Why Depression Is More Likely as You Age, and What to Do About It

Everyone feels sad or down from time to time. But you might notice you're experiencing more significant bouts of "the blues" with every candle you add to the birthday cake.

Though most seniors feel satisfied with their lives, depression can develop later in life and is a pretty common issue among elderly people, according to the National Institute on Aging (NIA)

Upwards of 5 percent of older adults living in the general community experience depression, per the National Council on Aging (NCOA). These rates jump to 11.5 percent and 13.5 percent for senior citizens who are hospitalized or require home health care, respectively.

While depression is more likely to occur in older people, it is a serious mood disorder — which affects the way you feel, think and behave — and it is not a natural part of aging. Even so, close to 60 percent of individuals over the age of 65 believe that depression is a "normal" aspect of growing older, per the Mental Health America (MHA).

"At all stages of life, depression is most common when contending with stressful life changes, and aging certainly involves many of these," says Jodie Skillicorn, DO, a holistic psychiatrist and author of ​‌Healing Depression Without Medication: A Psychiatrist's Guide to Balancing Mind, Body, and Soul‌‌.‌

Take a look at six reasons why depression can develop as you get older, plus steps you can take to help support your mental health and emotional resiliency. But as you read through this list, keep in mind that the reasons for a depressed mood are often multilayered, and that these factors can raise your risk — but don't automatically cause — depression with age.

The older you get, the greater your tendency to be more sedentary. But "whether young or old, lack of physical activity doubles the risk for depression," Dr. Skillicorn says. That's because movement not only benefits your body but also your brain health and emotional wellbeing.

Here's why: Physical activity triggers the release of certain feel-good brain chemicals that increase feelings of happiness and relaxation while reducing anxiety, according to the Mayo Clinic. Regular exercise can also promote mental health by enhancing your energy level, improving your quality of mood-supporting sleep and empowering you to feel more confident and in control, per the NIA.

And you don't need to commit a ton of time to the gym either.

"Research shows that just one hour of exercise a week, which can be broken down into just nine minutes a day, can reduce the risk of depression by 44 percent," Dr. Skillicorn says. Not to mention the physical incentives you'll gain, including improved bone density, muscle strength, heart health and even an increase in longevity. "Those are big advantages for a relatively short period of time," she says.

More than 90 percent of seniors have at least one chronic health condition such as stroke, cancer, cardiovascular disease or diabetes (and nearly 80 percent have two or more), according to the American Psychological Association (APA).

"When dealing with chronic illnesses, it becomes extremely difficult — perhaps even impossible — to distinguish the symptoms of the disease from depression," Dr. Skillicorn says. "Even when we have a simple cold, much less something more severe, we have less energy, less motivation, less interest in doing the things we normally like to do, changes in sleep and loss of appetite," she says. We're also inclined to be more irritable and moody.

While these are all symptoms of depression, they're also a normal response to sickness. "It's our body's way of reserving energy and resources for healing," Dr. Skillicorn says.

"However, if our illness continues for a long period of time (prolonged COVID is a good example of this), then we tend to get frustrated that we're not feeling better and start to spin negative stories in our heads," Dr. Skillicorn says. For example, we may worry that we'll never recover, or we might feel unproductive, worthless and powerless about our current situation.

"Those negative stories not only weigh us down even more but create more stress in the body, which increases the release of cortisol," Dr. Skillicorn says. This just results in more inflammation, making it even harder to recover. And this damaging domino effect is a recipe for depression, she says.

"The symptoms of dementia and depression can overlap significantly," Dr. Skillicorn says. For example, decreased energy and loss of interest in activities are both indicators of dementia ‌and‌ depression. And often one disorder contributes to the other.

Sometimes, depression is an early warning of dementia while other times cognitive impairment can cause depressed mood.

As the brain becomes more impaired during dementia, focusing on tasks and doing activities grow progressively more difficult, Dr. Skillicorn says. Because they require increased effort and energy, they lead to fatigue and frustration.

"Being less able to engage can not only feel frustrating but also isolating," Dr. Skillicorn says. "This may lead some to disengage from people and activities formerly enjoyed, which just perpetuates the problem," she adds.

Lack of sleep can negatively impact your physical health, contributing to many chronic illnesses including heart disease, cancer and even death, Dr. Skillicorn says. But it can also have a major impact on your mental health.

People who deal with sleep deprivation have triple to quadruple the risk of developing depression, Dr. Skillicorn says. When you're starved for sleep, your energy plummets, which may increase feelings of frustration, rumination and depression, Dr. Skillicorn says.

And these depressive thoughts and feelings can further sabotage your sleep, so it "can become a difficult feedback loop to untangle," she adds.

With age, you're more likely to run into these sleep troubles. "Changes in quality and duration of sleep are especially common in older adults," Dr. Skillicorn says.

"This is at least partially due to disruption of the body's internal clock, which occurs as one grows older," Dr. Skillicorn says. This internal clock controls your body's circadian rhythms, which not only regulate when you feel sleepy, but also when you feel hungry and when your body releases certain hormones, she says.

"Sunlight is the primary cue that drives this rhythm, but research has shown that many older people do not get sufficient daily exposure to daylight," Dr. Skillicorn says. "This [issue] is even worse for those living in nursing homes," she adds.

Complicating matters, chronic illness — and some medications used to treat health conditions — can also disrupt sleep and contribute to problems with depression, Dr. Skillicorn says.

Stress is a fact of life at any age. But seniors face a variety of uniquely stressful circumstances that increase their probability of developing a depressed mood.

"Major stressors of all kinds, whether life transitions, losses or physical illness, can play a big role in depression," Dr. Skillicorn says.

Other common sources of stress in older age include, per the NCOA:

• Decreased functional ability
• Reduced mobility
• Elder abuse
• Caregiver stress
• Financial issues related to retirement

"Humans are social beings who require social connection, yet nearly half of Americans report feeling lonely," Dr. Skillicorn says.

This isolation seems to increase as we age. Whether it's the loss of a loved or limited mobility that keeps us from connecting with others, many older folks find themselves spending more time in solitude in their senior years.

"Research shows that loneliness is more detrimental to our health than obesity or smoking," Dr. Skillicorn says. "Just like stress, physical illness and lack of sleep and exercise, loneliness increases cortisol levels."

This leads to inflammation that increases the risk for not only depression, but also anxiety, dementia, heart disease and stroke, she adds.

Being able to recognize the symptoms of depression is the first step to getting help.

However, sometimes it can be difficult to spot depression in older adults since they often exhibit different symptoms than younger people, according to the NIA. For example, some may not experience the telltale sadness associated with depression, but rather feelings of numbness instead.

While the following signs of depressed mood are most common, keep in mind that every individual is unique, so their symptoms can vary, per the NIA:

• Persistent sad, anxious or "empty" mood
• Feelings of hopelessness, guilt, worthlessness, helplessness or numbness
• Irritability, restlessness or having trouble sitting still
• Loss of interest in once pleasurable activities, including sex
• Decreased energy or fatigue
• Moving or talking more slowly
• Difficulty concentrating, remembering or making decisions
• Difficulty sleeping, waking up too early in the morning or oversleeping
• Eating more or less than usual, usually with unplanned weight gain or loss
• Thoughts of death or suicide or suicide attempts