According to the World Health Organization (WHO), 15 % of seniors, over the age of 60, will present with a mental health disorder. WHO also states that the population of the world’s older adults is estimated to double from 900 million to 2 billion for seniors over the age of 60 from 2015 to 2050. (WHO, 2017, December 12) That’s 135 million to 300 million seniors worldwide who will suffer from a mental health disorder. Older adults present with a wide variety of mental health disorders such as Depression, Bipolar Disorder, Generalized Anxiety Disorder, Obsessive Compulsive Disorder, Post Traumatic Stress Disorder, Delusions and Paranoid Schizophrenia.

Let’s look more closely at Depression. Depression often goes undiagnosed in seniors. In fact, 50% of seniors who visit their general practitioner with symptoms of depression will be missed. Often times the symptoms are perceived as “just getting older”. What is missed is a real underlying condition that should be treated by a mental health professional. Seeing a physician is the first step. So, what are the symptoms of depression?

If you are suffering from several of the following symptoms for longer than two weeks, you may be depressed (Older adults and depression., n.d.):

  • Sadness, empty feeling
  • Restlessness, irritability
  • Feelings of helplessness, guilt, worthlessness
  • Tiredness, lack of energy, feeling “slowed down”
  • Weight gain or loss
  • Loss of interest in activities
  • Problems sleeping, early morning awakenings, oversleeping
  • Inability to concentrate, remember, make decisions
  • Aches and pains, digestive problems that don’t respond to treatment
  • Suicide attempts, thoughts of suicide
  • Neglect of personal hygiene

Seniors who present with depression often have physical symptoms such as a belly ache, headache, backache and feeling very tired. Often times, older adults suffer from significant losses in their lives. Losing a loved one, changing residences, retirement from a beloved job and loss of mobility, all can contribute to depression when they have not been grieved properly.

Now the distinction between grief and depression is primarily that when grieving, an older adult will have moments of joy or humor mixed in with the grief. When depressed, the senior is not able to enjoy moments of humor and joy.

Another confusing factor in the elderly is when the senior might have dementia. Consider the following (What depression in the elderly looks like & how to get help., 2021):

Dementia– Slow mental decline, impaired motor skills, problems with short-term memory, unaware or indifferent to memory problems

Depression– Rapid and more limited mental decline, problems with concentration and energy, aware of memory problems

Another risk factor for the elderly and depression is suicide. Men over the age of 80 are most likely to kill themselves. If you or a loved one are having thoughts of suicide, you should contact the National Suicide Hotline Number- 1-800-273-8255 Text HOME 741741   Follow through with seeing the doctor or mental health professional. 

Loneliness is an additional risk factor for seniors, especially during this time of COVID-19. Loneliness is equivalent to smoking 15 cigarettes a day (Hartung, R. 2018) It increases risk of death by 26% and increases risk of dementia by 40% (Hartung, R. 2018). Loneliness also increases risk of depression and anxiety. Moreover, Medicare spends $ 6.7 billion dollars each year on lonely older adults (Chronic loneliness in the elderly. How to help yourself or someone else., 2021). Approximately $ 134 dollars are spent by Medicare each month on each lonely senior compared to well-connected social seniors (Chronic loneliness in the elderly. How to help yourself or someone else., 2021). We know that as of March 2020, 41 % of the senior population did not have an internet connection (Galant, 2020). Fortunately, a number of big companies such as Comcast and AT&T are offering low-cost service to low income seniors.

What can you or a loved one do if you’re experiencing depression, loneliness or any other mental health concern?

Seek professional help. If you can, find a geriatric doctor: www.webmd.com/findadoctor/specialty/family-practice-geriatric-medicine

They are well versed in the subtleties of geriatric medication and the senior’s greater sensitivity to medication. Don’t give in to stigmas about mental health. Follow through and begin treatment. Talk therapy and especially Cognitive Behavioral Therapy (CBT) can be very effective in mediating the effects of depression. In addition, antidepressant medication is often prescribed. One problem with prescribing an antidepressant is that 7 out of 10 older adults stop taking their medication within 4 weeks. They never get to experience the benefits of taking the antidepressant for 6-8 weeks. Also, the dosage may need to be adjusted or even another antidepressant may be needed.

Helpful behavior at home includes the following:

  1. Stay physically active- exercising 3 times a week decreases the risk of major depression and also decreases the risk of the depression returning.
  2. Volunteer- help by reading books to children, contact local charities, assist with tasks at your place of worship
  3. Join senior centers and clubs. Get involved with arts and crafts.
  4. Enhance cognitive functioning by doing crosswords, puzzles
  5. Go to sleep at the same time each night and get up at the same time each morning
  6. Establish good eating habits- have your groceries delivered, have your meals delivered once in a while, eat at the same time each day and evening.
  7. Visit online sites- join a book club, exercise class, receive online technology help, www.seniorplanet.com has established a tech help line that is free and helps seniors with all kinds of tech questions. It also has a list of companies who offer low-cost internet to seniors.
  8. Contact friends and family by zoom, facetime, skype and other video chats. If you don’t have a smart phone, call them on a landline phone. Reach out every day.
  9. Contact the Friendship Line 1-800-971-0016 – accepts crisis calls for the elderly, including elder abuse, isolation, medical problems. Also, they will call the elderly at regular times to provide support. The service is free.
  10. Join a support group. The Mental Health Association in Delaware has a number of different support groups, including depression and anxiety.
  11. www.eldercare.acl.gov . Good for locating services for the aging by state or zip code. Also, covers areas such as health, housing, transportation, elder rights, insurance and benefits and support services.
  12. www.screening.mentalhealthscreening.org/mhainde. Site for free and anonymous screens (questionnaires) for depression, bipolar, anxiety disorder, PTSD, gambling, eating disorders and more

As you can see, there are so many more ways to help yourself or a loved one. There are many resources for the older adult population. So, if you or a loved one are suffering from a mental health disorder, know that help is available.

Staff Blogger: Elizabeth Davis, Psy.D.

Elizabeth Davis, Psy.D. , was born and raised in Wilmington, DE. She graduated from the University of Delaware with a Bachelor’s Degree in Psychology and a Master’s Degree in Counseling. She then attended the Florida Institute of Technology and earned her Master’s Degree in Clinical Psychology and then a Doctoral Degree (Psy.D) in Clinical Psychology. Elizabeth completed her internship at the Manhattan VA and Bellevue Hospital in New York City with a specialization in Behavioral Medicine, including Stress Management. She had a private practice in New York City on the Upper West Side and then returned to Delaware. She has been working at the Mental Health Association in Delaware helping to coordinate National Depression Screening Day and Master Your Stress Workshops.

References:

Chronic loneliness in the elderly: How to help yourself or someone else. (2021, June 2). Great Senior Living. https://www.greatseniorliving.com/articles/chronic-loneliness

Hartung, R. (2018, October 29). Massive study confirms that loneliness increases risk of dementia. MedicalXpress.https://medicalxpress.com/news/2018-10-massive-loneliness-dementia.html

Galant, D. (2020, March 24). Stuck at home guide: How to get online. Senior Planet. https://seniorplanet.org/stuck-at-home-guide-get-online/

Older adults and depression. (n.d.). National Institute of Mental Health. https://www.nimh.nih.gov//health/publications/older-adults-and-depression/19-mh-8080-olderadultsanddepression_153371.pdf

What depression in the elderly looks like & how to get help. (2021, February 12). Great Senior Living. https://www.greatseniorliving.com/health-wellness/depression-in-the-elderly

WHO. (2017, December 12). Mental health of older adults. World Health Organization. www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults