Depressed seniors are more likely to tell their primary care physician about physical complaints than about subjective feelings of depressed mood. For example, they may report loss of appetite, insomnia, or lack of energy but not a loss of interest or enjoyment in daily activities. Unfortunately, doctors and patients alike often consider these symptoms a normal part of aging.
In addition, because older people often have other medical illnesses and take more prescription drugs, it can take some medical sleuthing to accurately pin down a diagnosis of depression. Depression might be the primary disorder, a reaction to a prescription drug, or the result of an underlying condition such as cancer or a stroke.
It also might be a psychological reaction to a diagnosis of a serious illness or debilitating chronic pain or impairment. Finally, it could be a direct or indirect biological effect of an illness on the brain.
The possibility of dementia adds further difficulties: Symptoms of major depression can mimic those of a dementia-causing condition such as Alzheimer's disease (disorientation, distractibility, and memory loss, for example). Doctors need to evaluate an individual's mental status, medical history, and current physical health status carefully to find the primary cause of the psychological symptoms.