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Subtle signs your mental health may need a boost    

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Depression isn’t always obvious. Here are some under-the-radar symptoms that older adults should watch for, plus how to get the support you need. 

There’s a lot to look forward to as you get older. You might have more free time to travel, garden, tackle a new hobby or have coffee with friends during the day. Or more chances to share your hard-won wisdom and knowledge with coworkers, friends and family. 

But as with any stage of life, getting older also has its share of challenges. It can bring achy knees and joints, health conditions that need attending to, caregiving duties or the loss of loved ones. So, it’s normal to feel sadness and grief along with contentment and joy.  

If you find yourself feeling sad, lonely or hopeless on most days, though, and those emotions last longer than two weeks, you may be depressed.1 And the signs may not always be so obvious for older adults, since they may have other medical conditions that can contribute to depression.2 

It’s important to know that depression isn’t a normal part of aging. And it’s treatable. Find out some of the subtle signs of depression and how to get the help you need to feel better again. 

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Common symptoms of depression 

Depression can be different for people, depending on their age. Still, there are some common symptoms across different age groups, including:2 

  • Feeling sad, anxious or restless  
  • Feeling hopeless, worthless or helpless 
  • Feeling sluggish or exhausted 
  • Trouble concentrating or making decisions  
  • Not eating enough, or eating too much 
  • Trouble sleeping, or sleeping too much 
  • Unintentionally losing or gaining weight 
  • Having suicidal thoughts 

It may be harder to spot these symptoms in older people, explains Steffanie Campbell, MD. She’s the chief of internal medicine at Optum in Houston. “It’s easy to blame changes such as memory loss, sleep issues and appetite loss on aging instead of depression,” she says. 

Another reason? If you have a chronic condition, especially one that keeps you close to home and more isolated, you may think your low mood is a reaction to that.3  

Providers may also miss signs. “We don’t think about older people as having depression since they don’t have typical stressors such as kids and work,” says Dr. Campbell. “Plus, the older generation is not as comfortable with mental health issues, so they have had many years masking their feelings and not sharing this type of information with their doctors.” 

Sometimes people are depressed and don’t realize it. Here are some more subtle symptoms that tend to affect older folks.  

Subtle symptom #1: Trouble falling or staying asleep 

As people get older, it gets harder to sleep soundly through the night. You may have to go to the bathroom more often. Pain or certain medications can also interfere with your z’s.4  

Just like everyone else, though, you need seven to nine hours of sleep a night. Otherwise, your mood can suffer. You may start to feel irritable or depressed.4  

Sleep issues can be a risk factor for depression.1 And they can also be a sign of depression. So, talk to your primary care doctor (PCP) if you’re having problems getting a good night’s rest. 

Looking for a doctor who gets you? Our team of providers is here to help you reach your health goals. Find an Optum doctor.  

Subtle symptom #2: Withdrawing from activities you enjoyed 

Older adults who are depressed can lose interest in their regular hobbies and activities, whether it’s knitting, reading or going to church, notes Dr. Campbell. Maybe you find yourself skipping yoga class or your book club. Or you're not excited to volunteer at the food bank anymore, even though you used to love it. That could be a red flag.  

The more isolated you are from others, the lonelier you’ll feel. And that can make you feel even more depressed, since loneliness is a risk factor for depression and cognitive decline.5  

It’s true that it’s more of a challenge to stay socially connected as you get older, especially if friends or family move away or you have a health condition that makes it harder to get around. But it’s also true that staying connected to others can improve your mood and outlook.5 

Subtle symptom #3: Memory loss 

Increased forgetfulness or complaints of memory loss can be a sign of depression, notes Dr. Campbell. But in older adults, memory loss can often be mistaken for early signs of dementia.1,3 

It can sometimes be hard to tell if someone has dementia or depression. They both have other symptoms in common, including:6 

  • Loss of interest in activities 
  • Trouble concentrating 
  • Becoming socially withdrawn 

And people with dementia can also be depressed.6 That’s why it’s always a good idea to talk to your provider about memory loss. That way, you can get screened for both conditions and get help sooner.  

Subtle symptom #4: Feeling like nothing matters 

Sometimes older adults don’t feel sad or hopeless the way younger people do. Instead, you might just feel numb about everything, even things you were once passionate about. But that lack of emotion can also be a sign of depression.2 

When you feel like nothing really matters, you’re more likely to stop doing things you like. You may withdraw from activities, from friends and family. 

How to get help 

If you are experiencing any of these signs, be sure to talk with a doctor right away. Don’t be afraid to reach out and ask for help. At Optum, the doctors and other members of your health team take pride in being caring and empathetic. 

Your PCP is the best place to start. PCPs are trained to diagnose and help with depression. Your doctor might run tests, such as blood work, to see if there is a medical reason for your depression. They may also give you a screening test for depression.1 

Examples of questions they might ask include: 

  • How do you feel about your emotions and mental health today compared to how you were feeling a year ago? 
  • Do your emotions or mental health make it hard to get work done or get through the day? 

If your PCP thinks you have depression, they may refer you to a mental health specialist such as a psychologist or psychiatrist for further evaluation. Your PCP or mental health specialist may also prescribe medications, such as antidepressants. Talk therapy is also effective for treating depression.1 

Depression is as serious as any other health condition. But it’s treatable. Your Optum care team is ready to help with mental health problems and to listen. The sooner you seek help, the faster you can get back to enjoying your life. 


  1. National Institute on Aging. Depression and older adults. Last reviewed July 7, 2021. Accessed January 2, 2024.  
  2. National Institute of Mental Health. Depression. Last revised 2021. Accessed January 2, 2024. 
  3. Centers for Disease Control and Prevention. Depression is not a normal part of growing older. Last reviewed September 14, 2022. Accessed January 2, 2024.  
  4. National Institute on Aging. A good night’s sleep. Last reviewed November 3, 2020. Accessed January 2, 2024. 
  5. National Institute on Aging. What do we know about healthy aging? Last reviewed February 23, 2022. Accessed January 2, 2024.  
  6. Alzheimer’s Association. Depression. Accessed January 2, 2024. 

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If you or someone you know is in crisis — seek safety and get help right away. If you or someone you know is in immediate danger, call 911 or go to the closest emergency room.  

To reach a trained crisis counselor, call or text the 988 Suicide & Crisis at 988 or 1-800-273-TALK (1-800-273-8255). You may also text 988 or chat at 988lifeline.org.  

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