Depression In Older Adults: Can It Develop After Retirement?
Chronic illnesses, financial stress, injury and grief can put older adults at an increased risk of developing depression—though many might find their symptoms are frequently dismissed, misdiagnosed and/or undertreated.
Some economists indicate that the risk of developing depression can increase by 40% after retirement, possibly due to the occurrence of reduced social interactions, less structured routine and a lower sense of purpose.
Understanding symptoms of depression and treatment options can help retirees manage their symptoms. Read on to learn more.
Depression can be an umbrella term for several mood disorders that are typically characterized by low mood and sadness. Types of depression that may occur in older adults include:
- Major depressive disorder: In this condition, symptoms generally last for at least two weeks and can interfere with daily life. Symptoms can be either physical or emotional.
- Persistent depressive disorder (PPD): Symptoms associated with this condition can last for two years or more. They may be either physical or emotional.
- Depressive disorder due to another medical condition: This is generally defined as depression that can be directly related to the effects of a medical condition, such as heart disease or Parkinson’s disease. People may have varying experiences with this type of depression.
Symptoms of depression in older adults
Symptoms of depression generally remain fairly consistent as we age, however, some practitioners may incorrectly assume that older adults’ symptoms are a part of typical aging—or they might provide a misdiagnosis (such as Alzheimer’s disease).
Common symptoms of depression can include the following:
- Prolonged feelings of sadness, numbness, or nervousness
- Crying easily and/or frequently
- Feeling helpless, hopeless, or worthless
- Negative self-talk or guilt
- Irritability or restlessness
- Lack of interest in activities you used to enjoy
- Difficulty concentrating, which may increase the risk of falling
- Forgetfulness
- Indecisiveness
- Fatigue
- Moving or talking lethargically
- Sleeping changes (such as not sleeping enough or sleeping too much)
- Changes in appetite or weight
- Unexplained body pains
- Suicidal ideation
Retirement, depression and risk factors
Major life transitions, including retirement, can increase your risk of developing depression. This may be due to a combination of factors, including changes in social networks, changes in assets and financial security, reduced access to mental healthcare, less mental stimulation, and a reduced sense of purpose.
Additionally, the occurrence of physical conditions that are diagnosed later in life, such as heart disease and Parkinson’s disease, can put people at a higher risk of developing depression.
Some other risk factors for depression can include the following:
- A family history of depression
- Social isolation and loneliness
- The loss of a spouse and/or living alone
- Financial challenges
- Medical conditions—including stroke, cancer and cardiovascular disease
- Mobility, vision impairment or other impediments to daily functioning
- Sleep difficulties
- Caregiver stress
Addressing depression after retirement
Adjusting to the possible loss of routine that occurs after retirement can be challenging, and has been shown quantitatively by a meta-analysis from 2020 estimating that nearly one-third of retirees experience depression. However, there are many effective strategies that can help address depression that occurs after retirement:
Tapering working hours
The transition to retirement from a 40+ hour workweek can be jarring. You may want to consider having a discussion with your employer to see if you can work part-time or work from home as you transition into retirement.
Avoiding “full retirement”
For some individuals, working part-time after retirement age can benefit mental health. If your job makes you happy, you don’t necessarily have to leave it. If you cannot stay at your job, however, you may want to consider mentorship opportunities, teaching, or volunteering to keep yourself busy.
Building a (new) routine
As you transition, you might want to consider maintaining a calendar with routine events. Routine can reduce stress, and improve sleep quality, diet, and physical health.
Adding activities like volunteering, taking a class at a local college, and exercising to your schedule can double as social opportunities and improve mental health.
Statistically, retirees who engage in activities are suggested to experience the most positive mental health effects from retirement.
Considering support from your health team
If you are experiencing a change in your mental health following retirement, you might consider seeing your medical practitioner. They can conduct a physical examination, evaluate medical records and family history and collect bloodwork to rule out other conditions. Your doctor can conduct mental health assessments and provide a depression diagnosis, or they may refer you to an in-person mental health professional.
How can online therapy help those entering retirement?
Overall, it is estimated that 28% of retirees might experience depression, which is thought by many to be significantly higher than other older adult populations. Regardless of whether you’re diagnosed with depression, you may want to consider reaching out to a therapist to talk with during such a major life change.
A common type of talk therapy, called cognitive behavioral therapy (CBT), can be very effective for addressing depression. For people who live in rural areas, online CBT can be a helpful option. Additionally, many find that licensed online therapists—like those at BetterHelp—can provide therapy that may be more cost-effective. This can be particularly useful for retirees on a budget.
Is online therapy effective?
A recent Cureus study found data that suggests that online CBT was generally effective at addressing many psychiatric disorders, including depression.
It was also found to produce comparable results to in-person methods for a range of other possible co-occurring conditions; such as anxiety disorders, panic disorder, substance use disorder, bipolar disorder and obsessive-compulsive disorder—or OCD.
Takeaway
What are the 6 types of depression?
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is a handbook used by licensed professionals to diagnose mental illnesses. The DSM-5 recognizes seven separate depressive disorders:
- Major depressive disorder (MDD): MDD is one of the most common mental disorders in the United States, and it’s often referred to as “clinical depression,” or just “depression.” To meet diagnostic criteria, a person must experience at least two weeks of low mood and other depressive symptoms that aren’t better explained by another condition.
- If depressive symptoms are caused by another condition or substance abuse, it may be diagnosed as “substance and medication induced depressive disorder” or “depressive disorder due to another medical condition.”
- Bipolar disorder is characterized by episodes of mania or hypomania and depression. which may meet criteria for a major depressive episode.
- Persistent depressive disorder (PDD): Sometimes called dysthymia, this disorder is characterized by an enduring low mood that occurs on most days for at least two years. PDD symptoms do not meet the severity required for a MDD diagnosis.
- Seasonal affective disorder (SAD): This type of depression is cyclical, often worsening during fall and winter months. SAD may be caused by circadian rhythm disruptions triggered by changes in day/night length.
- Peripartum depression: Hormonal changes, lack of sleep, stress, and lifestyle adjustments can all increase the risk of peripartum depression. This disorder is characterized by many symptoms, which may include low mood, lethargy, and hopelessness. Anyone, regardless of gender, may experience peripartum depression. Some people also experience post-weaning depression, which is not recognized in the DSM-5.
- Premenstrual dysphoric disorder (PMDD): Symptoms of PMDD are similar to those of PMS, but they are generally more severe. This disorder may develop as an abnormal response to the hormonal fluctuations that occur throughout the menstrual cycle.
- Disruptive mood dysregulation disorder (DMDD): DMDD is characterized by extreme behavioral symptoms and lack of self-control in children ages six to 18.
- Other specified depressive disorders: This diagnosis may be used when symptoms are characteristic of depression and cause significant distress or impairment, but do not meet the full criteria of another depressive disorder. A provider may choose to specify the diagnosis, or they may leave it unspecified.
What is the definition of a depressive disorder?
Depressive disorders are a group of mood disorders characterized by a persistent low or sad mood, and a variety of other symptoms like:
- Fatigue
- Little interest in things you used to enjoy
- Irritability, frustration, or restlessness
- Changes in sleeping, such as sleep too much or not enough
- Changes in appetite or weight
- Slowed movements
- Physical pain that is not explained by other physical and mental health
- Difficulty concentrating or making decisions
- Suicidal ideation or self-harm
Depression type can be differentiated based on factors like symptom severity, duration of symptoms, age, and specific circumstances under which symptoms develop.
What are disorders like depression?
Depressive disorders are classified as mood disorders, meaning that they disrupt emotions. Other mood disorders include:
- Bipolar I disorder: This disorder includes episodes of mania which occur for at least one week or require hospitalization.
- Bipolar II disorder: Bipolar II includes major depressive episodes with hypomanic periods which last for at least four days.
- Cyclothymia: Cyclothymia does not meet the diagnostic threshold for bipolar I or bipolar II, but it includes some symptoms of major depression and subthreshold hypomania.
- Mood disorder related to another health condition: People with conditions such as cancer, infections, or chronic illnesses may experience symptoms of depression.
- Substance-induced mood disorder: Substances, including prescription medicine, recreational substance use, and toxin exposure, may cause a mood disorder.
Additionally, some physical and mental health conditions can have symptoms that mimic depression. These may include vitamin deficiencies, hypothyroidism, diabetes, chronic fatigue syndrome, and anxiety disorders.
What are the 2 main types of depression?
The most common types of depression and major depressive disorder (MDD) and persistent depressive disorder (PDD).
MDD is characterized by having at least five of the following symptoms, which must persist for at least two weeks and cause significant distress or impairment:
- Low or depressed mood
- Lost of interest or pleasure in activities you used to enjoy
- Unintentional weight change
- Sleeping changes
- Slowed movement or restlessness
- Fatigue
- Feelings of worthlessness, guilt, or shame
- Difficulty concentrating or making decisions
- Thoughts of death or suicidal ideation
PDD symptoms are generally less severe than those of MDD, but they persist for longer. To meet diagnostic criteria, someone must have a “depressed mood most of the day, for more days than not, for at least two years."
What are the worst types of depression?
Depression, whether clinical or subclinical, can cause significant distress and disruption to daily life. However, symptoms of major depressive disorder are considered more severe than those of persistent depressive disorder.
Anyone at any age can experience depression. For example, people who have recently retired commonly experience so-called “retirement blues.” In the case of many retirees, those symptoms subside as they adjust to retirement life.
However, if your symptoms do not get better, they cause you distress, or they impair your life, it’s a good idea to talk with a professional. Data from the Health and Retirement Study found that early retirement can significantly increase depression risk. If you’re preparing for retirement, consider taking the following steps:
- Plan for a retirement transition period: Part-time jobs in a relevant field (bridge employment) can help make for a gradual transition into retirement and improve health insurance coverage.
- Find support from peers: Senior support groups are popular among older adults. They can provide emotional support, helpful advice, and encouragement. Additionally, they can help people learn new skills to manage stress and mental health issues that may arise in retirement.
What are the 10 hits of depression?
The 10 cause categories (or “hits”) of depression are:
- Genetics
- Development
- Lifestyle
- Circadian rhythm
- Addiction
- Nutrition
- Toxic
- Social/complicated grief
- Medical condition
- Frontal lobe
These 10 hits are risk factors for depression. According to the Nedley Depression Hit Hypothesis, a depressive episode may be triggered when four or more of these factors are combined.
What is bipolar mental disorder?
Harvard Health Publishing defines bipolar disorder as follows: “Bipolar disorder [...] is a mental disorder characterized by wide mood swings from high (manic) to low (depressed).”
Bipolar disorder is differentiated into bipolar I and bipolar II subtypes. Bipolar I disorder is characterized by the presence of manic episodes lasting at least two weeks or requiring hospitalization, whereas bipolar II includes at least one hypomanic and one depressive episode.
Is depression a disease or disorder?
Diseases and disorders are often used interchangeably, but they mean different things:
- Disease: A disease has a distinct pathology that a doctor can typically see or measure, such as cardiovascular disease.
- Disorder: An irregularity that is distinct from normal function, and causes distress or issues in daily life. Examples of disorders include epilepsy, social anxiety disorder, and postpartum depression.
Depression is a mental disorder, not a disease.
Why is it called depression?
According to the National Institutes of Health, the term “depression” was first used in the 19th century. At that time, depression referred to a “lowering of spirits” or a sense of being “pressed down.” In modern psychology, depression refers to a group of mental disorders with these core symptoms: depressed mood and loss of interest/pleasure.
What are signs of anxiety?
The signs and symptoms of anxiety can vary, but may include:
- Feeling fearful, restless, or worried
- A sense of impending danger
- Rapid heart rate, muscle tension, gastrointestinal distress, migraines, and other physical symptoms
- Trembling, shaking, clammy hands, or numbness
- Sweating
- Fatigue or exhaustion
- Sleeping difficulties
- Difficulty managing worry
- Avoidant behaviors
Most people experience anxiety from time to time. However, it may be a good idea to see your doctor if your symptoms begin interfering with your life or causing you distress.
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