AARP Hearing Center
If there is just one thing you should take away from this article, it’s that there is a world of difference between feeling depressed and having depression, which is a diagnosable mood disorder. We all feel sad or defeated at times; staying perpetually upbeat and cheerful is hardly the natural human experience, be it today or at any time in history. But a relatively short period of melancholy isn’t a medical condition.
Depression, in contrast, is a specific and serious mood disorder with a clear definition. To be diagnosed with depression (doctors also use the terms “clinical depression” and “major depressive disorder”), a person must be experiencing five or more of the common symptoms of the condition (see "Warning Signs of Depression in Older Adults") most of the day, nearly every day, for at least two weeks, says the American Psychiatric Association’s DSM-5.
Likewise, clinical depression has a range of causes that go far beyond how you might be responding to challenging times. It has a biological basis involving genetics and brain chemistry; on top of that are life experiences and psychological and social factors. Given clinical depression’s complexity, researchers are still trying to untangle how all these factors combine to create depression symptoms. But most people with depression need treatment, as appropriate for a medical condition, to feel better.
Given the complex web of depression triggers, telling someone with depression to “snap out of it” or “buck up” is about as helpful as telling someone with a cold to cure themselves by not coughing. Asking “How bad can it be?” or saying “Things could be worse” will do no good. What will? There are medicines, talk therapies and other approaches that can help most people. It will probably take some trial and error to find the right one, but it’s definitely important to get well.
Expecting the losses experienced in older age to spark lasting low moods might seem reasonable, but that assumption is wrong. “There are a lot of people who think depression is a normal part of aging, and it is not,” says Erin Emery-Tiburcio, a geropsychologist at Rush University Medical Center in Chicago.
Warning Signs of Depression in Older Adults
Here are the more common symptoms. This list is not exhaustive.
- Persistent sadness or emptiness
- Inability to experience pleasure
- Hopelessness, guilt, worthlessness
- Sleeping much more or less than usual
- Decreased appetite
- Weight loss
- Low energy or fatigue
- Moving or talking more slowly
- Problems concentrating
- Physical symptoms: aches, pains, headaches, digestive problems
- Thoughts of death or suicide
If you or someone you know is considering suicide, call, text or chat the 988 Suicide & Crisis Lifeline.
In fact, older people are less likely than younger people to face depression. In a 2023 Gallup poll, almost 25 percent of U.S. adults 18 to 29 reported having or being treated for depression, while about 16 percent of people 45 to 64 and 12 percent of those 65 and older reported the same. And the illness occurs more often in women than in men: almost 24 percent versus 11 percent, respectively. At the same time, so-called minor depression, which means having fewer than five of the symptoms mentioned above, is more common in older adults and can also lead to worse health overall.
What is depression?
To be diagnosed with major depression, “you must have one of the two cardinal symptoms of depression or both,” says George Alexopoulos, M.D., a geriatric psychiatrist at Weill Cornell Medical College. The two main symptoms — lasting at least two weeks — are sadness and anhedonia, an inability to experience pleasure.
Other symptoms that can contribute to a diagnosis are decreased appetite, weight loss and sleeping much more or much less than usual. A person with depression might feel tired, and their movements may appear to others as agitated or slowed down. They might also be unable to concentrate or think, feel excessive guilt and have thoughts of death.
In older adults, the symptoms may look slightly different, Alexopoulos says. “The inability to experience pleasure is more frequent in older adults than younger,” he says. Imagine an opera lover who turns down free opera tickets because they just can’t rally themselves to go.
AARP Membership— $12 for your first year when you sign up for Automatic Renewal
Get instant access to members-only products and hundreds of discounts, a free second membership, and a subscription to AARP the Magazine.
Trouble sleeping is another big one that Alexopoulos sees often in older patients. “They fall asleep, typically 8, 9 or 10 o’clock. And then an hour later, they’re up climbing the walls.” Insomnia can be a symptom of both depression and anxiety — another common mental illness that often goes hand in hand with depression. Finally, he says, older adults might have similar ratings on scales of depression as younger people but be far more disabled by their symptoms. “Essentially, they either take to their bed or they sit in front of the television [but] don’t watch it,” he says. “They neglect their hygiene; they neglect eating.” People of all ages will do this when severely depressed, but in older adults, even moderate depression can affect how well they care for themselves.
What happens in the brain to cause depression?
From ads for antidepressants, you’d think the key to treating the mood disorder is to reset a few brain chemicals that have dropped too low. For years, that was the main theory: Three chemicals, or neurotransmitters — mainly serotonin, dopamine and norepinephrine — weren’t doing their job, which is to carry messages from nerve cell to nerve cell in the brain. But there’s been a shift in thinking as scientists try to paint a fuller picture of the changes in the brain that lead to depressive episodes.
More From AARP
Pursuit of Happiness Challenge
Happiness is an important part of your well-being, as you’ll discover in this challenge
Think You Are Too Old for Mental Health Therapy?
Age can be an advantage, but many older people don't get help they need
How to Find the Right Therapist
Whether your mental health needs feel pandemic-specific or not, help is available
Recommended for You