Feel like middle age is closing in on you? You’re not alone. A 2008 study of data from 2 million people found that midlife depression spans the globe.

It seems it peaks at around age 40 for women and 50 for men, and usually starts to lift in the 50s. If you are wondering why, it seems it is because we may learn to adapt to their strengths and weaknesses and value life more, according to the researchers.

So which of these may apply to you?

Trigger 1: life overload

Squeezed between the demands of children, ageing parents, marriage, and your job women tend to shoulder more of the “sandwich generation” burdens and up to half become depressed as a result.

This can lead to feeling sad, worthless, and guilty.

Solutions: Make sure you’re caring for yourself, too with a plan that includes exercise, enough rest and healthy eating.

Reduce stress, which is common with overload, so make time to talk to friends, and get help for anxiety and depression if you need it.

Trigger 2: Low vitamin B12

If you’re feeling lethargic or depressed, too little vitamin B12 may be to blame. If you’re older, you’re more at risk for the B12 blues because you may not have enough stomach acid to release B12 from food.

Solutions: Your doctor can do a simple test to measure levels of B12 in your blood. If it’s low, they can offer you a regular injection, or you can get it in supplement form as it can be more difficult to obtain from food, particularly if you are vegetarian or vegan.

Sources include meat (especially liver), seafood, poultry, eggs, dairy products, leafy greens, seeds and fortified foods, such as breakfast cereal and nutritional yeast.

Trigger 3: Thyroid disorders

Depression can be one symptom of an underactive or occasionally overactive thyroid. And if you are older, it may be the only symptom.

Or it may appear with a subtle symptom. In the case of overactive thyroid, it could be accompanied by heart flutters, tremors, or fatigue.

An underactive thyroid can cause constipation or fatigue. That’s why this very treatable problem is often mistaken for bowel or nervous system disorders in older people.

Solutions: Make sure you know the symptoms of a thyroid disorder and see your doctor, especially if a close relative has thyroid disease.

Trigger 4: Joint issues

Living with a condition that causes chronic pain, such as rheumatoid arthritis or osteoarthritis, increases the chance of having depression.

In fact, people with chronic pain are three times as likely to have depression or an anxiety disorder and unfortunately depression can make pain worse.

Solutions: Bioidentical hormones can help with inflammation and some joint pain, as can exercise, meditation, or listening to music.

An hour of classical music a day has been shown to ease arthritis pain and depression and if it continues long-term ask about a therapist or counsellor to help you through it.

Trigger 5: Perimenopause and menopause

Hormone fluctuations, hot flushes, and life changes brought about by perimenopause and menopause can make your mood plummet.

If you have trouble sleeping, a history of depression, or PMS, mood swings or depression may worsen during this transitional period.

Solutions: For mild depression, try self-calming skills such as yoga or deep breathing. Do things that make you feel better, such as exercise or going out with friends, or find a creative outlet.

For more serious, long-lasting symptoms of depression, medication or talk therapy can help.

Trigger 6: Empty nest

If your child has left home, an “empty nest” can make you feel empty too as a major part of your life has ended. Going through menopause or retirement at the same time may make it harder.

Solutions: Try to see it as an opportunity and a way forward, rather than an ending. Stay even more connected to your partner, other family members, and friends and look at pursuing hobbies and interests you didn’t have time for before.

Give yourself time to adjust, in a way this is a form of bereavement so if your mood doesn’t lift in a few months, look for ways to help you adjust as in Trigger 5.

Trigger 7: Type 2 diabetes

Do you feel too listless to check your blood sugar regularly? Unpredictable blood sugar levels may be making you feel out of control, especially if you have turned to comfort eating and more sweet things.

Depression is a common complication of many chronic conditions, including diabetes and it also may keep you from taking good care of your diabetes.

Solutions: There are many excellent resources to help you manage your diabetes such as https://www.diabetes.co.uk and also talk to your doctor if on diabetes medication as you may be able to adjust your dosage or prescription if you’ve been depressed for more than two weeks. T

Trigger 8: Drinking

This is not about the occasional drink, but about 1 in 4 older people who drink heavily have major depression.

You may be drinking more than usual because of stressful events, such as retirement or a bereavement, and alcohol problems are often mistaken for other age-related issues.

Solutions: A combination of talk therapy, and organisations that offer support such as Alcoholics Anonymous can help you discover your drinking triggers and how to avoid them.

If alcohol is a serious condition there are also medications to treat both alcohol dependence.

Trigger 9: Poor sleep

Insomnia and other sleep disruptions, which are common as we age, are closely related to depression. Insomnia can be a sign that you are depressed, and if you have insomnia but aren’t depressed, you’re at higher risk of developing mood changes.

Obstructive sleep apnea and restless legs syndrome also have been linked to depression.

Solutions: Learn good sleep hygiene habits, such as regular bedtime hours and no distractions such as TV or mobile phone use in bed.

Exercise early regularly and avoid caffeine, alcohol, or nicotine, which interfere with sleep. Rather than prescription medication try alternative options first such as herbal teas, aromatherapy, lavender baths and bioidentical progesterone as these will all help relax you.

Trigger 10: Retirement

If your retirement was not planned, perhaps you lost your job and couldn’t get another, or because of poor health then that can leave you feeling out of control and may lead to depression.

If you are worried about financial insecurity or lack of social support that can also make retirement more of a struggle.

Solutions: Evidence clearly shows that keeping occupied definitely leads to a better retirement.

This is the time to learn new skills, take classes in a hobby you have been wanting to pursue and definitely make sure you get enjoyable exercise.

If you are not as mobile as you were, then check the Internet as there are good exercise programmes for everyone. If you are not able to travel, take advantage of the many museums worldwide offering virtual online tours.

Trigger: 12 Heart problems

It’s common to feel depressed after a diagnosis of heart disease or having a , TIA, heart attack or cardiac surgery.

Statistically many people with heart disease go on to experience long-term depression and if untreated that can worsen heart health.

Solutions: A healthy diet and sleep, mild exercise, relaxation techniques, and joining a support group can help you get through this, what is important is to recognise it and get help.

Trigger: 13 Medication

Some blood pressure medicines – as well as certain antibiotics, antiarrhythmics, acne products, and steroids, among other drugs – may be associated with depression or other mood changes.

Solutions: Be sure to ask your doctor if any new medications you may be taking could be linked with changes in mood. If it is, you may be able to switch to another drug.

Trigger: 14 Loneliness

Social support can help prevent or ease depression. But some kinds of social support may be better than others.

A study of people in a retirement community found that those who stayed connected with friends living elsewhere had less depression. Support from within the community didn’t affect mood, but don’t discount it as every interaction – jus saying hello to someone or exchanging a smile – can boost mood.

Solutions: Maintain ties with friends and family members and explore Internet technology that can give you virtual face-time if you are not able to actually meet up.

Trigger 15: Health problems

Any chronic or serious condition, such as Parkinson’s disease or a stroke, can lead to depression. A stroke can also affect the areas of the brain that control mood.

Solutions: Be realistic but positive and learn how to cope with physical effects of your illness from your doctor or health support worker.

Make sure you are taking care of yourself and having fun, however you can. If you have symptoms of depression, don’t wait but get help right away.

Trigger 16: Senior moments

Feeling foggy and forgetful? This is very common, especially at Menopause, and can be related to an imbalance of your hormones.

If persistent, it could be depression or dementia, a condition marked by memory loss. The signs and symptoms can be similar and depression is more common in older people who have dementia, especially Alzheimer’s.

Solutions: If you don’t know what’s causing your symptoms, see your doctor so you can get the right treatment, if necessary.

Trigger 17: Grief

It’s normal to grieve after losing a partner or other loved one. But grief can grow into depression and they can both raise the risk for heart-related deaths.

Memory problems, confusion, and social withdrawal can be all symptoms of depression as we get older.

Solutions: Let yourself grieve in whatever way you need to – everyone is different so don’t try to meet other people’s expectations but follow your own instincts.

Express your feelings to friends, in a support group, or to a grief counsellor.

Everyday ways to boost your mood

There are some very simple ways to help increase your mood, so see if any of these would work for you.

Mood Booster: Pets

To keep your mood up, it helps to have good emotional and social support. But who says social support needs to be human?

Studies show that pets can help people have less depression and loneliness and more self-esteem and happiness. Pets are friends with other benefits, too.

Walking a dog, for example, is good exercise and a great way to meet people.

Mood Booster: Laughter

A good laugh can relax muscles, reduce stress, and relieve pain. And research suggests that a good sense of humour can take the bite out of depression.

For humor on demand, create a laugh library of funny books, cartoons, and DVDs. Or try laughter yoga, which uses playful activities and breathing exercises to provoke giggles.

Mood Booster: Volunteer

Helping others can help you forget your own problems. Volunteering feels good at any age, but it may hold special benefits for older people.

If retirement has you adrift, for example, it can give your life a new sense of purpose and satisfaction. Recent research suggests that it may even prevent frailty in older people.

Find a cause that has special importance to you and get involved.