The Truth About Depression and Older Adults

Symptoms to Watch for, and How to Get Help

Jessica Israel, MD
Jessica Israel, MD

Do old age and depression go together especially in a pandemic? We asked two who know: Jessica Israel, MD, Senior Vice President, Geriatrics and Palliative Care, at RWJBarnabas Health, and Frank Ghinassi, Ph.D., ABPP, Senior Vice President of Behavioral Health and Addictions at RWJBarnabas Health and President and Chief Executive Officer of Rutgers University Behavioral Health Care.

Many people expect older adults to be depressed, or at least unhappy. Is that fair?

DR. GHINASSI: Seniors get a bad rap about that. In fact, the age 40 to age 58 group is more likely to be prone to depression. For every older person who is struggling, there are probably seven or eight who are doing very well as they transition to the later stages of their career and life.

Frank Ghinassi, PhD

Frank Ghinassi, PhD

DR. ISRAEL: That expectation is a stereotype and needs to change. In fact, chances are that someone who has had 80 years to develop strategies to deal with stresses in life is, in many ways, better at coping than a younger person.

How does social isolation affect seniors?

DR. ISRAEL: In my experience, people of any age who were already prone to depression have seen their symptoms magnified since the pandemic began. Of course, COVID-19 struck older adults in disproportionate ways. I would say that a significant number of my patients were able to stay safe at home and find new resources to help them stay connected, although some of them needed extra help to find those connections and services.

DR. GHINASSI: The folks we worry most about have a troubling package of circumstances—for example, they live alone, their children have moved away or they never had children, friends are beginning to die off, or they’ve moved to a community where they don’t have an existing network. Some may begin to show cognitive decline. If that’s combined with a history of depression or anxiety, that’s when we get most concerned.

What are signs of depression?

DR. GHINASSI: At any age, changes in baseline behavior are concerning: somebody who had a good sense of humor no longer laughs, somebody who had a healthy appetite isn’t eating, somebody who was a good sleeper now has sleep disturbances. Have they stopped doing the things they enjoy? Are they saying things like, “What’s the point of going on?”

DR. ISRAEL: These days, it may be harder to pinpoint these changes because people have less contact with other people—they haven’t been going to the gym, or they no longer get together with their knitting circle.

How can loved ones help?

DR. ISRAEL: It’s so important to reach out to someone who may be isolated and depressed—to learn more about the situation surrounding the person, and what’s happening inside that situation. If you see signs of depression, know that it’s treatable. The first step, the critical one, is to reach out.

DR. GHINASSI: This is the time to connect with seniors more frequently than usual. Options range from phone and video calls to screen porch visits and talking through windows—even providing iPads. Visual contact can be a godsend for both the senior and his or her family.

How to Thrive While Social Distancing

To reach the physician referral service at RWJBarnabas Health, call (888) 724-7123. To learn about Behavioral Health Services, call the RWJBarnabas Health Behavioral Health hotline at (800) 300-0628.