Alice Pomidor, MD, MPH, AGSF
Professor
Florida State University School of Medicine
Mary Palmer, PhD, RN, FAAN, AGSF
Helen W. and Thomas L. Umphlet Distinguished Professor in Aging
UNC School of Nursing
Many of today’s older adults grew up during a time when mental health problems were not as well understood as they are today. People didn’t discuss problems like depression, for example, and many people considered mental health issues as “weaknesses” that could be cured by simply improving one’s attitude.
Now, of course, we understand that good mental health and good physical health are equally important to our well-being. Experts understand that mental health challenges are treatable. You can improve the quality of your life, or that of an older adult you care for, by making sure healthcare professionals address any potential mental health issues.
Mental Health Problems: Common Among Older Adults
Among adults aged 65 and older, about one in five have a mental disorder, including dementia. Over 50% of people living in long-term care facilities have some form of cognitive impairment.
Other common mental health problems that affect older adults include anxiety and mood disorders, such as depression and bipolar disorder.
Even though older adults commonly have mental health issues, they are less likely than younger adults to receive treatment for them. When they do receive treatment, it’s also less likely for them to see a mental health specialist. More often, older adults seek mental health treatment from their primary care providers.
Mental Health Problems and Older Adults
Anxiety and anxiety disorders. All of us can relate to feeling anxious—a work problem, a major life decision, or a health problem can make you feel temporarily worried and anxious. But for older adults with anxiety disorders, that nervous feeling doesn’t disappear when the problem is resolved. Some 15% of older adults—women more frequently than men—can experience anxiety. However, anxiety disorders are less common for older adults than younger adults, and developing anxiety later in life is not a normal part of aging.
Depression. We all experience sadness from time to time—it’s a normal part of life. However, depression, the most common of all mood disorders, isn’t simply a passing case of the blues. You can’t just “snap out of” depression. Depression can affect your daily activities, and can cause long term sadness, anger, and frustration. It can interfere with your sleep and can make you feel hopeless. It can also drain your energy, affect your ability to work, and can even damage your relationships with others. Severely depressed people are at risk for suicide.
Of older adults who commit suicide, an estimated 75% were likely to be clinically depressed.
Symptoms of Major Depression
You can have major depression without realizing it. If you or the person you are caring for have any of these symptoms for more than two weeks, call your primary care provider or a mental health specialist. Call right away if there are frequent crying spells for no reason, or if depression is disrupting work or family life.
Symptoms include:
- Persistent sad, anxious, or “empty” mood
- Feeling hopeless or pessimistic
- Experiencing guilt, worthlessness, or helplessness
- Fatigue and/or lack of energy
- Problems with concentration, memory, and/or decision-making
- Sleep problems, including difficulty sleeping, early awakening, and oversleeping
- Changes in your appetite or weight—you might be more or less hungry than usual
- Thoughts of death or suicide and suicide attempts
- Restlessness, irritability
- Physical problems that don’t improve
Symptoms of Minor (Sub-Clinical) Depression
Some 15% of older adults have milder depression symptoms—but even though these may not feel serious, minor depression can be disturbing. Symptoms include:
- Difficulty in functioning
- Decreased social activity
- Vague complaints that lead to more frequent visits to healthcare providers
Psychotic Depression
This serious form of depression can be common toward the end of life. People with psychotic depression may experience hallucinations or delusions. They may also believe that people are trying to harm them. If you or a person you are caring for has symptoms such as these, schedule an immediate evaluation by a healthcare professional.