Ageing Well Series: Understanding Depression in Older Adults
- Admin
- 3 days ago
- 4 min read
Updated: 20 hours ago
Depression in later life often hides behind silence and unspoken grief. In understanding its complexity, we open up space for connection, dignity, and meaning.
When an older person seems withdrawn or “just slowing down,” it may be more than age. In Singapore and beyond, many seniors live with depression mistaken for fatigue or forgetfulness.
Late-life depression often arises at the crossroads of loss, whether of loved ones, health, or independence, and the physical and social changes of ageing. In cultures that value endurance, older adults may quietly endure emotional pain, believing they should stay strong rather than speak. Recognising this is the first step toward compassion and healing.
How does depression in older adults present differently?
Depression in older adults rarely looks like textbook sadness. It often shows up as:
Somatic complaints: Aches, pains, fatigue, appetite or sleep changes
Cognitive symptoms: Forgetfulness or slowed thinking that can mimic dementia
Irritability or withdrawal: Loss of interest or emotional flatness
Increased vulnerability: Depression is linked with higher medical complications and poorer recovery
Because these signs overlap with normal ageing, depression often goes unnoticed until it becomes severe.
Deep grief: loss behind the diagnosis
At the emotional core of many cases lies grief, some visible and some silent.
Bereavement of a partner or peers can leave deep emptiness as routines lose meaning and daily companionship disappears.
Loss of health and function can lead to frustration and changes in identity. Tasks once effortless, such as walking, remembering, or managing errands, can become exhausting.
The fading of role and purpose follows retirement, family distance, or shrinking social circles, leaving the question, “What is still mine?”
Layered and compounded losses often occur together. The death of a spouse may coincide with illness or declining mobility. Over time, these accumulate into a quiet heaviness that is easily mistaken for apathy. Depression, seen through this lens, is not failure but a human response to profound loss.
Body, biology and vulnerability
Ageing makes the body more sensitive to emotional strain. Blood vessels stiffen, inflammation increases, and brain pathways that regulate mood may weaken. Chronic stress also alters the body’s ability to recover.
When a new loss occurs, the emotional impact can be stronger and longer-lasting. Some older adults develop memory lapses or fatigue that blur the boundary between depression and cognitive decline. Understanding these connections reminds us that late-life depression is both psychological and biological, and deeply human.
Culture, family and emotional silence
Many older individuals grew up equating resilience with silence. Talking about sadness may still feel shameful or self-indulgent. Some try to stay cheerful for their children, hiding their pain. Others assume their struggles are personal weakness rather than illness.
As family structures change, love is often shown through financial support rather than time. Parents may feel forgotten, while children believe their parents are coping. Depression grows in this quiet distance. Gentle listening and presence can help bridge it, allowing both sides to reconnect without blame.
When therapy helps rebuild connection
Therapy provides space to explore grief and identity without pressure to “move on.” Many older adults have never been asked what they truly feel. Therapy allows them to speak about regrets, fears, or loneliness safely.
Talking about mortality often brings relief rather than despair. Remembering life’s stories, even painful ones, restores coherence and self-worth. As older adults reflect on what still matters, such as family, faith, creativity, or friendship, new meaning can emerge.
Therapy can also renew family connections. When older adults express needs clearly, loved ones respond with deeper understanding. These small repairs of communication often become the real work of healing.
Supporting older adults: what helps in daily life
For caregivers, family, or community members, small and steady actions make a difference:
Watch for changes: Withdrawal, appetite shifts, or new physical complaints.
Invite conversation: Ask what has been difficult lately, with empathy rather than solutions.
Normalise support: Counselling or joining community groups can be framed as care, not weakness.
Share memories: Reflect on moments of meaning and ongoing hopes.
Adjust activities: Encourage light movement or hobbies suited to current ability.
Coordinate care: Ensure doctors consider mood symptoms alongside physical health.
Depression in older adults is not a sign of weakness or resignation. It is often grief expressed through the body and silence. Healing is not about returning to who one used to be, but finding new ways to belong, to self, to others, and to life as it continues.
Ageing well means allowing space for sadness, reflection, and rediscovered purpose. Therapy and human connection remind us that meaning can still unfold, even in later chapters of life.
Restoring Peace is a private mental health centre offering counselling and psychotherapy for individuals, couples, families and groups facing challenges such as trauma, anxiety, depression, grief, and relational issues. Learn more at www.restoringpeace.com.sg or WhatsApp us at +65 8889 1848. For updates and resources, join our Telegram group: https://t.me/restoringpeace
Additional Read:
References
SingHealth. (n.d.). Geriatric depression. https://www.singhealth.com.sg/symptoms-treatments/geriatric-depression
National Institute on Aging. (2023). Depression and older adults. https://www.nia.nih.gov/health/mental-and-emotional-health/depression-and-older-adults
World Health Organization. (2023). Mental health of older adults. https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults
HelpGuide. (2024). Depression in older adults. https://www.helpguide.org/mental-health/depression/depression-in-older-adults
Szymkowicz, S. M., Gerlach, A. R., Homiack, D., & Taylor, W. D. (2023). Biological factors influencing depression in later life. Nature Translational Psychiatry. https://www.nature.com/articles/s41398-023-02464-9
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