolonged period of time

• tearful

• guilty

• irritable

• demotivated or uninterested in things

• indecisive or hesitant

• like life has no joy

• anxious or worried

• suicidal or like you may harm yourself

Alongside symptoms that affect your mood and thoughts, depression may also lead to:

• a lack of energy

• aches and pains

• low sex drive

• constipation

• slow speech or movements

• weight or appetite changes

• sleep disturbances

Some people also withdraw from friends and loved ones, neglect their hobbies, and struggle with their work or home life. Symptoms often come on gradually – so much so that you don’t notice them until someone else points them out.

Although these are the most common symptoms of depression, things often look a little different in people aged 65 and older.

Is depression different in older adults?

Everyone is unique, and depression tends to affect people in different ways. However, some patterns tend to be noticeable in older people.

Depression can be classed as early-onset or late-onset. Although depression may rear its head again as someone ages, around 50% of older adults with depression have never experienced it before.

Unlike in younger adults, older people can experience depression without feelings of sadness or low mood. Low energy levels, anxiety and fatigue are much more common signs of depression in people aged 65 and over.

Older people are also more likely to become uninterested in activities they used to enjoy or experience a kind of numbness. They may withdraw themselves, avoiding social situations, clubs, group activities, and even family gatherings.

Although many factors linked to depression are universal, some things more commonly affect people as they grow older. Social isolation, health problems, and loss of a loved one are common triggers of depression in older people. These factors may also make it harder to seek support.

Barriers to seeking help

Older people experience depression as much as younger people do, but are much less likely to get the help they need.

It's challenging for most individuals to talk about their feelings with older people having potentially more barriers in the way. Disabilities affecting their speech, hearing problems, or some level of confusion can find it even harder to communicate.

Physical health problems are also more common with age which makes it easy for the physical symptoms of depression to be overlooked. Aches, pains, appetite changes, or a lack of energy may be wrongly attributed to a physical health condition like arthritis.

Limitations in GP settings may lead towards healthcare professionals focussing on physical concerns over mental health. As symptoms can vary to a great degree in older people, knowing what to look out for is one of the first barriers to overcome. For this reason, diagnosis of depression can be overlooked.

Recognising signs of depression in older people

Whether you’re worried about a loved one or yourself, it’s good to know the common signs of depression in older adults.

Older people can get any of the symptoms of depression we discussed earlier, but are more likely to experience:

• dizziness

• memory loss

• aches and pains

• weight loss

• sleep problems

• low energy

• anxiety

Behavioural changes are also common. This may mean not wanting to leave the house or struggling to find enjoyment in things you previously liked doing. It can also mean not wanting to eat or even drinking more alcohol than normal as a way to cope.

For elderly people living in care homes, staff may notice changes in their behaviour like refusing food, falls, and even acts of violence.

A serious symptom of depression is having thoughts about wanting to end your life. Signs like giving away their personal possessions, talking about death a lot, or changing their will can all be signs of suicidal thoughts in a loved one. It’s important to take suicidal thoughts seriously and seek help from a medical professional. If you or someone else is at risk of immediate harm, call 999.

By noticing the signs of depression early, it makes it easier for you or your loved one to access the help and support they need to get better. But what does this involve?

Treatments for low mood

If you or someone you love has been struggling with any of the symptoms we’ve talked about for more than 2 weeks, it’s best to speak to a doctor. They will be able to offer advice on what to do next, including the different treatment options available.

Mild depression

For mild depression, a GP may decide to wait and see if things get better in a few weeks. In the meantime, they may offer some guided self-help tools based on cognitive behavioural therapy (CBT) or talking therapies.

CBT can be an effective way to reprogramme the way someone thinks when they’re distressed, but not all tools are suitable for everyone. Your GP should be able to advise on how to access therapy over the phone or in person if you feel this would suit your needs better than online tools.

Exercise can be an effective way to improve symptoms of depression in all age groups, but this in itself can be a challenge for older individuals. Resistance exercises and mind-body exercise have been shown in one study to be particularly effective for older adults. The Age UK website is a good resource for types of exercise to try and find nearby classes.

Moderate to severe depression

Alongside talking therapies, people with more serious depression may benefit from taking antidepressants. These medications can take 6-8 weeks to start working so it’s important to give them a chance.

A doctor can advise on which antidepressants are suitable to take with any prescribed medications you may already take, and for people with other medical conditions.

Usually, antidepressants are an effective treatment, but people that continue to struggle long-term with depression may be offered a type of treatment called electroconvulsive therapy (ECT).

ECT is generally safe for people up to 85 years old (and even older), but there is some risk as it involves having a general anaesthetic before receiving treatment.An electrical current is administered to the brain which acts to “reset” the brain and improve mood.

Studies suggest that 79% of people with major depression experience a long-term improvement in symptoms after receiving ECT, but it can come with side effects like short-term memory loss. Learn more about ECT in this NHS article.

If you or someone close to you needs help for a mental health crisis, book an emergency GP appointment or get advice by calling 111. If someone’s life is at risk, you should call 999.

Supporting your wellbeing as you age

Self-care is something you can do at home to help with managing symptoms of depression. By keeping up the activities you enjoy, staying active (even just a short walk every day), and maintaining connections with friends and family, you can boost your wellbeing and make life more enjoyable.

As we grow older, it's essential to recognise that feelings of depression and anxiety are not just "part of ageing." Experiencing persistent low mood, lack of energy, anxiety, or other symptoms are signs that something isn't right and should be addressed.

Talking about your feelings is often the first step toward feeling better, whether it's with a friend, family member, or healthcare professional. Remember, it's never too late to seek help, and doing so is a sign of strength, not weakness.