Depression in Older Adults: When ‘The Boss’ Broke Down

From Bruce Springsteen to Michelle Obama, many people confront depression later in life. Here’s how to tell if you or your loved one is just getting older…or if it’s something more serious.

**Playing to sold-out crowds in his 60s, “The Boss” was secretly suffering from clinical depression and anxiety.** GabboT, CC BY-SA 2.0 <https://creativecommons.org/licenses/by-sa/2.0>, via Wikimedia Commons

This article is part of a Wise & Well Special Report: The United States of Depression.

When Bruce Springsteen hit his 60s, it was his turn to be rocked. That was when The Boss began experiencing bouts of depression that left him feeling anything but in charge.

“I was crushed between 60 and 62, good for a year, and out again from 63 to 64,” he wrote in his autobiography Born to Run. “All I wanted was the bed, the bed, the bed, and unconsciousness. I spent good portions of the day with the covers up to my nose, waiting for it to stop.”

Fortunately for Springsteen and music lovers everywhere, his wife recognized his distress and helped get him the help he needed. Likewise, older adults such as former First Lady Michelle Obama, former Olympic swimmer Michael Phelps, and Pennsylvania Senator John Fetterman have received professional treatment for depression that emerged later in life.

But many others aren’t so lucky. In the U.S., despite the fact that 2% to 7% of older adults living outside group settings are depressed, more than two-thirds go untreated.

While on average, older adults tend to be happier than middle-aged adults, advanced age can usher in challenges that can harm mental health. That’s why it’s vital to know how to tell if you or your loved ones are simply aging, or if something more serious is going on.

Why depression in older adults is invisible

Depression is often called an “invisible illness.” For seniors, that’s especially true. When symptoms coincide with other illnesses or life events that commonly occur as people age — such as the loss of loved ones — mental illness can be masked.

And depression in older adults simply doesn’t get the attention it deserves. Even among mental health professionals, it’s a common myth that depression is a normal part of aging.

But it’s not. Feeling deeply “blue” — or any shade of despondency — for a long time isn’t normal for anyone. Depression is a real, manageable medical condition that should be treated at any age.

Symptoms in seniors

Unlike younger people, who often wear their feelings on their sleeves, seniors with diagnosable depression — or who are on the path to it — may not appear to be unhappy. “They may not feel as sad or blue, but it might manifest as feeling less energized,” Sheila Babendir, PhD, a licensed professional counselor, told Everyday Health.

In addition to the classic signs of depression — listlessness, difficulty sleeping, and recurrent thoughts of death or suicide — the Mayo Clinic states that older adults may experience:

Memory difficulties
Personality changes
Fatigue, loss of appetite, or loss of interest in sex
Desire to stay at home, rather than go out to socialize or do new things

Another clue may be difficulty with discarding or parting with possessions, regardless of their actual value. Research published in 2017 in International Psychogeriatrics supports the relationship between depression and hoarding among seniors.

Risk factors

One of the most significant precursors of senior depression is a decline in physical health — which often occurs with aging.

Approximately 80% of adults aged 60 and older live with a chronic disease — such as arthritis, diabetes, and high blood pressure — and 77% have at least two, according to the National Council on Aging. When poor health prevents engaging in enjoyable tasks — such as driving, reading, walking, playing sports, or socializing with friends — depression can follow.

Other signs to watch for include:

Loneliness — Among older adults, social isolation is both a trigger and a sign of depression, according to Dawn Carr, PhD, an associate professor of sociology at Florida State University’s Pepper Institute for Aging and Public Policy in Tallahassee. Social isolation is “often initiated as a consequence of not having a sense of meaning and purpose,” she told Everyday Health. “So it might even be caused by lack of social engagement and meaningful engagement with others on a regular basis.”

Grief — Bereavement can be a stressor that leads to depression. Studies show about 30% of bereaved spouses develop depression in the first months following a loved one’s death. If family members live far away, grief may linger, leaving the grieving person longing for in-person connections.

Retirement — Whether planned or not, when a person retires, loss occurs — of routines, status, roles, friendships, and more. It’s estimated that one-third of retirees experience depression after leaving full-time work.

How older adults can protect their mental health

There are steps people can take to protect themselves from depression as they age. Experts recommend the following:

Maintain regular routines. Older adults who consistently get up early and remain active during the day are happier and perform better on cognitive tests, according to a Sept. 2022 study in the journal JAMA Psychiatry.

“I sometimes recommend that people use a large calendar to orient themselves in the morning — to figure out what day it is, what medications they need to take, and if they have any appointments,” said geriatric physician Kathleen Rogers, MD, a geriatric physician at the Cleveland Clinic.

Stay physically active. New research published in the JAMA Network Open journal revealed that even moderate daily physical activity can reduce the risk of depression. The study showed that activities such as walking briskly for only 20 minutes a day, five days a week, were linked with a 16% lower rate of depressive symptoms and 43% lower odds of major depression.

“Try and build it into a routine with hobbies or activities you enjoy and try to do it with others,” said lead researcher Eamon Laird, PhD. “Social interactions, particularly with activity, can also have mental health benefits.”

Plan regular social engagements. Whether it’s a book club, a support group, a volunteer program, or a place of worship, social and community groups can help older adults maintain a sense of purpose and belonging.

A 2016 study published in BMJ Open found that retirees who maintained social group memberships enjoyed better quality of life and longer life spans than those who spent more time alone. Other research since then has confirmed the link.

Connect to spirituality. Feeling connected to something bigger than yourself can help seniors live a fulfilling life.

“This doesn’t have to mean following Jesus or the Buddha, though it could,” said John Sanitato, MD, a geriatric psychiatrist at the Cleveland Clinic. “It may mean being a part of an organized religious faith, or it may be participating in a 12-step program, spending a lot of time in the sun, or just having some feeling of connection to a higher power.”

Do activities to stimulate the brain. This could include something as simple as solving the daily Wordle puzzle or taking online classes geared toward seniors.

“Studies have shown that learning a new language, coloring, or listening to classical music can improve memory in some patients,” Rogers said.

Open up about your feelings. One of the biggest challenges is stigma: Many older people grew up at a time when having a mental health challenge was considered a character flaw.

If you’re supporting a loved one, know it’s not a good idea to open the conversation by asking, “Do you feel depressed?”

Instead, Carr suggests asking open-ended questions about the person’s well-being, activities, and social interactions. Try something like “What activities do you look forward to?” Or, “You don’t seem like yourself today. What’s on your mind?”

Taking the steps toward wellness

One way to check for depression is to take a mental health screening. A quick and confidential assessment is available at www.mhascreening.org.

People experiencing depression should talk to their doctor, who may recommend counseling, medication, or a combination of both. Many mental health services are covered through Medicare.

Whatever strategies you choose, don’t waste time.

“Early diagnosis is really important,” Rogers said. “The earlier you diagnose depression, anxiety, or memory loss, you can put things in place to help prevent or delay further decline.”

The result? You just might find yourself or your loved one feeling happier. Or as The Boss would say, you could be Dancing in the Street.

This article is part of a Wise & Well Special Report: The United States of Depression. If you or a loved one is depressed, it’s vital to talk about it. Because depression increases the risk of suicide, consider calling the confidential National Suicide Prevention Lifeline at 1–800–273-TALK (8255) for English, 1–888–628–9454 for Spanish, or call or text 988. Global support in 44 languages is available from Befrienders Worldwide.