Mental issues affecting senior population is largely overlooked
By Deborah Jeanne Sergeant
More than 15 percent of adults aged 60 and older experience mental health disorders, according to the World Health Organization. Many of those don’t receive proper treatment for conditions such as depression and anxiety.
“Depression is both under-diagnosed and undertreated in primary care settings,” the World Health Organization states on its website. “Symptoms are often overlooked and untreated because they co-occur with other problems encountered by older adults.”
Physician Anjeet K. Saini would agree. Saini is assistant professor of medicine at UBMD Internal Medicine, division of geriatrics and palliative medicine.
“It’s unrecognized, or treated as ‘Oh they’re having a hard time coping with aging,’” Saini said.
While Saini quipped that “growing old isn’t for wimps” and most people do experience some struggles acclimating to the limitations of older age, depression, anxiety, and other mental health issues are not normal part of aging.
Mental health issues are different from temporary adjustment to aging. For example, the American Psychiatric Association states that depression’s symptoms last two weeks or longer. An occasional feeling of sadness or grief from loss is different.
“People like to blame old age, but mental illness is pathological,” Saini said.
Young people experience depression, anxiety and other mental health issues, yet their age isn’t blamed for their conditions. But older adults may be more prone to mental health issues because of their life stage and the life changes that often come at that stage.
Many older adults possess fewer resources that support good mental health, such as a network of nearby loved ones, the ability to exercise vigorously, overall good physical health, and purposeful, engaging activity. Life changes such as retirement, loss of peers to death and relocation, encroaching physical limitations, and age-related physical issues all affect mental health.
“Mental health issues are largely overlooked and under-diagnosed in older adults,” said Rachel McCarley, licensed clinical social worker, owns Rachel’s Experience, Inc. in Buffalo.
She said that many people stereotypically think older adults simply experience mental health issues as a part of older age.
“It’s not normal for an elderly person to develop depression, anxiety and things of that nature,” McCarley said.
She views these as signs a person is deprived of an emotional, physical, or spiritual need.
“When you lack these things, it opens the door for disease, eating disorders, depression, anxiety, and cognitive issues as well.”
Robert S. Stall, geriatrician and owner of Stall Senior Medical in Amherst, said that depression and anxiety “can ‘kill’ a patient without them being dead.”
He said that more general practitioners need to screen for mental health issues, especially in older adults.
“As a geriatrician and doctor, it’s my responsibility to identify mental health issues and help people with that as well as physical health,” Stall said.
Some physicians don’t readily identify mental health issues in older adults. That’s in part because some of the health concerns that older adults tend to experience — and the medicines that treat them — may mask mental health issues, according to Louis Francis Ciola, certified hypnotist and owner of Amherst Hypnosis, specializes in addressing pain management, habit control and stress, among other conditions.
“A lot of physical nuances are overlooked in older adults,” Ciola said. “My surgeon said older adults are way over medicated for physical and mental health. They can’t metabolize the drugs as quickly.”
Sluggishness and lack of interest and motivation caused by over medicating can look like depression in some patients. Ciola said that some primary care doctors tend to treat symptoms rather than patients. He added that some would prescribe a medication for depression without asking more questions, such as other issues going on in their lives, what supplements they take, and how their diet looks.
“Maybe they need to get out of the house more, begin exercising, and start making more friends,” Ciola said. “You may get resistance from the clients but that’s the way it is.”
Some older adults may resist visiting a mental health professional, but would consider a physical, which could lead to mental health screening if a caregiver comes along and asks about issues the patient experiences.