5 Tips for Managing Depression as You Age

"Later life can force us to redefine how we see ourselves in terms of our role within our family structures and sense of purpose post-retirement," says Anna Plotkina, PsyD, a psychologist who treats older adults at Pathways Psychological Services in New York City. "We are also faced with more grief, loss, and, at times, social isolation as we get older. All of these factors increase the risk of developing depression, or making it more difficult to manage."

Addressing depression effectively usually necessitates a multipronged approach, she says. That tends to include visits to health professionals for treatment, as well as lifestyle changes. Here are five expert tips to help you manage depression as you age.

1. Acknowledge Your Depression

Particularly for those in the baby boomer generation (people born between 1946 and 1964) and older, depression can still come with a sense of stigma, says Matt Glowiak, PhD, a licensed counselor with Recovered, a mental health treatment provider in New York City.

"Anything related to mental health was highly frowned upon in previous generations, so one challenge in seeking and receiving treatment is that many older adults don't describe their experience as depression," he says. "When they were growing up, it was inappropriate and even unsafe to talk about mental health. Because of this, they tend to describe the more physical [symptoms] that come with depression."

Issues like ongoing fatigue, sleep disturbances, changes in appetite, and brain fog can all be indications of depression, as well as symptoms of age-related health concerns, he says.

"Because these types of issues can come with aging already, it makes diagnosing depression more complicated, but it is helpful for people to acknowledge that they may be experiencing depression," he says. "That represents a first step toward treating the condition."

2. Talk to Your Doctor or a Mental Health Professional

If you think you have depression, the next step is to talk with your primary care doctor or seek help from a mental health professional like a psychologist, psychiatrist, or other licensed therapist, says Pablo Sanchez-Barranco, MD, the associate director of psychiatry at Northwell Health Phelps Hospital in Sleepy Hollow, New York.

"Depression in older adults shouldn't be seen as an unavoidable part of aging, but instead as a treatable condition," says Dr. Sanchez-Barranco. "It requires a thorough and systematic assessment for diagnosis, and treatment that centers on improving quality of life and overall function."

There are several treatment options for depression. "Psychotherapy is an effective treatment option for mild to moderate depression, offering additional benefits when combined with medication for more severe presentations," he says.

• Cognitive Behavioral Therapy A type of therapy that helps people learn to identify problematic thinking or behavioral patterns and replace them with more constructive ones.

  [2]

• Interpersonal Therapy A form of therapy that focuses on a person’s relationships with others and ways to improve their interactions with others.

  [2]

• Problem-Solving Therapy A type of therapy that helps people find strategies to solve problems and cope with challenges in their lives.

  [3]

• Behavioral Activation A form of therapy in which people connect with and participate in activities that they find rewarding as a way of coping with mental health challenges.

  [4]

3. Ask Your Doctor to Review Your Prescriptions

Depression treatment in older adults can be complicated by other medical conditions, particularly because those issues are usually treated with multiple types of prescription medications, says Sanchez-Barranco.

"A thorough medication review that includes over-the-counter products, vitamins, and herbal or synthetic supplements, along with alcohol, cannabis, and other substances of abuse is warranted," he says.

"A particular concern when treating older depressed adults with medication is the potential for prescribing cascade," he says. "The term describes a scenario in which a patient’s complaint, which may result from a medication side effect, is mistakenly attributed to new or worsening medical symptoms, leading to new prescriptions."

This pattern of medication use may lead to an increasingly complex medication regimen, further aggravating medication-related problems. Because of this, it's essential to review prescriptions and supplements at every doctor visit, he says.

4. Build and Maintain Social Connections

• Call family or friends regularly.
• Meet friends or family at a restaurant for a meal.
• Find a retiree group or another group you can do activities with.
• Join a group dedicated to a hobby you enjoy, such as hiking or knitting.
• Play card games or board games with others.

5. Get Regular Physical Activity

"Movement is an underrated tool when it comes to managing depression as you age," says Dr. Glowiak.

• Better sleep quality
• Lowered risk of type 2 diabetes, heart disease, and stroke
• Reduced anxiety
• Lower blood pressure
• Decreased dementia and Alzheimer’s risk
• Improved balance and overall mobility
• Reduced risk of chronic diseases
• Better bone strength
• Decreased cancer risk

How much exercise can help? "The goal doesn't have to be running marathons,” says Glowiak. “Rather, a daily walk, gardening, or any form of regular physical activity can improve mood while reinforcing a sense of capability and independence. A single step at a time is still a step forward."