Older adults have an increased risk for mental illnesses because of the losses that can accompany the aging process. Many older adults have lost their independence, friends, family members and social roles. Even with this increased risk for mental health challenges, many older adults do not receive the treatment they need due to stigma of mental health and the frequent situation where signs of mental illnesses are looked and dismissed as normal symptoms of aging, such as slowing of thought, memory, and thinking, hearing loss, vision loss, and physical decline (National Institute of Mental Health, 2019).
Signs & Symptoms
Knowing the warning signs as a practitioner or a caregiver can help to assist in identifying when a patient is in crisis and in need of intervention.
Detecting depression in older adults can be difficult simply due to the fact that symptoms often vary from those in younger individuals. Symptoms might not be as overt and often sadness may not be the most prominent symptom. Furthermore, many older adults prefer to keep their problems private and view depression as a sign of weakness, which can cause them to be less forthright with feelings they are experiencing and resistant to talking about troubles they may have (Lyons et al., 2018). Another complicating factor in identifying mental health issues for older adults is that their symptoms may be caused by medications they may be taking, inducing adverse drug reactions, drug-drug interactions, or drug-disease interactions.
Older adults are less likely to manifest affective symptoms of depression, such as:
- Persistent sad, anxious, or “empty” mood
- Feelings of hopelessness, guilt, worthlessness, or helplessness
- Frequent crying
Instead, older adults are more likely to display the following symptoms:
- Cognitive changes (trouble concentrating, problems with memory, making decisions)
- Somatic symptoms (Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease with treatment
- Loss of interest (previously pleasurable activities, hobbies, sex)
- Irritability, restlessness, or having trouble sitting still
- Decreased energy or fatigue
- Moving or talking more slowly
- Difficulty sleeping, early-morning awakening, or oversleeping
- Eating more or less than usual, usually with unplanned weight gain or loss
And although older adults may be less likely to express suicidal thoughts and intentions, older men and women show the highest suicide rate in almost all countries, reaching 48.7/100,000 in the USA (Conejero, Olié, Courtet, & Calati, 2018). As such, the topic of suicidality should not be avoided in open discussions and should be integrated as a part of behavioral health screenings.
Depression and other mental illnesses can negatively impact treatment of other health conditions that older adults may be suffering from. It is important to screen older adults using proper assessments to ensure they are receiving the mental health treatment and interventions. For providers and practitioners, evidenced-based scales for assessing depression in older adults are the Geriatric Depression Scale (GDS) and the Cornell Scale for Depression in Dementia. Click here to learn more about screening tools for suicidality.
If you or someone you know might be at risk for mental health illness as an older adult, below are several resources for treatment:
- AARP (1-888-687-2277)
- Alzheimer’s Association (1-800-272-3900)
- Department of Veteran’s Affairs
- Depression & Bipolar Support Alliance (1-800-826-3632)
- KIPDA Mental Health & Aging Coalition
- LouisvilleKy.gov Senior Services
- Metro United Way (2-1-1)
- National Alliance on Mental Illness (NAMI) Louisville (1-800-950-6264)
- National Coalition on Mental Health and Aging
- Services Guide for Aging and Disabled Citizens
- Southeastern Association of Area Agencies on Aging
- Substance Abuse & Mental Health Services (SAMHSA) (1-800-662-4357)
- Suicide Prevention-Crisis Line (1-800-273-8255)
- UofL Depression Center
- UofL Trager Institue
- Veteran’s Crisis Line (1-800-273-8255, press 1)