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A Guide to Mental Wellness in Older
Age: Recognizing and Overcoming Depression
Am I Depressed?
Everyone has experienced a period
of sadness during his or her lifetime. Sometimes these
sadness are in response to something that has happened
such as the loss of a loved one or a difficult time
at home. But, there is a difference between feeling
sad in response to a life event and experiencing
a clinical depression. Depression is not just “feeling
blue” or feeling grief after a loss. Depression
is a feeling of sadness that lasts for many weeks
and does not go away. Depression interferes with
your daily activities and often includes changes
in sleep, changes in appetite, and a general loss
Depression is a common illness that affects
millions of Americans each year, but it is a treatable
Depression is not a personal weakness. You cannot
develop depression from reading sad stories or catch
someone else. Depression is caused by an imbalance
in brain chemicals called neurotransmitters. Men
and women of all ages, genders, races, ethnic groups,
economic status can experience depression. Famous
people including actors, successful business people,
have spoken out about their experiences with late-life
The symptoms of depression in older persons
differ from those experienced by young persons or
those in midlife. The signs that an older person
from depression include the inability to sleep,
memory problems, confusion, withdrawal from social
and irritability. People in their later years are
less likely to appear sad or talk about a depressed
This is partly because depression feels different
to a person in late life and also partly because
depressed person will often not talk about symptoms
of sadness. Sometimes the most common symptom of
depression in an older adult is persistent complaints
aches and pains along with frequent demanding behavior.
There is evidence that depression can run in families
and that the risk of depression can be passed from
parents to children. However, it is not known yet
how genetic factors work or how important they
risk factors for late-life depression include gender
(women are more likely to suffer from late-life
depression than men), being single (especially
lack of friends (living alone at home with few
with other people).
As we age, there are life events
that can trigger a clinical depression. Physical
as heart attack, stroke, hip fracture, bypass
surgery, and macular degeneration are often associated
the development of depression. Hormonal changes
in women have been shown to trigger depression.
alcohol or drug use (including over-the-counter
medications) may lead to a clinical depression.
prescribed by your physician or a combination
of medications can cause a clinical depression. Medicines
for pain, high blood pressure, and arthritis;
treatments; and tranquilizers can result in a
change in brain chemicals to trigger a clinical depression.
loss of a loved one may lead to a depression. Most
individuals grieve when a loved one dies,
but if that
grief becomes profound and lasts a long period
of time, it can evolve into a clinical depression
Symptoms of Depression
Symptoms of depression
usually last over two weeks.
- Disturbed sleep (sleeping too much or too
- Changes in appetite (weight loss or gain)
- Physical aches and pains
- Lack of energy or motivation
- Irritability and intolerance
- Loss of interest or pleasure
- Feelings of worthlessness or guilt
- Difficulties with concentration or decision
- Noticeable restlessness or slow movement
- Recurring thoughts of death or suicide
- Changed sex drive
Risk Factors for Late-Life Depression
in medications or newly prescribed medications
for other illnesses
- Recent loss of a loved one
- Presence of another illness or after a stroke,
bypass operation, or hip fracture
- Severe and chronic pain
- Living alone and feeling socially isolated
- Hormonal changes
- Family history of depression
- Alcohol or drug abuse or misuse
If you have become worried that you feel “low” or
your changes in sleep patterns are disrupting your normal
activities, you should seek help. Some of your friends
may have told you that your feelings are normal for
someone your age, or that depression is expected as
you experience physical limitations in life. This is
not true. Depression is not a normal function of aging.
When you feel depressed over a period of time, it is
time to seek treatment.
You don’t have to experience all of the symptoms of depression
to have depression—people experience depression differently.
One person may lack energy or motivation, sleep excessively, and
gain weight. Another person may become anxious and lose sleep. Older
adults usually experience more problems with sleep and are less
likely to have a depressed mood or guilty preoccupation (that is
common in younger persons with depression).
If you have thoughts of suicide or death, contact someone
immediately, whether it be a medical professional, a
spiritual advisor or a loved one. The most important
thing to remember about suicidal thoughts is that they
are symptoms due to the chemistry of your brain—they
are not signs of personal weakness nor will they go
away by themselves. Don’t let embarrassment stand
in the way of communicating how you feel.
Depression Scale (Short Form)
Depression Scale (GDS) is a screening tool designed
specifically for older adults who may
need further evaluation for depression. It is a valuable
and reliable measurement tool used in clinical practice
and research programs. If you suspect you are suffering
from depression, you can answer the questions yourself.
If you have a score of five or more points, you should
contact your health care provider for further evaluation.
Choose the best answer for how you have felt over
the past week.
||Are you basically satisfied with your life?
||Have you dropped many of your activities and interests?
||Do you feel that your life is empty?
||Do you often get bored?
||Are you in good spirits most of the time?
||Are you afraid that something bad is going to
happen to you?
||Do you feel happy most of the time?
||Do you often feel helpless?
||Do you prefer to stay at home, rather than going
out and doing things?
||Do you feel that you have more problems with memory
||Do you think it is wonderful to be alive now?
||Do you feel worthless the way you are now?
||Do you feel full of energy?
||Do you feel that your situation is hopeless?
||Do you think that most people are better off than
||Scoring: Score one point if you answered NO to
Questions 1, 5 7, 11, 13. Score one point if you
answered YES to Questions 2, 3, 4, 6, 8, 9, 10,
12, 14, 15. Total your points.
Author: Jerry Yesavage, M.D., Department of Psychiatry
and Behavioral Sciences, Stanford University Medical
Center. Reference: Yesavage JA, Brink TL, Rose TL, Lum
O, Huang V, Adey MB, Leirer VO: Development and validation
of a geriatric depression screening scale: A preliminary
report. Journal of Psychiatric Research. 17: 37-49,
A Guide to Mental Wellness in Older Age: Recognizing
and Overcoming Depression
Geriatric Mental Health Foundation 2004
7910 Woodmont Avenue, Suite 1050
Bethesda, Maryland 20814
Expert assistance was provided by
Lissy F. Jarvik, M.D., Professor Emerita of Psychiatry
and Biobehavioral Sciences,
University of California-Los Angeles, School of Medicine;
Susan Lieff, M.D., M.Ed., Assistant Professor, Department
of Psychiatry, University of Toronto; and Stephen
J. Bartels, M.D., M.S., Associate Professor of Psychiatry,
Dartmouth Medical School.
The Geriatric Mental Health
Foundation grants permission to print, photocopy,
and distribute this material.
Please cite the Foundation, including the address,