Depression is a medical condition, not a normal part of aging, and it can be treated. In older adults it often does not look like sadness: it may show up as tiredness, aches, irritability, poor sleep, changes in appetite, trouble concentrating or a loss of interest in things the person used to enjoy. If you or someone you care for is thinking about suicide, call or text 988 now, or call 911 in an emergency.
If someone is in crisis right now
Call or text 988, or chat at 988lifeline.org. The 988 Suicide & Crisis Lifeline is free, confidential and available 24 hours a day, every day, and SAMHSA describes it the same way. If you are deaf or hard of hearing, use your preferred relay service or dial 711, then 988.
In New York City, 988 is answered by NYC 988, which offers interpreters in more than 200 languages; Spanish speakers press 2. For a life-threatening emergency, call 911 or go to a hospital emergency room.
Is depression a normal part of getting older?
No. The National Institute on Aging says depression is common among older adults but is not a normal part of aging, and that most older adults are satisfied with their lives even though they often have more illnesses or physical challenges than younger people. It also says that for most people depression gets better with treatment.
What does depression look like in older adults?
NIA says depression in older adults can be hard to recognize. For some people sadness is not the main symptom; they may feel emotional numbness or lose interest in activities, and they may be less willing to talk about feelings than younger adults. In some cultures depression is expressed mostly through physical complaints such as aches, headaches, cramps or digestive problems. The National Institute of Mental Health adds that older adults may report a lack of emotions rather than a depressed mood.
| What a family member may notice | Matching symptom on the NIA and NIMH lists |
|---|---|
| Quiet, flat, “not herself” | Persistent sad, anxious or “empty” mood; trouble feeling positive emotions |
| Stops going to the senior center, church or card game | Loss of interest in once pleasurable activities |
| Tired all the time, slow to get started | Decreased energy or fatigue; moving or talking more slowly |
| Snappy, restless, easily upset | Irritability, restlessness or trouble sitting still |
| Up at 4 am, or sleeping most of the day | Difficulty sleeping, waking too early or oversleeping |
| Skips meals, or eats far more than usual | Eating more or less than usual |
| “I can’t think straight,” loses track of conversations | Difficulty concentrating, remembering or making decisions |
| Ongoing aches or stomach trouble with no clear cause | Aches, pains or digestive problems (NIMH lists ongoing headaches, digestive issues or pain) |
| Says “everyone would be better off without me,” or talks about death | Thoughts of death or suicide: call or text 988 right away |
NIA advises talking with a doctor when several of these signs last more than two weeks. They can point to depression or to another health condition. This list cannot diagnose anyone.
What raises the risk of depression in older adults?
NIA lists factors that research links to a higher risk of depression, without saying they cause it: medical conditions such as stroke or cancer, a personal or family history of depression, stress including caregiver stress, sleep problems, social isolation and loneliness, lack of physical activity, and limits that make daily activities hard. A major life event, such as a worrying diagnosis or a death, can also come first.
Two are easy to overlook. Pain and illness: NIMH notes that older adults are more likely to have medical conditions or pain that can cause or contribute to depression. Medicines: NIA says certain medications or medical conditions can sometimes cause symptoms of depression, and NIMH says side effects of medicines taken for an illness can contribute. Do not change or stop anything yourself; bring the full medication list to the prescriber or pharmacist. Our guide to medication management for seniors covers keeping that list organized.
For loneliness specifically, see loneliness and mental health in older adults in NYC.
How is depression different from grief, and from dementia?
All three can bring poor sleep, a smaller appetite and a foggy mind, and they can occur together. Only a clinician can sort them out.
| Grief | Depression | Dementia | |
|---|---|---|---|
| What it is | A normal response to a loss; NIA says there is no right or wrong way to mourn | A medical mood disorder that affects how a person feels, thinks and acts | A condition affecting memory, thinking and daily function (see dementia vs Alzheimer’s) |
| Typical signs | Numbness, sorrow, guilt, crying easily, trouble sleeping, little interest in food, trouble concentrating | Persistent sad or “empty” mood, hopelessness, lost interest, fatigue, sleep and appetite changes, trouble concentrating | Memory and thinking problems that interfere with daily life; it can also include mood symptoms |
| Course | For most people the intense pain eases over time, with good and bad days | Major depression means symptoms most of the day, nearly every day, for at least 2 weeks (NIMH) | Needs a clinical evaluation; see our delirium vs dementia guide for another cause of confusion that doctors check |
| When to get help | If sadness makes it hard to carry on day to day, or grief stays overwhelming (NIA calls this complicated grief) | See a doctor if signs last more than two weeks | See a doctor at the first changes you cannot explain |
On dementia, NIA says it can cause some of the same symptoms as depression, that depression is common in people with Alzheimer’s disease and related dementias, and that depression can be an early warning sign of possible dementia. NIMH notes that memory and thinking problems can be prominent in severe depression in older adults.
For grief, NIA says support groups exist at hospitals, senior centers and faith communities, and hospice teams can offer bereavement support even if hospice was not used before the death.
How is depression treated?
Treatment is decided by the person’s doctor or mental health professional, and it differs from person to person. NIA says it is usually treated with psychotherapy, medication or both, and that trying more than one approach is common.
- Talk therapy. Counseling or psychotherapy, such as cognitive-behavioral therapy or interpersonal therapy, can be done with a psychologist, a licensed clinical social worker, a psychiatrist or another licensed professional.
- Medicines. A psychiatrist, mental health nurse practitioner or primary care physician can prescribe and monitor them. NIMH says antidepressants usually take 4 to 8 weeks to work and that you should talk to a health care provider before starting or stopping any medication. NIA adds that older bodies handle medicines differently, so share every medicine and supplement with the doctor or pharmacist.
- Connection and activity. NIA lists staying in touch with friends and family, activities the person enjoys, physical activity and enough sleep as healthy habits that can help.
The first step is usually a doctor’s visit. NIA says a doctor can check, through an exam, health history and lab tests, whether a medicine or medical condition is behind the symptoms, and can refer the person to a mental health professional. NIMH says a primary care provider is a good place to start.
Does Medicare cover depression screening and treatment?
For people with Original Medicare, Medicare.gov says Part B covers outpatient mental health care, including the following.
| Service | What Medicare.gov says |
|---|---|
| Depression screening | One each year, in a primary care doctor’s office or clinic that can provide follow-up treatment and referrals; you pay nothing if the provider accepts assignment |
| Therapy and psychiatric care | Individual and group psychotherapy, psychiatric evaluation and medication management |
| Welcome to Medicare and yearly Wellness visits | The one-time visit reviews possible depression risk factors; at the yearly visit you can discuss changes in your mental health |
| Cost of other visits | After the Part B deductible, 20% of the Medicare-approved amount |
Medicare also covers a separate cognitive assessment visit to look for conditions such as dementia, depression, anxiety or delirium if the provider suspects impairment. If your parent has a Medicare Advantage or Medicaid managed care plan, call the plan about providers and costs.
What help is there in New York City?
| Resource | What it offers | How to reach it |
|---|---|---|
| NYC 988 / 988 Lifeline | Crisis counseling and referrals by call, text or chat, 24/7 | Call or text 988; 911 in an emergency |
| NYC Aging Geriatric Mental Health Initiative | Licensed clinicians at older adult centers in all five boroughs: screening, counseling and referrals, in person, virtual or by phone, for New Yorkers 60 and older; center membership not required | Aging Connect, 212-244-6469 (212-AGING-NYC); for thoughts of suicide, the page says to call 911 |
| NYC Aging Friendly Visiting | Volunteers visit homebound older adults with ongoing health challenges at home, by phone or by video | Aging Connect, 212-244-6469 |
| NY Connects | Free information on long term services, referrals to services such as home care, and links to caregiver support groups | 1-800-342-9871 statewide; Brooklyn (718) 671-6200; Queens (718) 559-4400 |
| Alzheimer’s Association Helpline | Support, information and local resources for people with dementia and caregivers, in more than 200 languages | 1-800-272-3900, 24/7; dial 711 for relay |
Details are on the official pages for the Geriatric Mental Health Initiative, Friendly Visiting and NY Connects, and on the Alzheimer’s Association site. The NYC Aging page does not state a fee, so ask when you call.
NYC Aging’s caregiving page lists training, support groups and respite for family caregivers. If you are the one who is exhausted, see our guide to caregiver burnout.
What can family and home care aides do?
NIA is clear that family and friends can support someone with depression but cannot treat it.
- Ask, and listen. NIA says not to shy away from asking whether someone feels depressed or suicidal; asking will not make them more likely to act on those thoughts. If the answer is yes, call or text 988.
- Help get the appointment. Set up the visit and go along if the person agrees, to describe changes since the last visit. A paid medical escort or a medical transportation service can solve the practical barrier of getting there.
- Encourage the treatment plan. Encourage the person to stick with the plan the doctor prescribes. Do not suggest stopping or changing a medicine; call the prescriber with questions.
- Build a gentle routine. Regular meals, a short walk, a phone call, an activity they like. NIA suggests offering to go for a walk, since physical activity can boost mood.
- Add places to go. An adult day program or an older adult center gives structure and company.
- Report changes. If the person has a home health aide, the aide should tell the nurse or family about changes in mood, sleep, eating or interest. Aides do not diagnose; they notice and report.
Home care is not therapy and does not replace treatment. Our nurse services page describes the nursing side of care at home.
Advice from our nurse director
Anna Klyauzova, RN, MSN, MPA, Director of Patient Services at ProLife Home Care, on what she sees in practice:
Small things matter more than people expect: tea together, talking about the news, looking through family photos, a short walk. I remind our home health aides that they are not just working through a task list. They are spending the day with a person who wants company.
The signs that worry me are loss of interest in things the person used to enjoy, refusing food, trouble sleeping, withdrawing and constant sadness. Aides report these to the nurse, and we ask the family to see a doctor. Depression is not a normal part of getting older.
We are a licensed home care agency in Brooklyn and Queens, licence #2572L001, New York State Department of Health. We do not treat depression; that is for a doctor or mental health professional. We can talk through what regular aide visits would look like for your family. Call (718) 232-2777 or use our contact page.
Programs, phone numbers and Medicare rules change. Everything above was checked on 15 October 2026 against NIA, NIMH, 988lifeline.org, SAMHSA, NYC 988, Medicare.gov, NYC Aging, the NYS Office for the Aging and the Alzheimer’s Association. This page is general information, not medical advice, and it cannot tell you whether anyone has depression. If someone is in crisis, call or text 988, or call 911.
Frequently asked questions
Is depression a normal part of aging?
No. The National Institute on Aging says depression is common in older adults but is not a normal part of aging, and that for most people it gets better with treatment. Talk with a doctor if symptoms last more than two weeks.
What are the signs of depression in the elderly?
Sadness may not be the main sign. Look for fatigue, irritability, loss of interest, sleep and appetite changes, trouble concentrating, unexplained aches and thoughts of death. Several signs lasting more than two weeks are a reason to see a doctor.
What number do I call if an older adult is thinking about suicide?
Call or text 988, or chat at 988lifeline.org, any time of day. In New York City the call is answered by NYC 988. If the person is in immediate danger, call 911.
How can I tell grief from depression?
They overlap, and only a clinician can tell them apart. NIA says grief often brings sadness, trouble sleeping and a poor appetite, and that for most people the pain eases over time. If symptoms stay severe, last most days for two weeks or more, or make daily life hard, see a doctor.
Can depression look like dementia?
It can. NIMH notes that memory and thinking problems can be prominent in severe depression, and NIA says depression can also be an early warning sign of dementia. A doctor should evaluate any change in memory rather than assuming one or the other.
Does Medicare cover depression screening and therapy?
Yes, under Part B. Medicare.gov lists one depression screening a year in a primary care setting that can provide follow-up, at no cost if the provider accepts assignment, and covers psychotherapy, psychiatric evaluation and medication management. After the deductible you generally pay 20% of the approved amount for other visits.
Where can an older New Yorker get mental health counseling?
Start with a primary care doctor, who can refer to a mental health professional. NYC Aging’s Geriatric Mental Health Initiative places licensed clinicians at older adult centers for New Yorkers 60 and older; call Aging Connect at 212-244-6469. NY Connects at 1-800-342-9871 can also point to local services.
