Anxiety, Depression and Mental Health Problems in the Elderly
Many elderly have a range of mental health problems, from depression and anxiety to Schizophrenia and Bipolar Disorder. In more severe cases, they can struggle with suicidal tendencies, psychosis or delirium. Because there are many losses that occur with old age, family members often assume that anxiety and depression are a normal and expected part of aging. “To the contrary, mental health is just as important to the elderly as it is to younger persons. Mental health issues, especially depression, anxiety and suicidal thoughts should not treated as part of the normal aging process and should be addressed when care giving,” says Daniel Carey, Vice President, Performance and Compliance at the Otis R. Bowen Center for Human Services, serving Northern Indiana.
The elderly often hesitate to talk about or complain about distress. They often focus on the physical aspects of their anxiety, instead of the more subjective “feelings.” “Unfortunately, this often leads physicians through an extensive medical evaluation before the correct diagnosis is established,” says Carey. Anxiety may be generalized, expressed through symptoms of restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tension and sleep disturbance. Anxiety may also be expressed as “panic attacks,” which include heart palpitations, sweating, trembling or shaking, shortness of breath, chest pain or discomfort, nausea, dizziness, numbness or tingling, chills or hot flashes.
Depression and Suicide
Depression in later life has serious consequences, including the distress of patients and family care givers and increased health care costs. Depression can amplify medical disabilities and cognitive disorders. It also increases the risk of suicide. “This is especially important, because studies have shown that there is a tendency in physicians to accept suicidal ideation in older persons, instead of treating the possibly underlying depression,” says RI Simon in Silent Suicide in the Elderly (Bulletin American Academic Psychiatry Law 1989; 17:83-95).
While mentally healthy adults may have suicidal thoughts, the threat of suicide tends to be most prevalent in individuals with mental health problems. According to the American Association of Suicidology, there is one elderly suicide every 99.2 minutes. Although older adults attempt suicide less often than those in other age groups, they have a higher completion rate, resulting in one suicide for every four attempts compared to one for every hundred attempts in younger persons. 84 percent of elderly suicides in persons over 85 were male and 72 percent of suicides are completed using firearms. Risk factors for suicide among the elderly include:
Age greater than 55, male, painful or disabling physical illness, solitary living situation, debt, decreased income or poverty, bereavement, depression (especially with guilt, self-reproach and insomnia), history of substance abuse, prior suicide attempts or family history of suicide, suicidal preoccupation and talk or well-defined plan for suicide.
“If you, or someone you love is suffering from anxiety, depression, or having thoughts of suicide, it is important to seek help”, encourages Carey. The Center for Disease Control and Prevention recommends the following resources:
National Institute for Mental Health
Suicide Prevention Resource Center
Surgeon General’s Call to Action to Prevent Suicide