Mazlan has a passion for health and fitness. He enjoys yoga, cycling, home workouts, and healthy food.
Depression in the Elderly
Depression can occur to anyone of any age irrespective of your background or how stressful was your life history.
What Causes Depression in the Elderly
For elderly people, depression can be a common problem and is a form of elderly illness. They may be lonely, may have lost their loved ones, financial savings could be running low, the absence of caring and supportive communal networks, have medical problems, or they expected more than what their loved ones can provide.
A depressed elderly person may refuse to see anyone or even take their prescribed medication. They may refuse to eat and do anything except just stay in bed. These will make the depression worse.
However, based on this study ‘Depression in Older Adults’ by Amy Fiske et al. Department of Psychology, West Virginia University, depression is less frequent in older adults compared to younger adults. Suicide rates in elderly people are also declining but still higher in younger adults. Nevertheless, depression and anxiety in the elderly still warrant serious attention as they can lead to serious consequences.
Symptoms of Depression in the Elderly
Most of the time it is difficult to know if the elderly are suffering from depression or otherwise. They may be suffering from existing conditions such as diabetes, cancer, or strokes and these are anxiety and not symptoms of depression.
They won't tell you their problem so as not to burden you. By the time you come to know of it, it may be too late.
Signs of Depression in Elderly
Look out for the following signs that may suggest depression:
- Difficulty doing routine things at home and may withdraw from pursuing their interest in what used to be their favorite pastime, such as gardening.
- The difficulty with their body movement or speech may be slow and sluggish.
- They may indicate or give signs of being disheartened, useless, or insignificant. They think that they will be a burden.
- They may harbor thoughts of suicide.
- They may have problems sleeping or falling asleep.
- Loss of appetite, eat very little, and failed to take care of personal hygiene.
- They may start to drink more.
- They may be impatient, irritable, and have memory problems.
Elderly Depression Scale
The elderly depression scale or also known as the geriatric depression scale is one of the many instruments used to measure depression. It was first created by Yesavage, et al., as a self-report measure of depression in older adults and is now used extensively with elderly people.
The geriatric depression scale is 30 questionnaires in which the elderly people are to respond by answering yes or no on how they felt over the past week. There is a shorter version with 15 questionnaires. Based on the responses, scores of 0 to 4 are normal and scores of 12 to 15 indicate severe depression.
You can check out the 15 questionnaires here in the New York University College of Nursing bulletin.
Aging and Depression
According to Dr. John Greden, the executive director of the University of Michigan Comprehensive Depression Center and founding chairman of the National Network of Depression Centers, 1 in 6 Americans has bipolar illnesses and lifetime depressions. And about 75 to 80 percent of deaths by suicide can be linked to these mood disorders esp. among the elderly.
Aging and Stress
While stress is good as it can provide energy and focus, too much stress especially in elderly people can throw their system off balance and is linked to many health problems including depression. For older people managing stress is therefore important.
How to Help the Elderly with Depression
There are several options to help the elderly with depression. Some people go for prescribed medication but this should be the last resort unless it is already a severe case. Check with your doctor on this matter. Instead, try the non-invasive way.
Treating Anxiety in the Elderly the Non-Invasive Way
The following suggestions look at the alternative non-medicinal approach. As each person is different, try various approaches to see which non invasive ways work best. Continue to do so until you find the right one.
Talk to them and listen. Listening can encourage them to pour out their problems and give them comfort. Listen attentively and do not pass any judgment or offer advice. Just listen because that is what they want at that moment.
This is a mild form of listening therapy otherwise this therapy is actually, listening to music. The sound wave of specifically modulated music can improve brain function including anxiety. It is not a cure for anxiety or for old age depression but can give short-term benefits.
2. Pet Therapy
Give them something to care for like a pet dog. This will also give them something to look forward to, which is good as psychological and physical comfort. Pet, as animal-assisted therapy, will give the elderly the needed companionship and is a good way to relieve anxiety in older adults.
3. Recognize Their Problem
Depression is a serious matter and people should accept it as a form of illness, disability, or elderly illness. Do not expect your elders to just buck up and be themselves again the next moment. Help to tackle their problem by breaking it into smaller tasks and steps, so that they easily handle them.
4. Diet and Food That Help Depression
Reduce salt in their diet as elderly people are sensitive to sodium intake. This will lower their stress or hypertension level, which is one of the key issues in depression in older adults. Avoid caffeine and alcohol as these will worsen and dampen their mood. Likewise, foods high in fat and sugar can also aggravate their mood.
Food that helps with depression are:
Nuts (cashews, brazil nuts, hazelnuts)
Seeds (chia seeds, flaxseed, pumpkin seeds, squash seed)
Probiotics (Kimchi, Kombucha, Miso, Sauerkraut, Tempeh, Tofu, Yogurt)
Darker leafy vegetables
Sometimes having children around can lift their mood, especially if it is their grandchildren. In some cases, this may not work. It might even be stressful and increase their anxiety level. So, assess the situation and see which works best.
6. Mild Exercise
Keeping the elderly occupied both in mind and body can lift them out of their depression. Go for a walk, go shopping for groceries together, go to the movies, have lunch or tea at their favorite restaurant, or anything that they used to enjoy. You may get the initial rejection of all these ideas but try to be gently firm.
7. Regular Visit
Nothing is more exciting than to anticipate the next visit. Arrange and schedule regular visits among family members and friends if you cannot make it on a regular basis. This visit is therapeutic as it helps fight loneliness and isolation especially for an elder that is already suffering from depression.
8. Herbal Remedies
For some older people, certain herbal remedies offer some form of relief for their depression. However, please check with the doctor if these herbal remedies have any side effects on their existing medications.
- Omega-3 fatty acids: Studies have shown that taking both omega-3's and antidepressants can be more helpful than taking antidepressants on their own. Take it before meals. Foods that are rich in Omega-3 fatty acids are fish such as cold-water fatty fish (tuna, sardines, mackerel) and other seafood (oysters and mussels). If they can take nuts and seeds, these are also good.
- St. John's Wort: Used traditionally as a treatment for anxiety, sadness, and nervousness, St. John’s Wort can be an effective antidepressant if they have mild or moderate depression. Do not take together with prescribed or over-the-counter antidepressants as it may interfere with its effectiveness.
- Magnesium: As stress will deplete magnesium, take food rich in magnesium such as green vegetables or whole grains. Alternatively, take magnesium supplements.
- Folic acid: Taking folic acid and vitamin B12 will also help improve the effectiveness of their anti-depressant medication. Cabbage, whole grain oats, and brewer’s yeast are rich in folic acid.
- Vitamin D: Fight depression by reducing inflammation, protecting against neurocognitive dysfunction, and regulating mood. You can take supplements, food rich in Vitamin D, or go outdoors and get it from direct sunshine as our body creates it when we are exposed to direct sunlight.
9. Brown Rice for Depressed Elderly
Brown rice is rich in vitamins B1, B3, and folic acid, essential for the production and regulation of neurotransmitters such as dopamine, serotonin, and gamma-aminobutyric acid. It will also release glucose gradually into the bloodstream, which will prevent any mood swings. So, include brown rice in the elderly people’s diet.
10. Oxygen Therapy
Oxygen therapy involves breathing in a concentrated form of oxygen. Studies show that it helps alleviate depression especially in the elderly. It improves blood circulation; sending energizing oxygen to the muscles and brain. This gives new strength to their body and mind. However, seek medical advice before you decide on this option.
11. Sunshine Therapy
Studies showed that natural sunlight helps people that suffer from depression. Exposure to sunlight will release serotonin, a hormone that boosts mood by relieving stressful feelings and making them feel calm and focused. As mentioned earlier, sunlight helps our body to create Vitamin D.
So, take them out for a walk or have drinks outside to benefit from the sunshine exposure. This is a simple and fun way to brighten the elderly mood swings.
12. Laughter Therapy
As the saying goes, laughter is the best medicine. When you laugh, the body releases the feel-good hormone, endorphins. This chemical gives the overall sense of well-being, reduces stress, can even temporarily relieve pain, and is a fun way to snap out of depression.
As a good therapy for depression in the elderly, let them listen to a comedy show or watch good comedies. The old Laurel and Hardy or Charlie Chaplin movies are possible choices but my favorite is ‘I Love Lucy’.
13. Reading Story Book
Nothing will excite the elderly more than to hear a child read to them or even hearing a child’s voice. Arrange for your children to take the turn to read storybooks or newspaper articles to their grandparents. Alternatively, you can try a product that lets you record the reading and have it sent to them. It is like a greeting card with sound. The moment they open the card, they will hear the story read by their loved one, a good way to help aging parents deal with loneliness.
14. Sessions With a Psychoanalyst
There may be issues that an elderly person is not comfortable talking to family members or friends. This is one of the signs of depression in the elderly and they will be withdrawn. So, having a session with a psychoanalyst will help.
Acupuncture is about yin and yang and striking the right balance. Depression can be due to this imbalance and acupuncture will put the body back into balance. Choose a well-trained and qualified practitioner for this option. It may not be easy to convince depressed elderly to try this option as some of them are not comfortable with needles. So, you have to explain that it is safe and not painful.
16. Massage Therapy
A feel-good factor is missing in anyone that is depressed. Massage, if properly administered, will enhance this feeling of wellbeing. Massage will also release neurotransmitters, serotonin, and endorphins that are responsible for the feeling good and feeling of calmness for the body. It will also lower the stress hormone.
Geriatric massage or massage for the elderly also improves blood flow and balance, which are common issues with old people. It also softens hard muscles and tissues and stimulates the nervous system, essential for elderly depression.
To some people, being close to their spiritual and religious beliefs provide a positive link between stable and good mental health. If this is the case, provide whatever support you can to give access to these services for your elderly parents.
Lastly, if they are already on medication and undergoing therapy or treatment, ensure these are taken and follow through with the treatment.
Helping the Elderly with Depression During Pandemic
Based on the study ‘Older Adults and the Mental Health Effects of COVID-19’ by Ipsit V. Vahia et al. of McLean Hospital, Belmont, Massachusetts, the elderly people have lower stress reactivity and a better emotional regulation compared to younger people, given the severity of the pandemic. This study was conducted eight months into the pandemic while the longer-term effects on older people remain unclear.
However, for the elderly people who did suffer due to limited contact with family, caregivers, and friends, you can help them by:
- Online contact via Google Talk, Zoom, WhatsApp video calls, etc.
- Maintain social connections and stay in touch ALL the time.
- Share and update information with them.
- Arrange for food, groceries, etc delivered to their homes.
- Pay bills on their behalf, online.
- Help them with any healthcare needs.
It is our responsibility to care for our elderly parents or grandparents irrespective of the situation. Depression in the elderly if not properly monitored and checked in the initial stage, can lead to more problems later.
It is our responsibility to care for our elderly parents or grandparents irrespective of the situation. Depression in the elderly if not properly monitored and checked in the initial stage can lead to more problems later.
It is also our responsibility to look out for our children, especially our teenage children. Depression among teenagers is on the increase and in some cases, it has led to suicide.
Our role as a caring parents to our children as well as to our own parents or grandparents are huge responsibilities and some are unable to cope with these ‘burdens’. There are support groups, caregivers, and free counseling centers that can come in and provide you with assistance. Check the local directories for their address or check online for details of their services.
Resources and References
- US National Library of Medicine: Folate, vitamin B12, and homocysteine in major depressive disorder
- GoodTherapy.org: Religion and Depression
- American Psychology Association: depression and Suicide in Older Adults
- World Health Organisation
- US National Library of Medicine: Elderly Patients with Schizophrenia and Depression: Treatment
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
Questions & Answers
Question: How much vitamin B12 should I take daily?
Answer: Refer to this WebMD article for assistance: https://www.webmd.com/a-to-z-guides/supplement-gui...
© 2012 Mazlan A
Mazlan A (author) from Malaysia on June 26, 2018:
Hi June. I am 65 years old and not far ahead of you :-)
June the suggested methods as per my article is the natural way but it will be a slow recovery process.
Have you tried yoga? The gentle yoga is very easy and you should give it a try. Search for a yoga center near you. Although you can buy video or do online, in your case a group yoga session will be more meaningful.
Let me know of your progress please.
Thanks for dropping by and chipping in to share your issues.
Hope to hear from you soon.
June Kaufman on June 25, 2018:
Hello. I'm not what you would call elderly. I'm 64 yrs young & have suffered with major depression & anxiety for quite some time. I am a post kidney transplant patient twice & deal with Artial Fibulation as well. I've been on anti-depressants, currently Celexa & Serquel for sleep. Are there any natural ways I can fight this without taking Celexa & Serquel ?
Mazlan A (author) from Malaysia on June 06, 2018:
Hi Deanna. Sometimes in front of friends, they will not show their current state of affairs and maybe that's why her church members don't see the signs. If you can talk to one of them and explain your concerns and ask if they could help by visiting your mom at home, call her regularly and later, to slowly ask whats troubling her.
In the meantime, can you take her out for a walk and have her exposed to more sunlight, draws the curtain to have more lights into the room, show some funny old sitcoms like 'I Love Lucy' etc. Do things that do not give her the impression that you suspect her of state of affairs.
Hope these help.
Deanna Deloatch from Chesapeake, Virginia on June 05, 2018:
This was a good article on depression and the elderly. My mom is currently going through depression however, she is in denial. Any tips for pulling her out of her denial? I try to help, but it seems like the only people she will listen to are her church members and they don't see it.
Mazlan A (author) from Malaysia on January 20, 2013:
@DeborahNeyens. Thanks for dropping by and sharing your thoughts. I am glad you find this article on depression in the elderly useful. Have a great weekend.
Deborah Neyens from Iowa on January 18, 2013:
It's good to bring awareness to this issue. As the population ages, this problem likely will be on the rise. Very useful information.
mizjo from New York City, NY on December 13, 2012:
@watergeek, I am so sorry about your mother. Yes, I know that dementia in a parent makes it difficult to care for her. If it is only slight, where she only forgets where she lives and how to care for herself, it is still possible to keep her home with a part/full time caretaker.
I agree that in severe dementia, where the person even forgets how to use her legs, then there is no option but to admit her into a care facility. She is beyond recognising her own family at that stage, does not miss them and depression is not an issue. With being bedridden, incontinence, and, in many publicised cases, elder abuse and neglect in nursing homes, death is not far off.
@TLC I feel your pain.
Susette Horspool from Pasadena CA on December 13, 2012:
I had to put my mother in a nursing home, because there was just me, I was working, and she had dementia. She used to just take off without saying anything and end up in the next town over, some stranger calling me from the phone number on her bracelet, her claiming that he was a good friend from church. A security guard found her wandering the local college a mile away one day (I was home when she took off - one minute there, the next gone) and called the hospital emergency ward, who put her in the mental ward, who referred her to a locked Alzheimers facility. I fought to get her into a better place and succeeded, but after a few months she lost the use of her legs and they couldn't keep her anymore.
mizjo from New York City, NY on December 13, 2012:
Greatstuff, it is cheaper to have a caretaker in the home (if the grandparent needs some help) than to keep the grandparent in a nursing or Old Folks' Home. As TLC says, 'they even take your Social Security', so the resident is penniless. That money could pay the caretaker, with some change.
And as 'ipcmc' from the Philippines says, ' the older (her grandmother) got the more she wanted to be with family and friends'. It is so cruel to dispose of an old parent just because she is old. She has to go to a strange place among strangers, at her age, when her only security and happiness is with her own family? The isolation and loneliness is so extreme she only wants to die. I know, I have worked in nursing homes. These people soon become incontinent, they don't want to get out of bed.
There are of course, Assisted Living Homes, where the atmosphere is very different. But they cost a LOT of money (EVERYTHING you have, in many cases) and that money could very well be used at home with the family and maybe a part time carer.
The truth of the matter is that, in 'first world countries', there is no room in the heart for the elderly. Until we go back to the mindset of our forefathers, where they lived with less material goods and more spiritual, where three generations lived and loved together through thick or thin, sharing wealth or poverty, then the curse of loneliness and depression and guilt will continue to thrive.
Even if both parents in the family work, the grandparent can still stay in the house till they come home, even if they employ a part-time caretaker. We have to give back to the parents who gave us everything.
Mazlan A (author) from Malaysia on December 13, 2012:
@mizjo: Now with both husband and wife working and things are getting expensive, the old ways of living with two or three generations under one roof is becoming tougher for those living in the big Asian cities. It is unfortunate but some had resorted to having their parents in old folks home. Even if their parents are away in the kampong (rural area) some, don’t even have time to call. That is why you will see TV advertisement asking sons and daughters to call their parents esp. during festive seasons. Sad but it is true.
@TCL: It is tough as we get older and I am in that zone now. Will be 60 next year and I keep myself busy with work, fitness, religion and charity work. I try not to expect anything from others so that I will not be disappointed later. Can you keep a pet, like hamster, which is easier than cat or dog (as in nursing home this will be difficult)? It helps. Don’t give up.
TCL on December 12, 2012:
In my family, we lived together, too. But now SSI, Section 8, and foodstamps won't pay if we live with or rent from relatives or even "closely interested" people. So I had to live alone. It really hurt. One thing I miss are the hugs.
Some laws should be outlawed. They do too much psychological damage.
Nursing home--It's like life imprisonment without parole--for the crime of getting old. They even take your Social Security money. I worked in a nursing home once. The joke among the residents was that they hoped they died before their clothes wore out--because they had no money to buy more. Just shoot me. It's a kinder death.
mizjo from New York City, NY on December 11, 2012:
Where I grew up, our grandparents lived with us, and still, many years later, there are three generations in most families.
There was no name for depression because we did not know of such a condition. If someone was grouchy or quiet, there was everyone else in the family to find out why. The mere interaction with members of the family was enough to dispel the clouds. There is no lack of stimulation in a family environment. Why should the elderly ever have to live by himself unless he has nobody?
I remember Crocodile Dundee's answer for the question of depression: 'A tells B, and B tells C, and soon everybody knows about it. A problem shared is a problem halved'. Or as close a quote as I can remember.
As for the argument that nobody has the time to take care of the old parent, is it not true that usually the old parent is mobile and independent until put into the nursing home, and then stops caring for or about himself?
When I first came to a western country (Australia), I could not believe that grandparents lived in Old Folks' Homes. The first one I heard of was called 'Sunset Home'. Rather telling, don't you think?
Anyway, this is my answer and comment to the problem of depression in the elderly.
Mazlan A (author) from Malaysia on November 30, 2012:
Hi TLC, Thanks for stopping by and commenting. You have shared some good ideas and what food to take and avoid. You have also shared some of your issues and these are real issues. I'm 59 years old now and I have seen how the young and old suffered due to problems such as depression. I take note of your comment and I hope things will get easier. Have a good weekend and Happy Holidays.
TCL on November 30, 2012:
I'm elderly, led a life of misery, climbed out by my own bootstraps every time, and learned from it, so I guess I can speak on the topic.
If you want me happy--take out my trash bags that get heavier every year that passes. If you visit me, bring some of the refreshments and pitch in to clean up afterward--in kindness to my bad heart and below-poverty social security income!
When my cognitive faculties began to fail, I learned that low thyroid can do that, as can a slew of other things. But one thing I could afford to try,with my doctor's permission, was a product that repaired and regrew the myelin sheaths around the nerves in the brain (and body, too, I suppose). Well, that worked well enough that my doctor was happy about it. Me being used to melancholy as a standard normality of life, I allowed myself to feel a little relieved, was all....
One caveat--Brown rice may fix mood swings, though I should think wild rice would be more effective; but any high-lectin food is risky, especially where there is already a damaged system. Gluten is one of the many plant lectins but they all are bad on the body, and the only way to defend against them is to avoid them 100% (impossible), or else take one of the products specifically designed to provide anti-lectin with sacrificial sugars for the lectins to latch onto instead of latching on to the body's cell sugars--thereby destroying that cell.
You guys have some great ideas--but please dig a little deeper before you support any modality.
Mazlan A (author) from Malaysia on September 24, 2012:
@leahlefler , meloncauli, and watergeek : caring for the elderly can be challenging at times. They can be 'stubborn' and in our opinion, 'will not listen' to our advice. They have their own reason and I pray that when I reach that age, things will work out fine, whatever that mean!
Susette Horspool from Pasadena CA on September 22, 2012:
Both of my parents suffered from depression when they grew older. I think my sister had the best opportunity to help them - which she did - since she had a family with young kids. The rest of us visited them whenever we went to visit her. Thanks for this hub. What you say is very true.
meloncauli from UK on July 15, 2012:
This is a great hub and very interesting. I know my dad is suffering with some amount of depression but he wont admit it. I guess he feels it will appear weak.
Leah Lefler from Western New York on July 11, 2012:
This is a great reminder for those who are caring for parents (or grandparents) suffering with depression. A lot of times, the elderly are overlooked when it comes to mental health needs. You have wonderful advice here, greatstuff!
Mazlan A (author) from Malaysia on July 10, 2012:
@SidKemp, Caring and connecting are indeed more important than diagnosis. It is also a lot less expensive! Thanks for your input and sharing your own experience.
@teaches12345 Thank you and I'm glad to hear that this was helpful.
@Om, Thanks for stopping by and leaving your comment
@lindacee I would think that alcoholism, late in life, could be related to depression. Thanks for your input and your compliment
Linda Chechar from Arizona on July 10, 2012:
I understand that alcoholism (appearing late in life) is also a prevalent problem among the elderly. I would assume this goes hand in hand with depression. I liked how you included ways to identify depression and a variety of methods to help those affected. Thanks for sharing this valuable info.
Om Paramapoonya on July 10, 2012:
Wonderful hub! I agree it could be difficult to tell whether an elderly person is suffering from depression or not. Most people just assume it's normal for elderly seniors to appear inactive, disinterested or quiet, but in fact, these things can be tell-tale signs of depression.
Dianna Mendez on July 10, 2012:
You have mentioned some interesting tips on this subject: massage, sunshine and brown rice. I would not have known how much this helps if I hadn't read your post. Well done!
Sid Kemp from Boca Raton, Florida (near Miami and Palm Beach) on July 10, 2012:
Thanks, Greatstuff. Your approach is right on. Loving care, listening, playing, and interaction, and attention to all health issues and emotional concerns is a great approach to depression for the old, young, and middle aged. Most of the time, caring and connecting are more important than diagnosis. My wife's father recently moved into a memory care facility, and we try to make sure he has a visitor 5 to 7 days a week.
kumar24894 from Fuck of HUBPAGES on July 09, 2012:
You are welcome :)
Mazlan A (author) from Malaysia on July 09, 2012:
kumar24894 , you are right. Thanks for reminding us that stress and depression can lead to weight gain.
kumar24894 from Fuck of HUBPAGES on July 09, 2012:
Depression and stress can lead to gain in weight.
Mazlan A (author) from Malaysia on July 09, 2012:
@lambservant, yes you are right. St John's Wort does interfere with prescribe medication. Thanks for the additional input and sharing these useful information.
@spartucusjones, thanks for for bringing up these very good points
@jpcmc, it is good that your grandma wants to be among family and friends. That is a healthy sign. Thanks for sharing.
JP Carlos from Quezon CIty, Phlippines on July 08, 2012:
How we see old age is very different. More so if you're already a senior. Regardless of how you see getting older, communicatino with family and friends will always be important. Every bit of support is appreciated. At least this is what I saw in my grandmother. The older she got the more she wanted to be with family and friends.
CJ Baker from Parts Unknown on July 08, 2012:
Very practical and well developed hub! It has been said that one parent can parent can look after 10 children, but ten children can't look after one parent. A good reminder for those that have elderly parents. We want to do what we can to care for them and we want to be on the look out for any signs of depression.
Lori Colbo from United States on July 08, 2012:
Wonderful hub and great advice. I would add that if your elderly loved one is taking medication for depression check with a pharmacist before adding natural remedies such as St John's wort. The combination of some natural herbal substances can actually cause harm. In fact it is important to talk to their doctor before adding anything not prescribed because some vitamins, foods and over the counter meds can clash with already prescribed meds. Thank you for this very good hub.
Mazlan A (author) from Malaysia on July 08, 2012:
@dinkan53, you are right. Loss of brain stimulation can be a big problem and could later lead to stressful situation and hence to depression. Thanks for the input.
dinkan53 from India on July 08, 2012:
The negative outcomes, especially for older retired people can be the loss of brain stimulation. Glad to know that brown rice can prevent mood swings. This is a useful article, rated up.