The geriatric population, defined as men and women 65 years and older, is the fastest growing population in the world. Often referred to as seniors or the elderly, the current number of geriatric people in American, alone, exceeds 40 million. With people living longer, and the combination of medical advances and technology improving healthcare, the senior population is expected to soar to 72 million by the year 2030.
While gerontology, the study of the aging process in human beings, has brought insights about the physical, emotional and social needs of this population, little has been done to train medical specialists for seniors. In fact, 97% of medical school students have no training in geriatrics, and the rate of doctors graduating with a geriatrician degree are lower now than ten years ago. Even geriatric psychology, or geropsychology, the specialty that focuses on the mental health of the elderly, isn’t gaining the kind of traction needed to help those living in their golden years.
So what can you do if you’re an adult about to surf the silver wave? Or a caregiver who tends to a geriatric loved one? Learn. Read. And educate yourself about the aging process and what it takes to age well. Understand that mental illness can strike at any age – even old age – even if you’ve never encountered difficulties before.
Myth: Depression is a normal part of the aging process.
Fact: Experiencing depression is NOT a part of the aging process. Many seniors find meaning and purpose in their life and don’t struggle with sadness, regret, grief or despair. Depression in later life is a category of depression that occurs after the age of 65. It can strike as a result of life stressors or vascular medical issues. Early detection and immediate treatment can bring recovery. About 2 million adults experience a late-onset depression in their geriatric years.
Myth: Seniors describe depression better than younger people given their life experience and age.
Fact: Though seniors have gathered wisdom through their life journey, the experience of depression is often missed symptomatically as an illness. Seniors often report more physical complaints (aches, pains, fatigue, slowness, difficulty concentrating and irritability) than psychological ones (hopelessness, tearfulness, sadness, despair, negative thinking, and worthlessness). Since many people mistakenly believe these physical pains are part of the aging process, many seniors don’t get accurately diagnosed with depression.
Fact: Research shows that both psychotherapy and medication are recommended for depression in later life. Medication requires specific management as the metabolism of seniors becomes uniquely sensitive. Psychotherapy often takes on a briefer kind of treatment style, with the goal of helping seniors manage their depression and finding meaning in life.
Myth: Seniors have the lowest rate of suicide as an age group.
Fact: The geriatric population has the HIGHEST rate of suicide of any age group – and is a major public health concern. Misdiagnosis of depression and inadequate mental health care are the greatest reasons for this enormous statistic. Suicide is the most preventable type of death. Educating the geriatric population, caregivers, health professionals and the general public about the risk factors for late life suicide is at a crisis point.
Myth: Outreach and education has decreased the stigma of mental illness in geriatric populations.
Fact: Stigma is a profound impediment to recovery for seniors who have depression. Statistics show that 3/4 of seniors prefer to talk to their primary care physician for mental health issues. Of great concern is that 50% of seniors with depression are misdiagnosed – and that 80% are given either too little or too much medication to adequately treat their disorder.
If you or a loved one are experiencing symptoms of Late Life Depression for more than two weeks, please seek out a mental health professional. Here are symptoms to look out for:
Centers for Disease Control and Prevention and National Association of Chronic Disease Directors. (2008). The state of mental health and aging in America: What do the data tell us? Atlanta: National Association of Chronic Disease Directors.
Conwell, Y. (2013). Suicide and suicide prevention in later life. Focus, 11(1): 39–47.
Gawande, A . (2014). Being mortal: Medicine and what matters in the end. New York: Metropolitan Books.
Marshall Williams, S.; Chapman, D. and Lando, J. (2005). The role of public health in mental health promotion. Morbidity and Mortality Weekly Report, 54(34):841-842.
US Census Bureau. (2012). Statistical abstract of the United States. (131st ed). Washington, DC: US Census Bureau.
Dr. Deborah Serani is a psychologist and author of the award-winning books "Depression and Your Child: A Guide for Parents and Caregivers" and "Living with Depression" by Rowman & Littlefield. Her next book “Depression in Later Life” launches in 2016.