Sadness or depression? A mental health guide for older adults

Feeling blue from time to time is a natural part of life. Depression is not. Answering these 5 questions can help you find your smile again.

Lauren Bedosky
Mature man drinking coffee on his patio

It’s normal to feel sad sometimes. It’s also common for sadness to feel all-consuming, especially after a big life change like moving from work to retirement, losing a loved one or dealing with a serious illness. But does that mean you’re depressed? Not necessarily.

While sadness and depression often go hand-in-hand, the latter is more than just a case of the blues. Feelings of sadness usually go away with a little time. But depression (also called “clinical depression” or a “depressive disorder”) is a long-term mental health disorder. It interferes with your ability to sleep, eat and enjoy life on a daily basis, according to the National Institute of Mental Health (NIMH).

Unfortunately, depression is on the rise among older adults, reports the Substance Abuse and Mental Health Services Administration (SAMHSA). Nearly 20% of Americans over age 65 have depression or another mental health issue, notes SAMHSA. 

Loneliness and social isolation is one factor, but having a chronic health condition or disability (such as hearing or vision loss) can also put you at a higher risk for depression, says SAMHSA.

“Depression is a health condition that deserves to be treated,” says Annette Nunez, Ph.D., a licensed psychotherapist. Older adults shouldn’t have to — or try to — suffer in silence, she adds. Untreated depression increases the risk for cognitive decline and heart disease. Plus, it’s a significant risk factor for suicide among older adults, according to NIMH.

Because it can be tricky to tell if you have sadness or depression, here are a few important questions to ask yourself — and what steps to take next.

Question #1: Did something cause your sadness?

“Sadness is a human reaction to an event that’s happened. There’s usually a trigger,” says Nunez. Think about what’s happened lately that might be getting you down, like a sudden illness, death or a big move.

Major life events can lead to depression, but depression often seems to come out of nowhere. “It’s that sense of feeling blue, but you just can’t explain why,” Nunez says. 

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Question #2: Do you feel hopeless, irritable or angry?

Sadness is a common symptom of depression, but it’s only one small part of it. If you’re depressed, you may feel sad, but you may also feel hopeless, worthless, anxious, fatigued, irritable or even angry, according to the NIMH. 

You may also feel empty, and lose interest in hobbies or activities you used to enjoy. “With depression, there’s a sense that there’s no purpose and nothing to look forward to in life,” Nunez says. 

Question #3: Have your sleeping habits changed?

Take note of any significant changes in your sleep routine. Unlike sadness, depression often affects your sleep habits in big ways, according to Nunez. 

If you feel anxious or restless, for example, you may struggle to fall asleep at night. On the other hand, if you feel hopeless or fatigued, you may find yourself oversleeping or napping more than usual.

Question #4: Are you eating more or less than usual?

A change in eating habits is another telltale sign that your sadness is really depression — in particular, a loss of appetite or overeating, states the NIMH. If you’ve noticed unintentional weight gain or loss over a short period of time, you may be dealing with depression.

Question #5: How long have you felt symptoms?

Think about how long you’ve felt sad or struggled with sleep, appetite, a loss of energy or hopelessness. Feelings of sadness typically improve or go away with a little time, whereas symptoms of depression tend to stick around. 

“If symptoms last longer than two weeks, that’s a strong indicator that something else is going on,” Nunez says. 

What to do if you’re sad

If your answers lead you to rule out depression, there are steps you can take to resolve your sadness on your own, says Nunez. 

Start by identifying the event that triggered your sadness. “Is it going from work to retirement? Is it that a loved one passed away? Because you will have feelings of grief and sadness, and the first step is to acknowledge them and feel the sadness,” she says.

Once you’ve identified the trigger event and allowed yourself to feel the sadness for a while, shift into thinking about the positive things you have to look forward to. 

For example, if you’ve recently downsized or moved, think about the fun you can have decorating your new space, or the first dinner you’ll host (once the pandemic passes, of course). The idea is to move your thought patterns toward the bright side, says Nunez.

She also recommends the following as good ways to help you feel happier:

  • Making plans with a friend to go for a socially distanced walk together.
  • Playing with a pet.
  • Watching funny movies or TV shows.
  • Reading a light book.
  • Spending time outside.

Tap into the power of Renew Positivity 

Your overall well-being is closely tied to your emotional health. With Renew Positivity, you can listen to a variety of music playlists that fit your mood — everything from classic oldies to peaceful meditation songs. Or read inspiring articles and find uplifting photos to keep or share. It’s all part of Renew by UnitedHealthcare®, which is included with most plans. Sign in to your plan website and go to Health & Wellness. Then look for Renew Positivity in the Quick Links section. Not a member? Learn more here.

What to do if you think you’re depressed

If you think you may have depression based on your answers, the first step is to check in with your primary care provider (PCP) or a mental health professional. You can visit your doctor in person, but many providers and therapists now offer virtual appointments, which allow you to talk to the doctor in the comfort of your home. 

During the appointment, your PCP will screen you for depression by asking a series of questions about your mood, energy and sleeping and eating habits. Be ready to talk about your current medical conditions and medications, as many can cause symptoms of depression, according to Nunez. 

If all signs point to depression, your doctor will review your treatment options. These may include medication changes, antidepressants, individual or group talk therapy and lifestyle changes that prioritize healthy nutrition, sleep and exercise habits. 

Keep in mind that there’s no blanket treatment regimen that works for everyone. In fact, Nunez says many people with depression rely on a number of different treatments to help them manage the condition.

The biggest thing to know is that there’s help, says Nunez. “Depression is a health condition that can be — and deserves to be — treated,” she says. 

Where to go for help

If you or someone you love needs immediate help, call 911, or reach out to one of these 24/7 national services:

  • Substance Abuse and Mental Health Services Administration (SAMHSA) helpline: call 800-662-HELP (4357). 
  • Crisis Text Line: text “HELLO” to 741741 to be connected with a counselor who can provide support and information.
  • Veterans Crisis Line: call 800-273-TALK (8255) and press 1 — or text 838255 — to speak with a trained responder. Veterans who are deaf or hard of hearing can call 800-799-4889.
  • National Suicide Prevention Lifeline: call 800-273-TALK (8255). Those who are deaf or hard of hearing should dial 711 and then the 800 number.

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.