The Unexpected Depression Sign a Geriatrician Is Begging People Over 50 to Pay Attention To

Your golden years are meant to be just that—golden. For many people they are. Depression rates among people 60 and older hover at just under 6%, which is lower than the population as a whole.

However, it’s important to know that for adults 85 and older, the rate of depression climbs to 27%. For older adults who are depressed, their depression often goes undetected or untreated. While it’s natural to feel sad sometimes, depression is not a normal part of aging. It’s important to know the signs because depression is treatable. There’s one sign in particular that experts say is often missed that they wish more people would pay attention to.

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The Unexpected Depression Sign Many Miss and Why It’s Not Just Part of Aging

One unexpected symptom of depression in older adults that many often miss is fatigue. “A person who is depressed does not have a lot of mental energy. Often, they lack motivation and don’t sleep well. Not sleeping well translates to fatigue and tiredness during the day,” says geriatric medicine physician Dr. Faith Atai, MD.

Dr. Atai explains that, often, when someone is depressed, they are not exercising, eating well or getting quality sleep. All of this can lead to fatigue. “Fatigue is not just regular tiredness. It’s a chronic, extreme lack of energy where you don’t think you can do anything,” she says.

Dr. Susan Maixner, MD, a professor of geriatric psychiatry at the University of Michigan, explains that depression causes stress hormones in the brain to increase. This causes sleep and appetite disruptions. “We have less interest and therefore are less motivated. All of these factors can contribute to low energy,” she says.

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Both doctors explain that this type of fatigue is not due to getting older. When fatigue is a symptom of depression, there are other symptoms as well. Dr. Maixner says other symptoms can include sleep changes, appetite changes, feeling hopeless, helpless or worthless, feeling guilty or feeling like a burden, or sometimes even feeling life isn't worth living, wishing to die or thoughts of suicide.

Dr. Atai says that, typically, someone with depression has stopped participating in activities or hobbies that used to give them joy. For example, they may have stopped going to church or haven’t done anything social in a while. These are clues, she says, that the fatigue one is experiencing may be a symptom of depression.

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How To Manage Depression Fatigue

If an older adult is regularly experiencing fatigue, Dr. Atai says the first step should be to see their primary healthcare provider. It’s important to make sure there is not a medical reason for the fatigue. Dr. Maixner agrees, saying thyroid disorders, heart conditions, low blood iron and B12 deficiency can all cause both low energy and low mood.

Dr. Atai adds that depression can also be a side effect of a medical issue. For example, if someone has cancer or is experiencing pain that makes it harder to be independent or move around, this could contribute to feeling depressed. In cases like these, managing the physical condition plays an important role in depression treatment.

“For mild to moderate depression, therapy can provide a confidential place to discuss problems, and to give techniques to manage anxiety and depression. For moderate to severe depression, medications help significantly and work even better in conjunction with counseling,” Dr. Maixner says.

There are ways to manage the fatigue that stems from depression while you are seeking help. Both doctors say it’s important to eat nutrient-rich meals, which will provide your body with energy. Exercising (as you’re able to) can help too. Dr. Maixner recommends re-establishing daily routines, including regular sleep and awakening times.

When creating your routines, Dr. Atai says to think about what you can integrate into your schedule that you can look forward to. For example, can you set up a weekly lunch date with a friend? Volunteer to pick up your grandchild from school a couple of times a week? Sign up for a new class that meets once a week? “Being social and around others often helps with energy and decreases our focus on fatigue,” adds Dr. Maixner.

Most importantly, Dr. Maixner emphasizes that depression is treatable and not a normal part of aging. If you are experiencing suicidal thoughts or need immediate help managing your depression, call or text the Suicide and Crisis Helpline at 988. Taking the first step to ask for help is the beginning of overcoming depression. That way, your golden years can be as vibrant as they’re meant to be.

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Sources

• Dr. Faith Atai, MD, geriatric medicine physician at UT Health Houston

• Dr. Susan Maixner, MD, professor of geriatric psychiatry at the University of Michigan, the Director of the Geriatric Psychiatry Program and Fellowship at the University of Michigan and the Secretary-Treasurer Elect of the American Association for Geriatric Psychiatry (AAGP)