Depression is not a normal part of aging, just as it is not a normal part of our development at any age. In older adulthood and at other times in our lives where we are facing loss, isolation, or change, we may be at higher risk of depression. Loss of loved ones, roles, home or community ties, or physical changes can all increase a person’s risk for depression. Men especially are more at risk for depression as they age, and suicide rates increase dramatically for men over 65, even more so for those with a history of depression.

Signs of depression include:

•  Sadness. Grief as a natural response to loss is different from depression. Unexplained, unrelenting sadness or grief that never lets up is a sign of depression.
• Feelings of loss of self-worth. A person may feel they are a burden, that life has lost meaning, or despair that they cannot do things they were once able to do.
• Withdrawal and isolation. A person may avoid visits with friends or avoid coming to Meeting.
• Avoidance of activities that were once loved. A person stops doing things that were once important to them.
• Changes in sleep patterns. This can look like extreme fatigue or insomnia.
• Changes in appetite. Often this results in weight loss, but some people may eat more to try to replace lost energy.
• Suicidal thoughts or fixation on death. Consult a professional if a person expresses thoughts of suicide.
• Other symptoms. In older adults and others, depression may also manifest as hopelessness, helplessness, increased irritability, anxiety, forgetfulness, or unexplained physical complaints. Symptoms such as confusion, forgetfulness, or paranoia may be similar to signs of dementia or other illness. A professional evaluation will help discern the root cause of the symptoms so that appropriate treatment can be determined.

How can I help? 

A person with depression needs professional care. Friends can help by encouraging one to seek professional care and by being a caring presence in their lives.

Often a person who is depressed does not recognize their symptoms and cannot take action to get help. They may be overwhelmed by symptoms of hopelessness and confusion, compounded by the stigma placed on mental illness. They may also feel ashamed or embarrassed. Let the person know they are accepted and supported, and learn about your local resources and refer to professionals.

• Validate feelings. Respect and validate the person’s feelings. When a person’s feelings are validated, they feel valued. This contributes to healing and opens the doors for communication. See the Quaker Aging Resources pamphlet on Validation.
• Walk beside the person. Even if they say “I don’t want to,” let them know that you want to spend time together. If you are rejected, suggest another activity—visiting pets, spending time with children, a visit to a garden. Walking and other exercise can help alleviate symptoms of depression. Mental health research shows that spiritual support, helping a person to find meaning and purpose, assists in recovery. Just listening goes a long way.
• Don’t give up. Continue to let the person know you care. Let go of expectations and understand it is the illness that is keeping the person from calling you back or taking you up on that potluck supper. Enlist the help of others and continue to encourage your Friend to accept professional help. Hold the person in the Light. If reluctance to seek care or accept medication is a concern, enlist professional help.
• Connect the person with the Meeting’s care. The Meeting might not know that the person is struggling. Most meetings have a committee that focuses on pastoral care for its members. That committee can help the person connect with treatment. 

Seek help promptly if thoughts of suicide are expressed or suspected. If thoughts are suspected, don’t be afraid to ask. If a person needs to be hospitalized, it can be very helpful to provide a non-anxious, non-judgmental presence to accompany them through the process. If you cannot accompany the person, ask them if you can contact the Meeting for help. Surround them with support.

National Suicide Prevention Lifeline: 988 or 1-800-273-TALK (8255)