5 Surprising Causes of Depression as You Get Older

As you age, mental health shifts can feel like they come out of nowhere. Here are some unexpected reasons you might be feeling emotional challenges.

Does this sound familiar? You've felt pretty optimistic and upbeat for years, maybe even most of your life. And then, out of nowhere, it feels like someone pulled the plug on your mood. You feel like you're just not that interested in doing things that used to bring you satisfaction and joy.

And that feeling leads to a ripple effect. You might find yourself turning down invitations to get together with friends. Or you find yourself exercising less and sitting on the sofa more. Maybe you're even showering less often or watching TV a lot more than you used to. All of which just makes you feel worse.

All of these could be symptoms of depression, according to the National Institute of Mental Health. Although many people think of depression as a deep sadness — and that’s definitely a legit description — depression can also mean an attitude of indifference or feeling “empty.” You simply don’t feel like engaging. It’s easier to just keep to yourself, to kind of retreat from the world.

But that's a major red flag. Sure, maybe you're not wallowing in grief or sadness, the way you might have traditionally thought of depression. But there are lots of scenarios for depression that you might not even think of as being related to the condition. If you're backing off from activities that once made you feel good, it could be a sign that your mental health is suffering.

Taking a look at some surprising common causes of depression might help you recognize the problem early. And that can help you get help and head it off.

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Surprising Depression Cause #1: Retirement

You've worked all your life to get here, you had the retirement party, you feel good about the nest egg you've built for this stage of your life. But once you actually retire, it's not what you envisioned.

You kind of miss the daily routines you once followed. You're less in touch with people you once spent lots of hours with every day. You might feel useless, like you're not contributing to the world around you.

According to a 2020 meta-analysis of research published in the journal Healthcare, retirees commonly experience depressionl This is especially common among those who’ve made the transition because of an illness or because there are mandatory retirement rules at their company — in other words, it wasn’t entirely your choice.

Try to remember this is a major life change, and that understandably can come with emotional baggage, says Scott Kaiser, M.D., geriatrician and director of geriatric cognitive health for Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, California.

That's true even if, in general, you think of retirement as a positive step in your life. "There's still uncertainty," he says, "and it can take time to adjust."

Surprising Depression Cause #2: Inactivity

Exercise is a powerful antidepressant, according to a 2020 American Psychological Association (APA) report. The APA notes well-established research shows that regular activity helps increase your body's production of those "feel-good" hormones you often hear about, like serotonin and dopamine.

If you don't get enough activity, the feel-good hormones start to dwindle, the APA report explains. The fix can be as simple as you'd think: Move your body more. Even a little will help.

There’s another upside to exercise, too: Activity that incorporates a social component can be even more powerful, says Dr. Kaiser. During Covid isolation, one study on older people found that even light activity helped alleviate some of the negative mental health impacts that came with social distancing. The 2020 research was published in the American Journal of Geriatric Psychiatry.

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Surprising Depression Cause #3: Low Back Pain

It might sound strange to think of such a specific condition as being associated with depression, but the link between stress, depression, and chronic lower back pain is well known, says Ai Mukai, M.D., specialist in rehabilitation and back pain for Texas Orthopedics.

In fact, a team of researchers in Canada found that low back pain significantly increases the risk of depression symptoms. And what’s worse is that when the pain lasts more than three months, the risk is even greater. Their research was published in the Journal of the Canadian Chiropractic Association.

One possible factor: Low back pain interferes with good sleep. "Pain, mood, and sleep are all regulated by similar chemicals in the body," Dr. Mukai says.

When you have pain, it affects your sleep. And when you don't get enough sleep, it affects your mood.

It also, unfortunately enough, can work in reverse, as well, says Dr. Mukai: If you feel depressed, you may not sleep well. And when you don't get enough sleep, your body can be more susceptible to pain.

The message: Don't discount that physical symptoms like pain might be responsible for mood changes - and vice versa. Talk frankly with your doctor about not only how your body is feeling, but how you're handling things mentally and emotionally, too.

Surprising Depression Cause #4: Cardiovascular Disease

Scientists aren’t sure whether depression leads to heart disease or heart disease leads to depression — and it could be both.

What they do know is that at least a quarter of patients who have heart disease also have depression. And on the flip side, people who have depression are at a higher risk of developing heart disease, according to the National Institutes of Health (NIH).

In fact, if you’ve been diagnosed with heart disease, depression can worsen your prognosis so much that the NIH says it’s the strongest predictor of death in the first decade after you know you have the condition.

That’s why it’s important to chat with your doctor about depression as part of your cardiovascular disease care, says Dr. Kaiser. Screening for depression among heart disease patients has been increasing over the last 15 years, according to a 2021 report in the Journal of the American College of Cardiology, but there’s still a long way to go.

Understanding that your physical and mental health are linked can help you gain the confidence to tell your doctors about all your symptoms. That leads to better understanding by your doctor, which leads to better care. And a better result for you.

Surprising Depression Cause #5: Medication Side Effects

If your depression symptoms begin soon after starting a new medication, definitely give your doctor a call or talk to your pharmacist, suggests Dr. Kaiser.

You might be surprised to find the range of medications that have depression as a side effect. For instance, it's listed even for some anti-anxiety medications, like Xanax and Ativan.

Below is a partial list of other medications and medication categories to be aware of. Keep in mind that this is just a start. If you're feeling symptoms of withdrawing from your life, examine the literature that comes with every medication you're taking to look for depression as a side effect. And get in touch with your doctor and/or your pharmacist to ask them to do the same thing. Often, the fix could be as simple as trying a different dose or a different drug, Dr. Kaiser says.

• Anticonvulsants
• Seizure medications
• Beta-blockers
• Calcium-channel blockers
• Opioids
• Statins
• Shingles medication like Zovirax

What You Should Do Next if You’re Feeling Depressed

Regardless of what might be causing feelings of depression, it's important to recognize that this is a health problem that can be treated. You should definitely talk to your doctor about what you're experiencing, say the experts interviewed.

If depression is untreated, it can lead to negative changes in sleep, appetite, self-esteem, and quality of life, reports the National Institute of Mental Healt. The Mayo Clinic also suggests tracking your symptoms over the course of several days and being more aware of how you're feeling. Share this information with your health care provider.

If you’re unsure whether you’re affected, a self-assessment can help — although it’s important to note that this self-check is not meant to be a diagnosis. Only a doctor can diagnose depression.

The National Institute on Aging notes that feeling down occasionally is part of life, but depression is not a normal part of aging. Don’t just resign yourself to it — do something about it.

If you’re thinking of harming yourself, seek help immediately. Call 988 to receive free and confidential emotional support 24/7 from the 988 Suicide & Crisis Lifeline. For TTY users: Use your preferred relay service or dial 711 then 988.

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