Depression in the elderly: symptoms, treatment, and how you can help

Published on 5 December 2022

Depression among the elderly is more common than you think. Here’s how to provide the support they need to help them through this mental health challenge.

Depression is one of the most debilitating and severe mental disorders, and if left untreated, can cause emotional, behavioural, and health problems – at its worst, it can even lead to death.

While depression can hit anyone, at any time, the elderly is particularly vulnerable to the condition. According to Dr Natalie Ling, Consultant at the Division of Geriatric Medicine, National University Hospital (NUH), “depression affects approximately one in five people aged 75 and above”.

Why are the elderly susceptible to depression?

Health issues like dementia, physical pain, limited mobility or other medical conditions can be triggers for depression in the elderly.

NUH Senior Consultant Dr Chris Tsoi added, “People who are widowed, divorced and living alone are much more likely to have symptoms of depression.”

Alarmingly, depression can lead to other health problems such as heart disease and stroke. As such, it is crucial to learn how to identify the signs of depression in the elderly, so that it can be diagnosed and treated early.

Unfortunately, the symptoms of depression in the elderly often get overlooked, as many mistakenly believe that it is a natural part of ageing. 

It can also be hard for the elderly to express their feelings, as Dr Tsoi explained, “There are cultural taboos around discussing mental illness in Singapore, which can lead to many people (who have depression) going undiagnosed.”

“Many additional barriers, such as impaired mobility and cognitive problems, can also make it harder for those affected to seek treatment.”

Identifying symptoms of depression in the elderly

If you have an elderly in your family, especially one who is living alone or has health issues, keep an eye out for the following symptoms of anxiety and depression:

• Lack of energy

• Reduced appetite

• Problems sleeping

• A gradual or sudden loss of interest in hobbies or activities

• Outbursts of emotions including anger, irritability, and sadness

• Feelings of panic and discomfort

Treatment: Therapy before medication 

So, how do you treat depression and anxiety? Contrary to popular belief, the use of medications is often not the preferred option.

“They (medications) should be considered on a case-by-case basis. It’s mostly used to treat patients whose symptoms are debilitating and impair their ability to carry out activities of daily living,” said Dr Ling.

Instead, therapy is the more common treatment option. One of the ways elderly patients with depression can seek help is through the NUHS Geriatric Psychiatry Out-Reach Assessment, Consultation and Enablement (G-RACE) programme.

G-RACE pools together a multidisciplinary team of healthcare professionals which includes psychogeriatricians, case managers, and occupational therapists to provide help and support to the elderly with depression.

However, Dr Ling emphasised that the first step in the recovery process is the acknowledgement of the problem itself, followed by the willingness to seek treatment.

“Depressed individuals might not realise or recognise that they have a problem,” Dr Ling shared.

“Even if they do, they may not want to ask for help. So it is important that their families and loved ones speak with them, show them concern and support, and let them know they are available to help them through this.”

“Gentle encouragement and support is integral to getting them to open up, and it is important to give them reassurances.”

One way to help people with depression is to get them to engage in more social events, as Dr Ling elaborated, “They should also be encouraged to take part in activities that they enjoy. Activities such as small group classes organised by community centres that can engage their senses and minds are good for them. After that, they can also move on to more interactive activities like exercise classes.”

Caregivers can also partake in activities together with the elderly. Dr Ling concluded, “If you have the time, attending these activities with the elderly can help encourage them to be more participative, especially if they are shy or anxious about going out.”