When Laurie became mentally ill, she remained blissfully unaware. She saw no reason to doubt her own sanity based on interactions with her daughter and grandchildren, who visited once a week. They treated her like they always had, and responded to her in the usual ways. Eventually, she started noticing that it took a bit more effort to make sense of the news every night. One afternoon, despite her best efforts, she couldn’t finish that newspaper crossword puzzle she had been doing for the last 15 years. But that was because she was 82 years old! And when she stopped going to Sunday brunch like she always had, it was because she was too tired – and she knew her friends would understand.
Little by little, Laurie began withdrawing from her social life. She felt it took too much energy. She nestled herself in the comfort of isolation. It seemed everyone else was too busy to see her. Laurie was always tired but couldn’t sleep, and had no waking will to spare. “That comes with old age,” she told herself – but she had no interest in what she used to enjoy, no energy for it, and no desire to find out why. She had already lived a full life, so what more was there to want?
If you read between the lines of Laurie’s story, you may or may not recognize signs of mental illness. If you don’t, you’re in the same boat as many. Common elderly mental disorders like depression and anxiety often go under-diagnosed and under-treated, frequently unrecognized by health professionals and adult caretakers. According to the World Health Organization (WHO), 15% of adults aged 60 and over suffer from a mental disorder. Of that percentage, few are helped. In addition, older adults are less likely to access mental health issues. The National Council on Aging points to various reasons: from the stigma associated with mental illness to lack of access to treatment from providers to misconceptions that conditions like depression and anxiety are a normal part of aging.
Our common goal to address mental illness in the elderly and ensure their mental health is often inhibited by our lack of awareness, the way we downplay symptoms, and the stigma attached to diagnoses. In the face of these challenges to acknowledging mental illness in the elderly, how do we help a sick senior who may not even be in the right state of mind?
There are clear signs that caregivers and loved ones must catch before mental illness strikes in a full-fledged way. Senior citizens have particular risk factors to mental illness that should be understood. Proactive recognition is always a better care solution than emergency reaction. Before a senior you love becomes ill, you should first address these causes that invite mental distress.
- Social Isolation – The loneliness of social isolation has dire consequences. Elderly adults who do not have children, or the communicative ability to organize care are prone to live alone and do much by themselves. An isolated senior can feel unworthy of company but desperate for contact. They can begin to feel pessimistic, invisible, and even physically unwell. Loneliness is a major risk factor for depression, according to numerous studies.
- Biological History – If a mental illness has occurred somewhere else in a senior’s family, they are at risk as well. Family history is a known risk factor for disorders like Alzheimer’s. Some also classify schizophrenia, major depression, delusional disorders, OCD, and bipolar disorder as biologically-based mental illnesses under Timothy’s Law.
- Physical Health – Prolonged health problems that senior citizens especially suffer from can trigger unhealthy thoughts and feelings that lead to mental illness. Physical impairments that diminish seniors’ independence also affect their sense of identity and self-worth. When a senior feels significantly different than they used to when they were healthy and happy, they can mourn their loss of self and become pessimistic about the future. In this way, mental health is undeniably connected to physical health, and vice versa.
- Trauma – Besides the obvious impairments that physical trauma can cause – injury, immobility, etc., emotional trauma is also a risk factor some seniors encounter. Older adults are vulnerable to elder abuse, which is inflicted on 1 in 10 of them, according to WHO. Coupled with limited ability and close to total dependence on care, seniors become the perfect victim to elder abuse criminals. These victims suffer serious losses in dignity and respect when abusers inflict physical, sexual, psychological, financial, and material harm. These kinds of abuses can destroy mental wellbeing in an almost irreparable way.
Prevention & Intervention
The point of addressing risk factors is prevention and slower progression: the opportunity to avoid the pain and disillusionment a senior would feel if they ever became fully mentally ill. Most seniors like Laurie, who have led happy, full lives before falling ill, would not otherwise suffer like this in their final days. However, some mental illnesses in the elderly are unavoidable. After doing all you can to prevent the worst, it can help to be aware of the resources listed below when you need help or information.
National Alliance on Mental Illness (National Alliance on Mental Illness (NAMI))
NAMI Hotline: 1-800-950-NAMI (6264)
Call 24/7: 1-800-273-8255
SAMHSA Treatment Referral Helpline: 1-800-662-HELP (4357)
“Catching the Signs of Mental Illness in the Elderly,” written by Michelle Mendoza and Jeremy Brooker, Amada Blog contributors.