Early Signs of Mental Health Struggles and Illness in Seniors

According to the Centers for Disease Control, 20 percent of people aged 55 or older experience some kind of mental health struggle. The most common of these issues include anxiety, severe cognitive impairment, and mood disorders (such as depression or bipolar disorder). Therefore, it is essential that senior adults, their family members and caregivers learn about the risk factors, symptoms and when to seek senior mental health services.

Risk Factors for Mental Health Issues

Stress accompanies many stages of aging. The loss of loved ones, spending more time at home, natural changes to the brain,  and feeling a lack of purpose all take their toll and pose a risk to our seniors’ mental health.

Other risks for mental health disorders include:

• Alcohol or substance abuse
• Dementia
• Long-term illness
• Chronic pain
• Medication interactions
• Physical disability
• Physical illnesses, which can affect emotion, memory, and thought
• Poor diet or malnutrition

Symptoms of Mental Health Issues

Caregivers and loved ones can pick up on warning signs by taking note of any changes in their senior loved one’s behaviors and moods.

One factor that has possible psychological repercussions is lack of mobility. Caregivers should watch the senior walk across a room, taking note of their walking speed and the movement of their feet. Do they shuffle or drag their feet along? Are they having trouble with balance or rising from a chair?

Illnesses like depression are not always easy to spot. Feeling down from time to time is normal for many seniors, just as it is for people of any age. It’s important to watch for significant changes in energy levels, irritability and anger, loss of interest, confusion, sleep problems, changes in appetite, substance abuse, or expressions of despair.

You should also be on the lookout for the following:

• Changes in appearance or dress
• Disorientation
• Difficulty making decisions
• Depressed mood lasting longer than two weeks
• Feelings of worthlessness, guilt, helplessness
• Memory loss; especially short-term memory
• Thoughts of suicide
• Social withdrawal
• Unexplained fatigue and physical problems

Mental Illness, Dementia, and Mild Cognitive Impairment

The exact cause of a mental illness is not always known and can be attributed to a combination of biological, psychological or environmental factors.

Dementia is not a specific disease but several diseases, with Alzheimer’s disease being the most common form. It is caused by damage to or loss of nerve cells and their connections in the brain. It is progressive and incurable.

Some signs of dementia include:

• Difficulty with everyday tasks like keeping up with bills or following a recipe
• Asking the same question or telling the same story repeatedly
• Difficulty in joining in a conversation—stopping in the middle of a thought or struggling with word choices
• Confusion about time and place—forgetting where they are and routinely not knowing what day of the week it is
• Neglecting grooming and cleanliness
• Acting unusually anxious, confused, fearful or suspicious
• Loss of interest in activities and depression

The possibility of dementia adds to the complexity of diagnosing senior mental health issues due to the overlap of symptoms.  Depression often gets diagnosed as dementia because of shared symptoms, such as withdrawal from social activities and general apathy. And dementia can lead to, and coexist with, mental illnesses.

Mild cognitive impairment (MCI) encompasses minor problems with mental abilities, such as memory, attention, and language challenges. However, it does not interfere with daily life. It can be treatable if caused by physical health problems, poor eyesight, vitamin deficiency or as a side effect of medications. However, for some, MCI is a precondition for Alzheimer’s disease.

According to the Mental Health Foundation, people with dementia experience a higher likelihood of other mental issues.

Anxiety is more common in individuals with dementia. Further, dementia may lead to late-onset bipolar disorder, a mental health condition characterized by intense, unpredictable mood swings. There is some evidence that schizophrenia—a serious mental illness that affects how a person thinks, feels, and behaves—may pose an increased risk of developing dementia.

Psychosis, which also sometimes develops with dementia, is a condition that causes a loss of contact with reality, hindering a person’s ability to distinguish what is real and what is not. Other symptoms include delusions, hallucinations, incoherent speech, and inappropriate behaviors.

There are many more mental health issues that could be added to the list above. This is why professional evaluation and further senior mental health services are critical in determining and mitigating the sources of these issues.

Professional Diagnosis

Sometimes it is obvious that a senior needs help with their mental health. Other times it can be more subtle and  difficult to recognize.

Family members and caregivers are critical frontline resources in helping to identify symptoms of mental illness. Check in often and ask the senior if he or she is feeling sad or anxious about something. Listen and provide emotional support.

Senior mental health services and healthcare professionals are available to help you and your senior. They include geriatric care managers, geriatric psychologists, specialists and the senior’s primary physician, all who can assist you in finding the needed resources and solutions.

As a family member or caregiver, you can encourage your senior to seek testing when the quality of his or her life has been diminished. This may not be an easy conversation to have, but seek agreement if possible.

The stigma of mental illness runs deep, particularly with seniors who fear losing their independence. Emphasize that seeking help is not an admission of weakness or about losing control but about regaining strength and control, and easing your concerns as well.

A healthcare professional may want to run a variety of tests based upon the senior’s symptoms and unique health history.

Testing and evaluation may include:

• Cognitive tests, such as memory and recall, logic, speech and reasoning
• Lab assessments
• A review of all medications, supplements, and treatments
• Mental status exam
• Brain scans
• Full medical, physical, developmental, social, and emotional history, including any prior emotional or mental health issues

Many mental health conditions are treatable, but early diagnosis is a key to clear up uncertainty, and begin treatments and therapy.

For more information on mental health in seniors, visit Bethesda’s Health & Wellness blog.