As we age, we encounter stressful situations, such as a chronic illness, the loss of a loved one, adjusting to life after retirement or downsizing. It’s natural to experience occasional bouts of depression. Persistent depression, however, is not a normal part of aging, and it can be treated.

If you are thinking about harming yourself, tell someone who can help immediately. Call 911 or go to a hospital emergency room. Call the toll-free, 24-hour National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or 1-800-799-4TTY (1-800-799-4889).

Here’s what you can do if you or someone you love may be experiencing depression.

  1. Recognize the symptoms.

Unlike younger people, older adults may not outwardly appear sad. Symptoms of depression may include:

  • Fatigue and trouble sleeping.
  • Irritability
  • Confusion, which might mimic Alzheimer’s disease or another form of dementia.
  • Social withdrawal.
  • A lack of interest in once-loved pastimes, a hobby or grandchildren.
  • Delusions.
  • Persistent anxiety.
  • Feelings of hopelessness, guilt, worthlessness or helplessness.
  • Eating more or less than usual.
  • Aches or pains without a clear cause and don’t respond to treatment.
  • Frequent crying.
  • Suicidal thoughts.
  1. Know the risk factors.

You are at a higher risk for depression if you have:

  • A family history of depression.
  • A history of depression when you were younger.
  • Certain brain chemistry.
  • Perhaps you’ve lost a loved one, made a sudden move or a had a falling out with a friend.
  • Vascular depression, which happens when there is restricted blood flow to the body’s organs, including the brain.

Some illnesses, such as heart disease or Parkinson’s disease, or excessive alcohol use can cause or worsen depression, and there are medications whose side effects include depression.

  1. Seek treatment.

Getting help can improve any current illnesses you’re experiencing and your depression.

Your doctor will do a physical exam and may order lab tests. He or she may suggest an antidepressant or refer you to a provider who specializes in mental health conditions for medication and/or talk therapy. It’s essential that you:

  • Talk openly about subjects you might consider sensitive, such as your feelings and moods.
  • Let your counselor, psychologist or psychiatrist know about your current medications.
  • Take any medications for depression as prescribed, and do not stop taking them without consulting your doctor. These medications need time to work.
  • Be flexible. Each person is unique, and your doctor may need to try several approaches.
  • Be patient and perseverant as it may take time for your mood to improve.
  1. Make lifestyle changes.

People with depression often curtail their activities. Unfortunately, many pull away from the ones that might benefit them. These activities can help ease depression:

  • Exercising, which research shows has a strong antidepressant effect.
  • Socializing with friends and family doing things you enjoy.
  • Going to church, temple or civic organization meetings.
  • Taking care of yourself by limiting your alcohol intake and eating nutritious meals.

Depressed people may feel alone and hopeless, but depression is one of the most treatable of medical conditions. Once you reach out to get the help you need from your loved ones and health care providers, you are on the road to recovery.

Author James M. Ellison, M.D., MPH, is The Swank Foundation Endowed Chair in Memory Care and Geriatrics.