As people age, we tend to focus on physical health: blood pressure, arthritis, falls, medications. Mental health often gets pushed to the side, or quietly written off as “just getting older.”
Clinically, we know that is not accurate.
Depression and anxiety are not a normal part of aging.
Most older adults describe feeling satisfied with their lives, even while managing medical conditions. When mood, behavior, or thinking change in a big way, it is a signal that the brain and nervous system need attention, just like the heart or lungs.
This article explains how depression and anxiety can show up in older adults, what family caregivers can watch for, and how to use local supports in Region Five – including the Gero Community Stabilization Team – when safety and housing are at risk.
How aging and mental health interact
Older adults experience many changes at once: retirement, losses, medical conditions, shifts in mobility, and sometimes changes in housing or independence. Those stressors can increase risk for depression and anxiety, especially when they stack up without enough support.
At the same time, it is important to be clear:
- Depression is a serious mood disorder, not a personality flaw or weakness.
- Anxiety is more than “worrying too much.” It can become a chronic, distressing condition that affects sleep, appetite, and daily functioning.
- Dementia and other brain changes can overlap with, worsen, or be mistaken for mental health conditions.
Research suggests that roughly 10–15 percent of older adults in the community have significant depressive symptoms, and rates are higher among those with chronic illness, pain, or cognitive impairment.
The challenge is that depression in older adults often looks different than it does in younger people. Instead of naming “sadness,” older adults may describe fatigue, headaches, body pain, or a general sense of slowing down. They may be more likely to talk about losing interest in activities, trouble concentrating, or feeling like a burden.
Recognizing signs of depression and anxiety in older adults
If you support an older adult at home or in the community, you may be the first to notice subtle changes. Signs to pay attention to include:
- A noticeable loss of interest in activities they used to enjoy
- Withdrawing from friends, family, church, or community events
- Sleeping much more or much less than usual
- Eating significantly more or less, or unexplained weight change
- New irritability, worry, or agitation that is out of character
- Complaints of body pain, headaches, or stomach issues without clear medical cause
- Increased confusion, especially if it seems to fluctuate with mood
Any talk about death, feeling like a burden, or wishing life would just “be over” should be taken seriously, even if the person insists they would never act on those thoughts.
If these changes last more than a couple of weeks or interfere with daily life, it is time to consider a mental health evaluation, ideally one that includes a medical workup. Physical health conditions, medications, and mental health all interact, especially as we age.
For a helpful overview of depression in older adults, you can explore the National Institute on Aging’s guide to Depression and Older Adults.
Caregiver support: your mental health matters too
Family and friends are the backbone of care for older adults. That role can be meaningful and deeply valued. It can also be exhausting.
National and international studies show that caregivers of older adults often face higher rates of depression, anxiety, and physical health problems compared with people who are not caregiving. Caregivers frequently report emotional strain, disrupted sleep, financial stress, and social isolation.
If you are helping an older adult with appointments, medications, finances, personal care, or behavior changes, it is normal to feel stretched thin. You may find yourself thinking:
- “I am always on alert.”
- “I feel guilty if I am not with them.”
- “I am exhausted and I do not know how long I can keep this up.”
From a clinical standpoint, caregiver distress is a risk factor for both the caregiver’s health and the older adult’s health. That is why any realistic plan for supporting an older adult’s mental health should include support for the people caring for them.
The Centers for Disease Control and Prevention (CDC) names caregiving as a public health issue and encourages communities to attend to the physical and mental health of caregivers, not just care recipients.
Supporting older adults’ mental health at home
At home, you do not need to act as a therapist. You can, however, shape the environment in ways that support mental health:
- Maintain simple routines. Regular wake times, meals, and bedtime help orient older adults and reduce anxiety.
- Stay curious about changes. If your loved one is quieter, more withdrawn, or sleeping more, ask gentle questions instead of assuming it is “just age.”
- Encourage small, realistic activity. A short walk, time in a garden, or a favorite game can lift mood more than you might expect.
- Keep medical providers in the loop. If you are seeing changes in mood or behavior, bring specific examples to primary care appointments. Ask whether a depression or anxiety screening would be appropriate.
- Make room for feelings. Older adults sometimes feel pressure to “stay positive” or “not complain.” Giving them space to be honest about grief, worry, or fear can be deeply protective.
If you are worried about memory changes or confusion alongside mood changes, talk with a provider about screening for dementia or other cognitive issues. Mental health and cognitive health often overlap in later life.
Locally, Region Five’s Community Special Services can be a helpful entry point for older adults who need more structured support than can be provided at home. The Gero Community Stabilization Team is one of those services.
When behavior changes put housing or safety at risk
Sometimes, changes in mood, thinking, or behavior become so significant that an older adult is at risk of losing housing, being hospitalized, or even becoming involved with the legal system. This is especially common when dementia or serious mental illness leads to aggression, wandering, or other behaviors that family cannot manage safely.
In the Region Five area, the Gero Community Stabilization Team (GCST) supports adults 65 and older with dementia, Alzheimer’s disease, or serious mental illness who are at risk of hospitalization, homelessness, or incarceration because of their behaviors. GCST is an interdisciplinary team that offers short-term, intensive services to stabilize the situation and help older adults remain in the community when possible.
If you live in Chesapeake, Norfolk, Virginia Beach, Portsmouth, Newport News, Hampton, Western Tidewater, the Middle Peninsula, the Northern Neck, or the Eastern Shore, and you are caring for an older adult whose behavior is putting housing or safety at risk, you can learn more about GCST through Region Five’s Community Special Services page.
Partnering with your local CSB in Region Five
Community Services Boards (CSBs) are local public agencies that provide mental health, substance use, and developmental services in Virginia. Region Five includes nine CSBs serving Chesapeake, Norfolk, Portsmouth, Virginia Beach, Hampton-Newport News, Western Tidewater, Eastern Shore, Colonial, and Middle Peninsula-Northern Neck.
If you are worried about an older adult’s mental health, your local CSB can:
- Complete a mental health assessment
- Connect your family with outpatient counseling, psychiatry, or case management
- Offer caregiver support, education, and referrals to groups or community resources
- Coordinate with programs like the Gero Community Stabilization Team when more intensive support is needed
You can find contact information for CSBs in Region Five on the CSB Locations page.
When to seek urgent help
If an older adult is talking about wanting to die, expressing hopelessness, or showing behaviors that put them or others in immediate danger, it is important to act quickly.
- In any mental health crisis, you can call or text 988 to reach the Suicide & Crisis Lifeline 24/7.
- If there is an immediate risk of harm, call 911 and state that this is a mental health emergency.
Region Five’s crisis continuum can then work with you and your local CSB to determine the safest next steps, which may include mobile crisis services, crisis receiving centers, or short-term stabilization supports in your community.
Supporting an older adult’s mental health is not about having all the answers. It is about noticing changes, asking questions, and partnering with professionals who understand aging, dementia, and serious mental illness.
If you are concerned about an older adult, reach out to your local CSB. You do not have to navigate this alone.
