Geriatric Depression Is Real And Families Often Miss The Signs Until It’s Too Late

Saturday, September 27, 2025, 10:33

We often imagine older adults as peaceful, wise, and content. But behind the routines and polite smiles, many are silently battling something we rarely talk about: depression. And it's not rare.

In India, research shows that anywhere between 15% to 35% of older adults may be dealing with depressive symptoms. In some pockets-urban areas, especially among elderly women-those numbers are even higher. Yet, mental health in later life is frequently overlooked, both by families and doctors.

What Is Geriatric Depression And Why It Leads To Suicide More Likely In Later Life?

Geriatric depression is a clinical condition affecting people aged 60 and above, marked by persistent low mood, fatigue, sleep problems, and sometimes memory issues. It's often missed because older adults may not openly speak about emotional distress. Instead, they might complain of physical discomfort or slowly withdraw from daily life.

The risk of suicide increases in later life due to a combination of factors: chronic illness, physical pain, bereavement, isolation, and a deepening sense of hopelessness. When these are left unaddressed, they can quietly build into severe emotional suffering-and in some cases, suicidal thoughts or actions.

Why Some People Feel There's Nothing To Look Forward To

Getting older isn't just about slower routines or more medicines. It's also about navigating deep personal changes-diminished roles in the family, reduced independence, and fewer social connections.

Dr Sheeba Ninan,a Geriatric Psychiatrist from IMHANS Calicut, explains:

"The fact is, frailty, hidden chronic diseases, low physical reserves, and isolation are some of the key factors when someone feels there's nothing to look forward to. Being unemployed, having lower levels of education, and a family history of psychiatric illness are other contributing factors."

These aren't abstract ideas. They play out in real homes and real lives, often making people feel like they've lost direction or meaning.

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Emotional Isolation Isn't Just About Being Alone

One of the biggest misconceptions is that loneliness means having no one around. In reality, you can live in a full house and still feel deeply disconnected.

Dr Ninan puts it clearly:

"Poor social connectedness can include co-relationships, living alone, not having a confidante, when they are unlikely to participate in community activities, not being active or being inactive in organisations, not having many hobbies, having family discord, financial problems, and functional impairments. All of these add to emotional isolation, which can worsen one's emotional state."

In short, it's not just about physical presence-it's about emotional connection.

Why Suicide In Older Adults Often Goes Unnoticed

Many assume that if someone hasn't said anything alarming, they're probably okay. But older adults often don't label their emotional pain as "depression."

As Dr Ninan points out:

"We often overlook low mood, poor appetite, disrupted sleep, fatigue, concentration deficits, diminished memory, lack of initiative. They are less likely to report that feeling as well. Then there is the problem of sensitization."

These symptoms are subtle and easy to mistake for "normal aging." That's exactly why they get missed.

It's Not Just One Bad Day

Suicide in older adults doesn't usually happen suddenly. It is often the result of a long build-up of emotional pain, unresolved trauma, and social neglect.

Dr Ninan reminds us:

"Suicide is the third leading cause of death especially in low and middle income countries. Reasons for suicide are multi-faceted, influenced by many socio-environmental factors throughout the life course."

It's not about one moment of despair, it's about months or years of unspoken suffering.

What To Watch Out For

What should we be paying attention to in ageing parents, grandparents, or neighbours?

Dr Ninan says:

"Symptoms like the above should be monitored closely, and there should be someone to keep an eye on them to ensure that such symptoms are not missed. Factors such as isolation, depressive disorder, keeping away from usual things they once used to enjoy, these are important things that should be dealt with and not ignored."

This isn't about interfering. It's about noticing patterns and caring enough to ask the second question when the first gets a vague "I'm fine."

So, What Can We Do?

Start by listening. Really listening. Don't rush to fix. Ask how they're feeling-not just physically, but emotionally. Include them in conversations that matter. Encourage small routines, daily walks, community groups, even hobbies from their younger days.

Dr Ninan emphasises,

"Depression is treatable if identified at the right time and offered the right kind of treatment. But left untreated, it can become quite difficult to resolve-and not just that, it becomes a significant risk factor for suicide as well. If suicide risk factors are identified early and if you are able to give the right kind of support, there is a chance you can prevent the risk of suicide."

It's not about doing everything perfectly. It's about being present, asking the second question when the first one gets a vague "I'm fine," and remembering that emotional pain doesn't always look like what we expect.