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The more you know about the many — and often unexpected — root causes of this common mental health condition, the faster you may begin to feel better
You may have heard that depression is caused by a hormone imbalance. Or by a combination of chemicals in the brain. Maybe you’ve even bought into the idea that depression and growing older go hand in hand.
But here’s the thing: Depression isn’t a normal part of aging. And it doesn’t mean that something is wrong with your brain. In fact, depression often sneaks up on older adults. Certain medications, vitamin deficiencies and even another health issue such as arthritis or diabetes can raise your risk of depression.
“Most people think of depression as strictly something in the mind, or something that’s brought on by a broken heart or other heavy emotion,” says Nicole Beurkens, Ph.D., a licensed psychologist.
But the reality is depression has many triggers — including physical ones — that can easily be missed, Beurkens says.
What’s more, older adults may not feel sadness as their primary sign of depression, according to the National Institute of Aging (NIA). Instead, older adults may feel tired, irritable and have trouble sleeping.
Ready to put aside your outdated notions of what leads to depression? Read on for 5 lesser-known triggers. Plus, learn the steps you can take to help get back on the path to feeling happy.
Surprise trigger #1: A long-term condition
Ongoing health conditions such as arthritis, diabetes or cancer can take a toll on a person. Physically, these diseases cause swelling and inflammation in the body, which is linked to depression and other mood changes, says Beurkens.
It can also be emotionally difficult to have a long-lasting illness. In fact, adults who are managing chronic conditions frequently point to depression as a big factor that is keeping them from enjoying life more, according to a 2019 report in the journal Frontiers in Immunology.
The more advanced your condition becomes, the more likely you are to step back from the people and activities that bring you joy, says Beurkens. “If it becomes too difficult to go out and do things, or if you generally feel physically unwell, that’s when feelings of hopelessness begin to take hold,” she says. “Depression can follow.”
Your move: Work closely with your health care team to keep up with and adapt your treatment plan. Many chronic conditions are best managed by a combination of medications and lifestyle changes. Beurkens says it’s important to discuss the daily habits that may literally help make a difference between a good day and a bad day.
Your Annual Physical and Wellness Visit is a good opportunity to talk to your provider about how your chronic condition may be impacting your mental health. To help you prepare for your appointment, download your Annual Care Checklist, found plan website.
Don’t be shy about mentioning any emotional struggles tied to managing your condition. During your visit, your provider can give you a simple depression screening. Depending on your answers, you may benefit from a few sessions with a therapist. These days, mental health professionals are just a phone call or video chat away.
In addition to serving as a reminder of important health screenings and immunizations, the checklist includes important topics to discuss with your provider. For example, you may want to ask your provider if visits with a physical therapist or nutritionist would be right for you. There’s a strong food-mood connection, so making a few simple diet swaps may prove helpful.
Virtual care includes mental health coverage
Most UnitedHealthcare Medicare Advantage plans include telehealth appointments* to get a private evaluation or treat general mental health conditions. To find a list of participating virtual providers, sign in to your plan website and click on Find Care. Not a member? Learn more here.
Surprise trigger #2: Your medications
A variety of commonly prescribed medications can affect your mood and lead to symptoms of depression, says Beurkens. This includes:
- Certain antibiotics
- Beta blockers for high blood pressure
- Statins for high cholesterol
- Corticosteroids for allergies, asthma or arthritis
More puzzling, sometimes medications that are used to help treat mood disorders — including depression and anxiety — may cause your mood to worsen.
The reasons for these mood changes brought on by any of the above medications aren’t always clear, she says. In the case of some cholesterol-lowering medications, for example, it’s thought that the drugs may lower cholesterol levels in the brain too much, according to a 2018 study in the journal BMC Psychiatry.
Other times, the medications may interfere with your brain’s “feel good” receptors. Or, your body may simply respond to the medication in a way that wasn’t intended or hoped for, Beurkens says. This is often what’s happening when an antidepressant leads to worse mood swings, she adds. That’s why medication treatment plans for mental health conditions are often a trial-and-error process.
Your move: If you suspect that a medication you are taking may be causing your symptoms, call your provider right away. They may be able to change your dose or try a different medication. Most importantly, don’t stop taking a medication without taking to your provider first.
Also, whenever you’re prescribed a new medication, ask about any possible side effects and what steps to take if you experience any.
Surprise trigger #3: Low vitamin B12
Vitamin B12 is a key nutrient that helps keep the body’s nerve and blood cells healthy. If you start to run low on B12, symptoms of depression can creep in, says Beurkens. This is especially true for older adults, who can have natural age-related changes that make it harder to use the B12 they get from food.
Signs you might have low B12 include fatigue, constipation, lack of appetite and weight loss.
Your move: Ask your provider to check your B12 levels with a blood test. They may recommend taking a supplement. And keep these B12-rich foods in regular rotation at mealtime:
Surprise trigger #4: Poor sleep
Lack of sleep isn’t just annoying — it’s unhealthy, for your body and your mind. People who have trouble sleeping have a higher risk of developing depression, says Dr. Beurkens. And the older you get, the tougher it becomes to get a good night’s sleep, she adds.
For one thing, your body is naturally wired to “sleep lighter” as you age, according to researchers at the University of Pittsburgh who studied the relationship between sleep and mental health problems in older adults.
Other factors are also at work: A trio of sleep disorders — insomnia, sleep apnea and restless leg syndrome — often bubble up later in life, notes the U.S. National Library of Medicine. A study in the Journal of Affective Disorders found that people with insomnia were twice as likely to be depressed as those who slept soundly. It’s also common for older adults to have conditions like heart disease or diabetes, both of which can disturb your z’s.
Your move: Bring up any sleep difficulties you may be having with your provider. They can check for and diagnose sleep disorders or other conditions that are impacting your sleep.
Also, commit to a more peaceful nightly routine. Beurkens suggests moving your catch-up phone calls, social media scrolling and workouts to earlier in the day. These kinds of stimulating activities tend to keep your body and mind in wake mode.
Instead, save your evenings for a good book, a quiet hobby or TV shows that make you laugh. Music has also been shown to help people get better shut-eye. One review of studies from the Cochrane Database of Systematic Reviews showed that listening to music for 25 to 60 minutes can help improve sleep quality in people who have insomnia.
Download the Sanvello app
Peer support, relaxation and coping tools, a place to track your mood — it’s all at your fingertips with the Sanvello app. And it’s included with many UnitedHealthcare Medicare Advantage plans. To learn more and get started, sign in to your plan website and go to Health & Wellness. Then search Sanvello.
Surprise trigger #5: Caregiving duties
In the U.S., about 1 in 5 adults over the age of 65 are caregivers, according to the Centers for Disease Control and Prevention (CDC). If you’re one of them, thank you! Taking care of another person’s health is a noble job. It can also be a great way to bond with loved ones.
However, caregivers are at risk for what’s known as “caregiver burnout.” That tends to happen when caregivers set aside their own well-being and focus solely on the other person’s needs. The Cleveland Clinic describes this type of burnout as a “state of physical, emotional and mental exhaustion.” It’s a recipe for depression, says Beurkens.
According to the Cleveland Clinic, signs you might be taking on too much include:
- Loss of interest in your favorite activities
- Extreme fatigue
- Feeling helpless or hopeless
- Turning away from other loved ones
- Changes in sleep patterns
- Changes in appetite and/or weight
Your move: Caregiver burnout can be avoided when you set realistic expectations about what you can and cannot do. “Ask for help — from your friends and family, from others in your loved one’s circle and from your providers,” says Beurkens. “You have to become comfortable asking for help. And you have to carve out time for yourself.”
Your loved one’s health care team is a valuable connection for you. They may be able to connect you to resources in your community that you’re not aware of, such as transportation services or financial help. Don’t forget to take advantage of the caregiving resources that are available through your or your loved one’s UnitedHealthcare Medicare Advantage plan. You can take an easy-to-follow online learning course for caregivers here. Or check out other valuable Renew resources around providing caregiver support by signing in to your plan website and going to Health & Wellness. Then look for Caregiving in the Quick Links section. Not a member? Learn more here.
Support groups can also be an important lifeline for caregivers. Many national groups focused on different conditions, including the Cancer Support Community and the Alzheimer’s Association, organize support groups at the local level. To find one near you, do an internet search by typing in your loved one’s condition and “support group near me.”
*Virtual visits may require video-enabled smartphone or other device. Not for use in emergencies.