As people slip into old age, we realise they have lived their life and already faced a lot of hardships and also lived their best years. With the weakening of physical muscles, the tissues in the brain also start to weaken. Memories start to fade out, neural connectivities start weakening. A fulfilling life is all a person aspires to live. Throughout their lives, some people excel and many of them remain stuck due to numerous reasons, some reasons being physical constraints while others being mental, emotional or financial.
Human beings during their life form a tendency of clinging on to habits that have a detrimental effect on their overall health that gradually starts to manifest during old age. The unresolved interpersonal issues, excessive anxiety, various other environmental issues and life events collectively stack up to manifest as mental issues in later life.
However, certain habits and lifestyles bring about change in the biological genes as well.
If your loved ones are in their mid or late sixties, or older, and if they have been struggling with emotional or behavioural issues lately, it could be possible that they are going through some age-related troubles. But, it is also very likely that they might simply be reacting to an overwhelming situation in their personal life. Either way, it’s safe to seek some kind of help that you find useful during this time.
Overlap of depression and anxiety is very common with up to almost half of the elderly patients reporting significant depressive and anxiety symptoms. Geriatric depression overarchingly becomes the most studied and most common psychiatric disorder. Growth in the elderly population means a direct increase in age-related diseases such as dementia and poor mental health outcomes such as depression, anxiety, suicide and serious constraints on the quality of life among elderly individuals.
Keeping in view the statistics of geriatric depression and other health conditions in the elderly, the need to identify novel and unmet problem areas and develop efficient therapeutic outcomes for this special population is the most important need of the hour. Old age is a worldwide phenomenon, generally accompanied by a number of problems that the aged have to face and get attuned to. There are a lot of lifestyle changes that the elderly have to go through as they age especially at this changing era of globalisation. There is a great body of evidence of a rise in morbidity, mortality, hospitalisation and loss of functional status related to common mental disorders in the elderly patients.
As the number of aged people in our population is increasing, many of their traditional life-sustaining and fostering influences have been wearing away. Changes in society seem to leave them no meaningful social role either within the family or in the community.
Often, the elderly are socially isolated, and many exist within the confines of a nursing home or an institution, where their main social links are only with other inmates and equally alienated old people which rather is a question of concern that requires alteration. Can we be more inclusive of the elderly and empathetically consider how lonely and alienated they might feel as members of society?
The most prevalent mental health problems among the elderly are:
Dementia
Dementia is a progressive syndrome which leads to a deterioration of thinking, memory and behaviour, including the ability to perform routine activities. WHO rightly points out that this is not necessarily a normal part of ageing, rather it is more likely to occur in the elderly.
Some of the causes of dementia have been identified as- Alzheimer’s, a progressive brain disease that leads to various cognitive impairments that worsen over time; Chronic high blood pressure, blood vessel disease or stroke; Parkinson’s disease, in severe and advanced stages; Huntington’s disease, a genetic disorder signalled by mental dysfunction, altered personality, psychosis, and movement disturbance; Creutzfeldt-Jakob disease, a viral infection that leads to rapid and progressive dementia.
However, it is important not to confuse dementia with other potential medical conditions such as side effects or reactions to certain medications, the fallout of poor eating habits, the lack of oxygen resulting from lung disease or lack of blood flow to the brain resulting from heart failure.
Also, the symptoms of diseases related to the adrenal, thyroid, pituitary or other glands may mimic the symptoms of dementia since these regulate memory, perception, emotions and thought processes. Understanding the underlying condition is essential in getting the right treatment and assessment by a medical professional.
Depression
Depression is one of those conditions that is often overlooked and taken for granted because it is easily misunderstood as general tiredness, the result of having a bad day or experiencing a negative phase. The reality is that it is a debilitating mental health disorder that occurs in 7% of the older population.
Depression in the elderly, commonly referred to as geriatric depression, may mirror the symptoms of a general depression diagnosis for any age group, and because the symptoms occur in conjunction with other illnesses, the disorder may go undiagnosed and untreated.
Types of depression vary and include major depression, double depression, persistent depressive disorder or dysthymia, bipolar disorder or seasonal affective disorder. Some of the common signs of depression to look out for are a persistently sad or anxious mood, feelings of worthlessness, helplessness or hopelessness, decreased energy, constant fatigue, irritability and loss of interest in pleasurable activities. It is worth noting that these feelings can occur in a person but not classify as depression; what sets the diagnosis apart is a severe constant episode of the above symptoms that significantly interfere with daily functioning.
Also, the extent of the symptoms may not meet the criteria of a full-blown depressive episode, leading medical professionals to assume that treatment is not imperative. In fact, caregivers or doctors may not even realise something is wrong because the common yet faulty assumption is that ‘feeling blue’ is a part of ageing. If you or your loved ones are going through a difficult time and depressive feelings are interfering with the normal day-to-day functioning, it’s time to consult a specialist.
Anxiety disorders
Older adults might exhibit symptoms of anxiety that may not warrant a diagnosis of an anxiety disorder but have a real impact on their ability to function normally. Generalised Anxiety Disorder and Specific Phobias are the most prevalent anxiety disorders, with social phobias, panic disorders, post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD) being less common.
The key defining feature of an anxiety disorder is a constant, excessive apprehension or worry about everyday events and issues which should not cause such severe uneasiness. Although it is normal for the elderly to worry about health problems and financial affairs, a constant state of worry is cause for concern. Medication and therapy can be very effective in helping the elderly cope with anxiety and an effective treatment plan is instrumental in improving the quality of life.