When your septuagenarian father complains daily about aches, pains and physical disabilities, loss of appetite and the lack of will to live, how do you react?
More often than not, these symptoms are dismissed as the natural expressions of old age. But does it occur to you that your father could be suffering from depression or some other mental health concern?
According to the WHO, over 20 per cent of adults aged 60 and above suffer from a mental or neurological disorder and 6.6 per cent of all disability-adjusted life years among the 60-plus age group is attributed to neurological and mental disorders. The most common neuro-psychiatric disorders in this age group are dementia and depression, says WHO.
“Mental health problems in the elderly are poorly recognised by the family and health-care professionals. Owing to the stigma surrounding mental illnesses, the family is often reluctant to seek help. The physical ailments of the elderly might be attended to, but sadly, depression and mood disorders among older persons go undiagnosed and untreated,” says P.S. Kiran, a psychiatrist and the nodal officer of the District Mental Health Programme.
One of the main issues that affects the diagnosis and treatment of mental health issues among elderly is the lack of awareness that in old age, even the normal age-related physical problems and emotional upheavals can trigger depression and anxiety disorders.
The reverse of this — mental health issues presenting as physical disabilities — is also very much possible.
Chronic illnesses, dementia, thyroid or adrenal diseases that can affect mood and memory, loss of spouse or sibling, medication interactions or side effects, nutrition issues or a change in environment can all act as trigger for mental health issues in the elderly.
Depression is not a normal phase of old age and it needs to be treated as in any age group. But the symptoms of depression in the elderly often remain unrecognised because it coincides with other problems of old age such as loss of mobility or the ability to live independently.
Depression also increases the perception of poor health among the elderly themselves, aggravating their frail mental state.
“All cases may not be depression. On many occasions we find that the elderly are just suffering from loneliness because the younger ones in the household may be just too busy to spend time with them. For many, socialisation may go down with the death of the spouse and their world becomes smaller,” Dr. Kiran points out.
In many primary health centres in the district, the once-a-week Psychiatry OP clinic would have a few regulars — mostly elderly men and women who come complaining of vague symptoms but who are just looking for an opportunity to ventilate, he says.
The mental health status of a person is determined by multiple social, biological and psychological factors. For the elderly, it is a cascade of events that occur about the same time — social isolation, boredom, bereavement and the loss of independence — which sends them down a precipice.
Reporting by
C. Maya
