Dr. Anne Koplin
The Aging Well Issue

Aging Isn’t Synonymous With Depression

As a psychiatrist who focuses on an older population, there is one thing I share with every client: Depression is not a normal part of the aging process, but it is something that older adults do go through.

Experiences with depression as you age often go undiagnosed. Some people simply believe that getting older triggers sadness and depression, so they just live with it. I make sure to remind people that depression is never something you should just live with.

Unpacking the misconceptions around depression and aging start by asking the right questions, like:

  • How can older adults struggling with depression get support? 
  • What does depression look like as we age? 
  • What advice is useful for someone seeking mental health support for the first time? 

Depression is not a normal part of the aging process.

Help With Depression as You Get Older

Whenever I onboard a new patient—before we land on any specific diagnosis—I work to get as much information about them as possible. This includes:

  • Asking about family history
  • Ordering blood work

Once we’ve established that there are no physical or reversible causes to the way someone has been feeling, this is when we start addressing what could be depression.

Those adults who do come to me for mental health support are actually a small fraction of an even smaller number. According to Mental Health America, less than 3% of people age 65 and older receive treatment from mental health professionals.

Understanding that the root of what they may have been feeling (or that loved ones may have been noticing) is actually depression is a good first step to getting the mental health support they’ve always deserved.

Depressions Symptoms as You Age

Depression symptoms can be described differently depending on the patient’s age. Children and older adults for instance won’t use language like “sad” to describe what they have been feeling. Instead of saying they haven’t gotten out of bed or are having trouble brushing their teeth, they may be more easily frustrated, or in some cases, they may struggle with something like pseudodementia

Pseudodementia is a condition caused by depression and is characterized by:

  • Forgetfulness
  • Lack of attention
  • Inability to concentrate

Pseudodementia is not clinical dementia. Many patients who walk into my clinic afraid that they have dementia are actually struggling with pseudodementia as a result of depression. Once we are able to address the depression, the pseudodementia subsides.

Regardless of age, anything that is unknown can feel intimidating, scary, or overwhelming.

As a healthcare provider for those navigating depression, I’ve found that leading with empathy and an open ear is the best way to truly understand how depression uniquely manifests with each person and what could be of most help to them.

Seeking Medical Help for the First Time

Just because some older generations are not as comfortable or well-versed about mental health, doesn’t mean that they aren’t open to being helped or supported. It’s also important to note that they aren’t alone. In a Mental Health America study, 68% of adults aged 65 and over said they knew little or nothing about depression.

Regardless of age, anything that is unknown can feel intimidating, scary, or overwhelming. 

Here are my key tips for anyone who is trying therapy for the first time: 

  • Don’t settle for anyone you aren’t comfortable with.
  • Prioritize comfort because it is what will allow you to be as honest and open as possible during your sessions.
  • Don’t feel apprehensive about telling your therapist you’ll be trying someone else, they understand that it is not personal.

As a psychiatrist, I also see many people who may be trying medication for the first time. Our first order of business is typically to address any negative preconceived notions they may have about taking medications in the first place.

I remind people that medication won’t change their personality, it will only help them move through the days with fewer of the symptoms that have been holding them back. In addition, I also assure my patients that we prioritize starting low (on dosages) and going slow; this helps us both build trust and an understanding of what is helping and where more gaps may need to be filled.

Mental health among older adults is as important as mental health care for anyone who is less than 65 years old. The more that we are able to have open conversations about the topic, the more likely it will be that we can lessen the number of older adults who feel alone.

1 Source
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  1. Mental Health America. Depression in older adults: more facts.