May is Mental Health Awareness Month, and it’s clear that, after the few years we’ve had, we need this time to focus on our psychological well being. But here’s the thing: a lot of the talk surrounding mental health lately has been centered on young people, and while that is an extremely important topic, we need to remember that there is no age limit on mental health issues. In fact, older adults can be hit especially hard in this area. So, for this Mental Health Awareness Month, we’d like to remind everyone of that fact, and restart the conversation about mental health and aging with some important facts.
1. Mental Health Issues in Older Adults Are More Common Than Many People Think
We have a rapidly aging population. It’s projected that by 2050, we’ll have leapt from 900 million people over 60 to around 2 billion! And we have to start recognizing that all of these millions of older adults need to have their mental health needs addressed in the same way that we address their physical needs. Why? First of all, mental health is incredibly important: we know that good mental health contributes greatly to an overall feeling of well-being. But on the other hand, untreated mental health disorders in older adults can lead to diminished functioning, substance abuse, poor quality of life, and increased mortality.
Second of all, mental health issues are very common among older adults – maybe more common than many people think. According to the CDC, around 20% of adults over 55 (or 1 in 5) experience some sort of mental health concern, with other studies putting that number at 1 in 4 adults over 60. The most common issues are depression, cognitive impairment, and anxiety. Depression and dementia are the most common, affecting 5% to 7% of the population over 60. Anxiety follows as a close second, with the World Health Organization (WHO) reporting that it affects 3.8% of older adults. Considering the size of the older population, these numbers are pretty concerning.
2. Mental Health Issues Can Lead to Physical Issues
To pick up on a point from above, mental health and physical health go hand-in-hand, especially among older adults. Physical issues, like reduced mobility or chronic pain can lead to mental distress, and older adults with physical health conditions such as heart disease have higher rates of depression than those who are healthy. But, this is a two-way street: untreated depression in an older person with heart disease can actually lead to worse outcomes. In fact, studies show that treatment programs for depressed elderly patients suffering from cardiovascular disease and other major illnesses usually take longer than normal and are less successful.
Mental health issues like depression can affect older adults physically in other ways, too. Depression can lead to overeating and obesity or, can even cause a significant loss of appetite and lower energy levels, sometimes resulting in a condition known as geriatric anorexia. Older adults with mental health issues could also end up with insomnia and memory loss, which is bad in itself, but can also lead to more accidents around the house or on the road.
3. Mental Health Issues Can Develop Later in Life
While some older adults with mental health issues have been living with them for their entire lives, some develop these concerns later in life. Mental health can deteriorate after a stroke, or even after a diagnosis of Parkinson’s disease, cancer, arthritis, or diabetes; some medications can also cause changes in mental health. Not only that, but the changes brought on by getting older, or declining health, can cause some older adults without a history of substance abuse to begin abusing medications, alcohol, or drugs.
4. Depression Is Often Overlooked in Older Adults
Conventional wisdom says that young people tend to experience mental health issues more often than older adults, and that might be true, but it’s also true that older adults seek help less often than young people do. And not only that, but according to the CDC, “Older adults are often misdiagnosed and undertreated. Healthcare providers may mistake an older adult’s symptoms of depression as just a natural reaction to illness or the life changes that may occur as we age, and therefore not see the depression as something to be treated. Older adults themselves often share this belief and do not seek help because they don’t understand that they could feel better with appropriate treatment.”
In fact, according to some studies, primary care physicians fail to diagnose depression 50% of the time, and only half of older adults who discuss specific mental health problems with a physician receive any treatment.
5. Older Adults Have the Highest Rates of Suicide
Think older adults don’t die by suicide at the same rate as younger people? You’re right: older adults actually have the highest rates of suicide of any age group. To be more specific, people aged 85 and over have the highest suicide rate of any age group, and those aged 75 to 84 have the second highest, with men dying by suicide more often than women. Not only that, but older adults’ suicide attempts tend to be more lethal: for people 65 and older, there is one suicide for every four attempts, compared to one suicide for every 20 attempts for all other age groups.
6. There Are Signs to Look Out For
While mental health issues can develop later in life in people who had never been previously diagnosed with them, they generally don’t come out of nowhere. Aging brings with it a lot of changes, both in physical condition and in life circumstances, and these changes can become risk factors for mental health issues. Risk factors can include things like:
- Alcohol or substance abuse
- Dementia-causing illness (e.g., Alzheimer’s disease)
- Illness or loss of a loved one
- Long-term illness (e.g., cancer or heart disease)
- Chronic pain
- Medication interactions
- Physical disability or loss of mobility
- Physical illnesses that can affect emotion, memory, and thought
- Poor diet or malnutrition
There are also warning signs to look out for that can mean things aren’t quite right, like:
- Change in sleeping patterns (not enough sleep or oversleeping)
- High stress levels or constant worrying
- Suicidal thoughts
- Trouble feeling positive emotions
- Unusual ideas or behaviors
- A need or dependence on drugs and alcohol
- Feeling hopeless or giving up
- Constant headaches and pain
- Anger and irritability
- Engaging in high-risk activities
If you or a loved one are experiencing the above, you should speak to your doctor or a trained mental health professional as soon as possible – and don’t be put off or told that what you’re feeling is a normal part of aging! As we’re about to discuss, we need to be doing more for the mental health of older adults.
7. We’re Not Doing Enough
While adequate social and emotional support is associated with reduced risk of mental illness, physical illness, and mortality, we’re just not doing enough to keep older adults in tip-top mental shape. Unfortunately, the older people get, the less likely they are to say they receive the social and emotional support they need, according to the CDC. Their studies show that adults aged 65 or older were more likely than adults aged 50–64 to report that they “rarely” or “never” received the social and emotional support they needed (12.2% compared to 8.1%, respectively).
And, again, our health system is dropping the ball on this, with far too many older adults not being adequately diagnosed, cared for, and treated. Consider these shocking statistics:
- Primary care physicians fail to diagnose depression 50% of the time.
- Only half of older adults who discuss specific mental health problems with a physician receive any treatment.
- Researchers estimate that up to 63% of older adults with a mental disorder do not receive the services they need.
- 75% of older adults who commit suicide have visited a primary care physician within a month of their suicide.
This is an unacceptable state of affairs, especially when studies show that 80% of older adults recover from depression after receiving treatment that includes both psychotherapy and antidepressant medication. Mental health issues are not a normal part of aging, but they are treatable, we just need to do more to raise awareness in older adults and those who care for them.
So this Mental Health Awareness Month, take the time to check in with yourself and your loved ones, make sure you know the risks and what to look out for, and stay as social and active as possible to keep yourself in a good mental state and connected to what and who you love. And if you or a loved one are struggling, don’t hesitate to reach out to a trusted professional and get the help you need and deserve. Growing older has its challenges, but you have the strength to face them head on, with a little help if needed.