When we think of mental health issues in seniors, Alzheimer’s and dementia are at the forefront of our thoughts, conversations and research. But there is another silent killer that poses the biggest threat to senior mental health — depression.

Depressive disorders are the top mental

health issue faced by seniors today, said gerontologist Patrick Arbore, director

of the  Center for Elderly Suicide Prevention and Grief-Related Services, a program of the Institute on Aging in San Francisco. 

According to the Centers for Disease Control and Prevention, between 1 and 5 percent of seniors living at home suffer from major depression; the  numbers rise to about 14 percent for those who need home health care or in assisted-living. Although the condition is eminently treatable, it is widely underrecognized and untreated among seniors.

People with chronic diseases  are especially prone to depression, and seniors are vulnerable to seasonal depression, which often leads to further depression when untreated. A variety of factors can bring on the “holiday blues” — cold weather, shorter days, disabilities that  prevent participation in holiday traditions, loneliness, isolation, loss of a spouse, etc. 

“The holidays are a time of tradition and the gathering of family and friends for many people,” said social worker Mary Stehle. “For some seniors, this can  be a time that reminds them of losses … the loss of loved ones, the loss of a home and the loss of good health.”

If these symptoms worsen, it can lead to bigger issues, Arbore said.

“Loneliness and isolation are such a concern among community-dwelling elderly,” he said. “If that milder depression isn’t recognized, it can get worse, for example, with the death of a spouse or adult  son or daughter. That  loss could  trigger a major depressive episode.” 

He also pointed out that many seniors don’t know who to ask for help and may not see the need for a specialist.

So  how do we fight elderly depression? Family, caregivers and the health care industry must be aware of the signs of depression and how to treat it. 

The following are some signs that a senior may be suffering from a mental health concern:


Persistent sadness.

Trouble falling asleep or sleeping too much.

Decreased socialization.

Loss of interest in usual activities.

Excessive worrying.


Feeling worthless, helpless or hopeless.

Changes in appetite.

Crying spells.

Trouble focusing, remembering or making decisions.


The main reason depression so often goes untreated in seniors is because the value placed on independence makes it difficult to ask for help. Arbore said.

“It’s going to make them less likely to say to somebody, ‘I haven’t been sleeping that well,’ ‘I’m not making good decisions’ or ‘I’m not eating very well,’ ” Arbore said. “That would  normally trigger a question about, ‘Hey, what’s going on?’ But often — even if they are aware that something has been changing — they still won’t ask for help.” JN


Kimberly Perkins-Akers is a Certified Senior Advisor and owner of Amada  Senior Care, which serves the southeast Valley. Visit AmadaPhoenix.com.

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