Renew’s Checkup Challenge: 5 reasons to take mild depression seriously

Can’t sleep? Forgetting things? Those symptoms could be signs of mild depression. On Day 4 of the Checkup Challenge, you’ll learn what to look for so you can start feeling better sooner.

Leslie Goldman
Woman having breakfast

The Renew Checkup Challenge is here to help you take charge of your health in a new way. Over 7 days, you’ll prepare for your next annual wellness visit, learn how to build a stronger relationship with your provider and become a better advocate for your health. Because no one ever said you had to take the changes that can come with getting older sitting down.

We all feel sad, down or just off sometimes. It’s totally normal. When those feelings of unhappiness last for weeks or months and interfere with your ability to live your life, however, it may be a sign of depression.

But you don’t have to cry all the time to be depressed. In fact, depression often looks different in older adults. It can show up as poor sleep, trouble concentrating or short-term memory issues, says Elizabeth J. Santos, M.D. She’s the clinical chief in the division of geriatric mental health and memory care at the University of Rochester School of Medicine & Dentistry.

Yet all too often, these unexpected symptoms are mistakenly chalked up to aging or even dementia. A clear sign to watch for? Loss of interest in activities that typically bring you joy, says Dolores Gallagher Thompson, Ph.D., a research professor emerita at Stanford University School of Medicine and psychologist who treats later-in-life depression.

Gardening and golf lose their appeal. Even spending time with young relatives might not feel as special. “You may still meet up with your bridge club of 20 years, but the zest has gone out of it,” says Gallagher Thompson.

If this sounds familiar, you could be experiencing mild or early signs of depression. But don’t let the word “mild” fool you: It can feel just as difficult as regular depression.

It’s important to remember that you’re not the only one — far from it. In a 2021 study of adults ages 50 to 80 that was published in the Journal of General Internal Medicine, nearly 20% of the participants reported that their mental health had become worse during the previous year.

Unfortunately, there’s still a stigma that prevents many people from getting the treatment they need.

“Baby boomers who are now in their 60s are probably more open to the idea of getting help for emotional issues. They lived through the Vietnam War and learned about mental health and PTSD,” Gallagher Thompson notes. “But people in their late 70s, 80s and 90s grew up in a different generation. You were not supposed to complain about things. You just learned to live with it.”

But there’s no need to suffer in silence. Now is the perfect time to get help and talk to your primary care provider (PCP) — the earlier, the better, says Gallagher Thompson.

Here are a few common signs of mild depression that can be easily dismissed:

Surprising depression symptom #1: Disrupted sleep

According to Johns Hopkins Medicine, 75% of people with depression experience trouble falling or staying asleep. Waking up after a full night of sleep still feeling exhausted is another warning sign.

Older adults may blame aging for their sleep troubles. And while it’s true that biological changes occur as we get older that can make sleep less restful, depression may also be the culprit, says Gallagher Thompson.

And it can become a tough cycle: A 2020 study published in the journal Sleep found that older adults with depression who are experiencing persistent or worsening sleep problems are more likely to remain depressed than those who don’t have this symptom.

Try a virtual visit for your mental health care
If you’ve been struggling with your emotions, it’s smart to reach out for help. UnitedHealthcare® Medicare Advantage plan members may have virtual visits with mental health providers as part of their plan. Sign in to MyUHCMedicare.com. Click on Find Care and Costs to search participating virtual providers. Not a member? Learn more here.

Surprising depression symptom #2: Stomach trouble

Many older adults taking heartburn or antidiarrheal medication may have hidden depression or anxiety, not a gastrointestinal (GI) problem, says Dr. Santos. That’s because your gut and brain are connected. (Think about the last time you felt butterflies in your stomach.)

Other common mental health–related GI symptoms include indigestion, stomach cramps, nausea, constipation, loss of appetite and even ulcers, per the Anxiety & Depression Association of America. If you’re having new GI issues and are also feeling a bit blue, the two could be connected. Be sure to see your PCP to rule out any other underlying conditions.

Surprising depression symptom #3: Fatigue

Fatigue is an often-missed symptom of depression. People “can’t get out of bed, can’t get going,” Gallagher Thompson says. One theory is that intense emotions such as depression, grief or anger can cause daytime fatigue. And people who are depressed don’t sleep great, and that can leave them feeling groggy during the day.

While being tired doesn’t mean you have depression, it can be a warning sign in some people, especially if you’re already feeling a bit lonely. When researchers surveyed about 2,500 adults age 60 and older, those who reported feeling socially isolated had higher rates of fatigue, sleep problems and depression, according to a 2019 study in the journal Aging & Mental Health.

Surprising depression symptom #4: Difficulty concentrating or short-term memory problems

Older adults may blame these issues on their age — or even worry that they have dementia — when depression is the true cause. You may find yourself asking the same questions repeatedly, Dr. Santos says. The good news is that when you treat depression, the short-term memory problems often clear up too, says Gallagher Thompson.

You can also give your mind a workout with Renew’s brain games. UnitedHealthcare Medicare Advantage members can sign in to MyUHCMedicare.com,  go to Health & Wellness and look for Brain Games. Not a member? Learn more here.

Surprising depression symptom #5: Unexplained weight gain or weight loss

Depression can increase your appetite or decrease it. Some people put on weight because they turn to comfort foods like french fries and cake to cope with their low mood. These foods tend to be high in sugar and fat. But the opposite occurs too: Stress hormones can take away your appetite, leading to weight loss.

But because weight changes can also be related to other issues, it’s important to let your PCP know if you’ve had a recent shift.

 

Still not sure if you need help? Take this quick quiz

Grab your Renew Checkup Challenge Activity Guide (download it here and turn to Day 4. Providers use the following two questions — called the Patient Health Questionnaire 2 (PHQ-2) — as a screening check for depression. Answer each question honestly and add up your score. If you have a score of 3 or higher, it’s time to see your PCP.

Over the past 2 weeks, how often have you been bothered by any of the following problems?

a) Little interest or pleasure in doing things
b) Feeling down, depressed or hopeless

Not at all (0)

Several days (+1)

More than half the days (+2)

Nearly every day (+3)

Here’s how to get help

As always, let your provider know how you’ve been feeling. Your PCP can refer you to a mental health professional for an in-depth evaluation and next steps. Treatment may include virtual therapy sessions, medication and/or lifestyle changes, such as regular exercise.

You win when you stand up for your emotional health. “Depression doesn’t automatically come with the territory of aging,” says Dr. Santos. “I’ve had patients say, ‘Well of course I’m a little depressed — I’m old.’” But it doesn’t have to be that way, she says: “You can have a fulfilling life.”

You can get help on your mental health journey Renew offers many mental health resources for UnitedHealthcare Medicare Advantage plan members. To learn more, sign in to MyUHCMedicare.com, go to Health & Wellness and look for Emotional Health. Not a member? Learn more here.

Catch up with the rest of the Checkup Challenge:
Day 1: Assess your physical activity level
Day 2: Test your balance
Day 3: Think about your bowel and bladder function
Day 5: Take charge of your care
Day 6: Check your medication knowledge
Day 7: Make your health emergency plan