Florida

Depression and Anxiety in Later Life: A Guide for Older Floridians and Their Families

By Dr. Stacey Forbes, DNP, APRN, PMHNP-BC

Families often notice it before the person does. A father who stopped going to his card game. A mother who says she is “just tired” for months. A widowed neighbour who has not left the condo much since the funeral. It is easy to put these changes down to getting older. The research says otherwise: depression and anxiety in later life are common, they are not an expected part of aging, and they respond to treatment.

Not a normal part of aging

The National Institute on Aging is direct on this point: depression is a common problem among older adults, but it is not a normal part of aging. In fact, NIA notes, most older adults feel satisfied with their lives despite often living with more illnesses or physical challenges than younger people. When low mood lasts for weeks or months, it deserves the same attention it would get at any other age.

The National Institute of Mental Health adds that later life brings changes that affect mental health — a serious illness, the loss of a spouse or friends — and that while many people adjust, grief, isolation, and loneliness that persist can lead to depression and anxiety. Effective treatment options are available at every age.

Why it is easy to miss

Depression in older adults can be hard to recognize. According to NIA, sadness is not always the main symptom. An older person may instead feel emotionally numb, lose interest in things they used to enjoy, or simply be less willing than younger adults to talk about feelings. Some of what gets described as “slowing down” is actually depression.

• Withdrawing from friends, church, clubs, or family calls
• Losing interest in hobbies or routines that once mattered
• Changes in sleep or appetite that are not explained by illness
• Complaints of fatigue or aches with no clear medical cause
• Irritability, worry, or restlessness that is new

Dementia complicates the picture. NIA notes that dementia can cause some of the same symptoms as depression, and that depression can be an early warning sign of possible dementia. That is one reason a careful evaluation matters more than a guess.

What raises the risk

NIA lists several factors associated with depression in later life. None of them causes depression on its own, but they add up.

• Medical conditions such as stroke or cancer
• A personal or family history of depression
• Stress, including the stress of caring for a spouse or relative
• Sleep problems
• Social isolation and loneliness
• Lack of physical activity, and limitations that make daily tasks difficult
• Alcohol use

Some medications and medical conditions can also produce depression-like symptoms. A good evaluation looks at the whole medication list and medical history before deciding what is going on — especially for someone taking several prescriptions from different doctors.

Florida-specific support

Florida’s Department of Elder Affairs runs the Elder Helpline at 1-800-96-ELDER (1-800-963-5337), with information and assistance services organized county by county. It is a practical first call for an older adult or a family member trying to find local services. The helplines can also be reached through the Florida Relay service at 1-800-955-8771 (TDD) or 1-800-955-8770 (voice).

Florida law also includes a specific safeguard for older adults with dementia. Before a person 60 or older with dementia who is being transferred from a nursing home or assisted living facility can be admitted to a psychiatric facility as a voluntary patient, an initial assessment of their ability to give informed consent is required. For crisis situations more broadly, see the Baker Act guide.

Treatment, and getting to it

Depression, even severe depression, can be treated. Counseling, medication, or both help most people. For older adults the practical barriers are often the hardest part: giving up driving, mobility problems, or simply not wanting to sit in a waiting room. A telehealth appointment from home removes most of those barriers, and a family member can join the call to help with the history and the plan.

Willow & Stone provides integrative psychiatric care by telehealth to patients anywhere in Florida, including seasonal residents who split the year between states. If an older adult is ever talking about ending their life, call or text 988 or call 911 right away. NIA notes that asking someone directly about suicide does not make them more likely to act on it.

Common Questions

Sources & Further Reading

• National Institute on Aging — Depression and Older Adults
• NIMH — Older Adults and Mental Health
• Florida Department of Elder Affairs — Elder Helpline
• Florida Statutes §394.4625 — Voluntary Admissions
• 988 Suicide & Crisis Lifeline