By JR Thorpe
It was my birthday yesterday (thank you, thank you), and this year marks a decade since my diagnosis with Major Depressive Disorder, or MDD. A lot has changed in the intervening ten years, but realistically, it’s likely that I’ll have MDD for the remainder of my life — and that’s an interesting situation, because research reveals that depression itself doesn’t remain static. As we get older, depressive symptoms can change, both in relation to life events (grief, upheaval, breakups) and natural physiological shifts. However, a lot of the time depression is still depicted as a monolith: a diagnosis with the same symptoms and treatments throughout your life. The truth is a lot more dynamic.
There are various types of depression, and it’s important to note that my diagnosis is distinct from situational depression, which is depression that develops in response to trauma and sad events. MDD sticks around even when there’s nothing apparently triggering it. It’s not more or less serious than other kinds of depression. However, it’s important that anybody with a depression diagnosis — and anyone who may have noted it in their family — knows how age can cause flare-ups and change symptoms. Here are six ways depression can change as you age.
1. Depression Can Change The Way Your Body Ages
In 2018, scientists discovered that depression ages both our bodies and our brains. One study found that having depression prematurely ages your DNA, making it appear older by an average of around eight months, which has a series of knock-on effects on cells and chromosomes. Depression not only changes as we age; we physically change in response to it.
2. It Can Change Your Brain, Too
Another 2018 study of 71,000 people found that if you have depression, your brain ages faster, experiencing cognitive decline, memory loss, and slowdowns in processing information at an earlier age. “Cognitive function may need to be monitored closely in individuals with affective disorders, as these individuals may be at particular risk of greater cognitive decline,” the scientists wrote. Unfortunately he more cognitive decline experienced, the worse depressive symptoms can get.
3. Depressive Symptoms Can Appear For The First Time As You Age
While depression can crop up when we’re young, it can also turn up for the first time past the age of 50. A 2015 study found that depression diagnoses increase from the ages of 65 to 85. Part of this is likely due to the issues of aging in general; the Cleveland Clinic has noted that an increase in health issues, loneliness, and grief as we age can be the trigger for depression and depressive feelings.
It’s not just about old age, though. A study in 2014 found that middle-aged women, between 40 and 59, had the highest proportion of depression diagnoses in the United States. There was a slight dip in diagnoses after the age of 60 before an increase again.
4. Age At Menopause Can Affect Depression, Too
Menopause may feel like a long way off, but studies show it seems to affect depressive symptoms too. A study in 2016 published in JAMA Psychiatry found a link between the age at which people hit menopause and their level of depression symptoms. The later they experienced menopause after the age of 40, the less likely they were to have depression.
The scientists said in a press release that “a potentially protective effect of increasing duration of exposure to endogenous estrogens […] as well as by the duration of the reproductive period” might be responsible for lowering depression risk; in other words, the longer we menstruate throughout our lives, the more we’re protected against hormonal-induced depression when menstruation ends.
5. Your Response To Anti-Depressants Can Change Over Time
Many people with depression will take anti-depressants for a long time, but it’s possible that as we age, our reactions to those medications changes. “It may be that over time certain medications lose their effectiveness or there could be biochemical changes that occur with age,” Dr. Kristina Randle wrote for Psych Central in 2018. “It is important to report your symptoms to your prescribing physician so that he or she may make the necessary adjustments.”
The Mayo Clinic identifies age as a potential reason for antidepressants losing their effectiveness, noting, “As you get older, you may have changes in your brain and thinking (neurological changes) that affect your mood. In addition, the manner in which your body processes medications may be less efficient. You’re also likely to be taking more medications.” Those factors combined can make antidepressants less useful as you age, requiring dosage changes.
6. Your Levels Of This Vitamin May Lead To Greater Depression Risk
For women, a particular consequence of aging can change our depression: folate. “Recent studies suggest that lower concentrations of folate in the blood and nervous system may contribute to depression, mental impairment and dementia,” notes the American Psychological Association. Folate is a B vitamin, and pregnant women are often told to take more folic acid to reduce the risk of miscarriage, but it also has a role in mental health more generally.
Some of us may naturally have lower folate levels, which can lead to problems with antidepressants, depression and anxiety expert Christine Borchard wrote for Everyday Health: up to 40 percent of the U.S. population has a genetic modification that makes folate conversion difficult. However, folate deficiency also increases with age. Studies have repeatedly found that the older you are, the more likely you are to have low folate levels, across numerous populations around the world. As we age, our dipping folate levels may contribute to more depressive symptoms over time.
Depression and age make for a powerful and difficult combination. One thing’s clear: there’s no such thing as a fixed, unchanging depression diagnosis. As we change and age, so does depression.
If you or someone you know is seeking help for mental health concerns, visit the National Alliance on Mental Health (NAMI) website, or call 1-800-950-NAMI(6264). For confidential treatment referrals, visit the Substance Abuse and Mental Health Services Administration (SAMHSA) website, or call the National Helpline at 1-800-662-HELP(4357). In an emergency, contact the National Suicide Prevention Lifeline at 1-800-273-TALK(8255) or call 911.