Depression has emerged as a significant public health concern, with its prevalence fluctuating based on varying environmental and demographic factors. This study categorized participants based on altitude. A convenient sampling approach was used, and the hamilton depression rating scale-24 was used to assess depressed symptoms while gathering demographic information. A total of 600 Tibetan residents from the Dege area of Garze Prefecture, Sichuan, China, participated in the survey. The mean age is 56.81 years, males comprising 52.8% and females 47.2% of the sample. Of the participants, 41.2% resided permanently at elevations exceeding 3500 m. The results found that the weighted prevalence of depression in the area was 24.62%. Regardless of gender, the age group with the highest prevalence was 55-64 years old. Depression increased with age as well as gradually decreased after the age of 60. Logistic regression analysis showed that middle-aged (OR 2.86, 95% CI 1.69-4.82, P < 0.01) and elderly people (OR 2.27, 95% CI 1.30-3.98, P < 0.01), living in ultra-high altitude areas (OR 3.48, 95% CI 1.35-2.91, P < 0.01) and low BMI (OR 4.31, 95% CI 1.33-13.93) are high-risk factors for depression. This study enhances the understanding of the characteristics of depression in high-altitude regions of China, contributing to a more comprehensive view of the psychological well-being of residents in these areas. The findings underscore the need for targeted prevention and treatment strategies tailored to the specific needs of these populations.