There are lots of aspects about growing older that can cause us to feel situationally sad or melancholy in the moment. But a true diagnosis of depression, where you can’t function or lift yourself out of your funk, is something else. Estimates are that 15-20 % of those 65 and older, who live independently in the community, suffer from a major depressive disorder (unsurprisingly the percentages escalate for those who reside in nursing homes). Those numbers suggest that hundreds of thousands of older adults suffer from depression at some point. Further evidence of a rise in alcohol abuse, other self-medication behaviors, and even suicide among older adults seems to suggest high numbers of depressed older individuals. Finally, in the last 2 decades, prescriptions for antidepressants among those over 65 have more than doubled, yet rates of depression seem to be holding steady. So what can be done?

Using antidepressants to treat depression in older adults can be tricky and may explain why some of the numbers don’t seem to be moving in the right direction. To begin with, just as with any drug, there are both risks and benefits of prescribing antidepressants for seniors, including concerns about falling and fractures. Moreover, a recent study out of Israel suggests a connection between the use of antidepressants and the risk of dementia (however, this conclusion is controversial as some suspect that depression may be a symptom of dementia rather than a causal factor). So, with the cautionary notes about prescribing antidepressants among older patients, why have prescriptions skyrocketed over the last couple of decades? This could be due to a number of factors including improved diagnosis of geriatric depression, overprescribing of antidepressants or even off-label use of these drugs for such conditions as neuropathic pain or sleep disorders.

There are no quick and easy answers for treating depression in older adults. And a brand new study puts that dilemma in even starker contrast: Almost 60% of adults suffer from depression in the last month of life before death which, if left untreated, could lead to unnecessary suffering and distress. So, what to do? The first step is to understand the signs and symptoms of depression in older adults and to identify whether self-help options would be effective or whether professional help is required. And there are geriatric psychiatrists to help you or your loved one sort this out. Finally, for those who think your depression is something seasonal that comes and goes with the long and dark winter days, you may be suffering from Seasonal Affective Disorder. For insights into how to combat this, turn up your lights and click here.