BY DR. SYED SHAZIA RIZVI
Depression, suicide, anxiety disorders, drug abuse, Due to varied reasons, several studies suggest that mental health issues are on an exponential rise in Kashmir and senior citizens are no exception.
There are many risk factors for mental health conditions in different stages of life and advanced age itself happens to be one of the risk factors for mental problems.
Significant ongoing loss in capacities and a decline in functional ability, reduced mobility, chronic pain, frailty, associated co-morbidities, decline in socioeconomic status after retirement and elder abuse are some predisposing conditions that leaves a negative impact on mental health of the elderly..
All of these stressors can result in isolation, loneliness or psychological distress. Globally 0ver 20% of adults aged 60 and over suffer from a mental or neurological disorder.
The most common mental and neurological disorders in this age group are dementia and depression, which affect approximately 5% and 7% of the world’s older population, respectively. Anxiety disorders affect 3.8% of the older population.
Moreover mental health illnesses in older adults may be difficult to recognize because older people may have different symptoms than younger people. In some older adults with depression low mood is not their main symptom.
They could instead present with memory problems, confusion, social withdrawal, loss of appetite, inability to sleep, irritability and in some cases delusions and hallucinations.
Hindrances such as the overwhelming stigma and the cultural sensitivity associated with mental health issues both sustain and perpetuate mental ill health and also prevent any treatment and rehabilitation.
Older adults are also vulnerable to elder abuse - including physical, verbal, psychological, financial and sexual abuse; abandonment; neglect; and serious losses of dignity and respect.
Current evidence suggests that globally 1 in 6 older people experience elder abuse. Elder abuse can lead not only to physical injuries, but also to serious, sometimes long-lasting psychological consequences, including depression and anxiety.
It is important to prepare health providers and societies to meet the specific needs of older populations, including:
Training for health professionals in providing care for older people;
Preventing and managing age-associated chronic mental illnesses like dementia.
Designing sustainable policies on long-term and palliative care Developing age-friendly services and settings.
Interventions like Prompt recognition and treatment of mental health issues in older adults is essential. Both psychosocial interventions and medicines are recommended.
There is a lot that our elderly population can do for themselves. Considering the Hindrances to get help for mental health issues there is a strong need for effective, non-pharmacological treatment and prevention approaches. Behavioural activation interventions have been found to be effective in both the treatment and prevention of depression.
Behavioural activation for depression is about making your life meaningful and pleasurable again, it involves these steps:
Learning about the vicious cycle of inactivity > depression > inactivity and understanding that we need to activate ourselves to feel better again. Scheduling and carrying out meaningful activities to boost our experiences of pleasure and mastery. Try doing some exercise, meeting a friend for coffee, cooking a healthy meal for yourself, cleaning the house, listen to music one likes, doing something nice for someone, reading a book , going on a walk with your friend, visiting a religious place.
Monitoring your daily activities to understand the relationships between your activity and your mood. You can use an activity monitoring worksheet to record what you do each waking hour every day for a week. Make sure to record everything on this behavioural activation worksheet – even activities that don’t seem very important.
You need to find out how your mood changes as you do different activities.
Recognize what elevates your mood and what has a negative effect.
Identifying your values and goals and working out what really matters to you. Parenting, social life, personal growth, spirituality, leisure time, community, health and physical wellbeing.
Sleep disturbance and mood are strongly associated, and as circadian rhythms and sleep patterns change with age, these associations are pivotal in older adults’ sleep regulation. Keep check on what influences your sleep and behaviour that can inhibit or promote sleep.
Loneliness and social isolation that may occur as an older individual’s social network decreases can further contribute to depression. So keep your social network strong, visit family and friends.
Depression is common among older adults with visual impairment and hearing loss as these impair an individual’s ability to engage in activities that were once enjoyed e.g., driving, watching television, social interaction. Therefore get glasses and hearing aids if needed.
There is no medication currently available to cure dementia but medications are available to decelerate the progress of dementia, besides much can be done to support and improve the lives of people with dementia and other mental health illnesses and their caregivers and families, such as: early diagnosis, in order to promote early and optimal managementoptimizing physical and mental health, functional ability and well-beingidentifying and treating accompanying physical illness detecting and managing challenging behaviourproviding information and long-term support to careers
Due to reasons such as lack of awareness, lack of accessible services, lack of trained manpower and last but not the least, the stigma, the treatment gap is huge and may be increasing. Therefore, there is an urgent need to at least increase the mental health awareness about elderly population for early detection and prompt action.
(Dr Rizvi (MRCPsyc) is speciality registrar psychiatry, North Staffordshire Combined Healthcare, United Kingdom)
Disclaimer: The views and opinions expressed in this article are the personal opinions of the author.
The facts, analysis, assumptions and perspective appearing in the article do not reflect the views of GK .