Older Adults and Mental Health
Author: Dr. Deb Nelson
As a greater number of adults have moved into the phase of life known as “older adulthood,” there is an increased understanding that this period of life is as distinct a developmental period as any. Researchers are noting that old age is not simply an older version of our younger selves, or a steep decline towards death, but rather a more complex process. Although older adulthood is often marked by losses – loss of abilities and of those we love – it frequently is also a period of increased satisfaction with life. In a study published in the Proceedings of the National Academy of Sciences (2010), researchers found that psychological wellbeing increased after the age of 50 and continued to increase throughout the life span. So what contributes to this experience of increased psychological wellbeing during a period marked by so many challenges?
One of the first steps towards psychological wellbeing is an understanding and acceptance of the ebbs and flows of life, which comes through active engagement in the present. This type of acceptance has also been defined as “an active process in which persons acknowledge their thoughts, feelings and memories” and as a “present-oriented activity requiring energy and characterized by receptivity toward and satisfaction with someone or something, including past circumstance, present situations, others and ultimately the self.” Furthermore, a recent study found that while aging increases vulnerability to chronic illness, greater acceptance was correlated with fewer chronic conditions and better functioning (McDonald, Zausniewski, Hanna & Bekhet, 2011).
Acceptance, while healthy, does not mean life will be easy. Like all phases marked by changes, there are often great difficulties to be borne. Sadness and grief are normal responses to many of these challenges, but depression is not a condition that should be accepted as a normal part of the aging process. Signs of depression can include the following: fatigue, confusion, desire to isolate, changes in eating and / or sleeping habits, and a lack of interest in activities that were previously enjoyable. Understanding the differences between normal sadness and grief versus depression can be difficult. A visit to your primary care physician or a psychologist to discuss your concerns and symptoms can help you to get appropriate care.
Receiving the proper care is critical as depression not only reduces the quality of one’s life, but also contributes to serious health problems. For example, perseverative thoughts (ruminating on a single thought) about a sad or regretful event in the past, can lead to a depressed mood, which will reduce an elders’ interest in socializing and self care, which leads to other health problems. The importance of treating depression in older adults has been validated in countless research articles. In a report published in the British Journal of Psychiatry (2013), researchers found that depressed older adults were “more than twice as likely to develop vascular dementia and 65 percent more likely to develop Alzheimer’s disease” than similarly aged people who weren’t depressed.
However, being depressed may not be the whole story. Maintaining regular check ups with your primary care provider can help rule out other health conditions that may mimic the signs of depression. Some symptoms of depression, such as tiredness or forgetfulness, can be signs of other disease processes, or from side effects from medications. After ruling out physical health issues, a visit to a psychologist can help older adults and their families manage these transitions. Psychologists are required to take coursework specifically on working with older adults, and there are many who specialize in treating elders and their families. The MCPA website is a great place to start your search, or ask your family physician for a recommendation. Other resources are listed below.
Diniz, B.S., Butters, M.A., Albert, S.M., Dew, M.A. & Reynolds, C.F. (2013). Late life depression and risk of vascular dementia and Alzheimer’s disease: systematic review and meta-analysis of community-based cohort studies. British Journal of Psychiatry. 202, 329-335.
McDonald, P.E., Zausniewski, J.A., Hanna, K., Bekhet, A.K. (2011). Cultural comparison of chronic conditions, functional status and acceptance in older African American and White Adults. Journal National Black Nurses Association. 21(1), 1-6.
Stone, A.A., Schwartz, J.E., Broderick, J.E, Deaton, A. (2010). A snapshot of the age distribution of psychological well-being in the United States. Proceedings of the National Academy of Sciences, USA, 1-6. doi: 10.1073/pnas.1003744107