As individuals age, society often, and mistakenly, assumes that a certain degree of sadness or worry is a natural part of growing older. However, this misconception can lead to the serious under-recognition and under-treatment of depression and anxiety in seniors.

These are not inevitable consequences of ageing but are distinct mental health conditions that can significantly diminish an older person’s quality of life, independence, and physical health. Unfortunately, the symptoms of anxiety and depression in the elderly can be subtle, masked by physical ailments, or dismissed as ‘just old age’ by both the individuals themselves and their loved ones.

This article aims to shed light on these prevalent issues, helping families, caregivers, and healthcare professionals better understand, identify, and effectively support older adults experiencing anxiety and depression in old age.

Understanding Depression and Anxiety in Elderly Individuals

It is crucial to understand that depression and anxiety are treatable medical conditions, not character flaws or signs of weakness. In older adults, they can manifest differently than in younger populations, making diagnosis challenging.

What Causes Anxiety and Depression in Older Adults?

Numerous factors contribute to what causes anxiety and depression in older adults, and often, it’s a combination of these elements:

• Loss and Bereavement: The death of a spouse, friend, or family member is a profound trigger for grief, which can evolve into clinical depression.
• Chronic Health Conditions: Living with long-term illnesses such as arthritis, diabetes, heart disease, or chronic pain can lead to persistent distress and limit engagement in enjoyable activities. The worry about managing these conditions is often what causes anxiety in the elderly.
• Medication Side Effects and Interactions: Polypharmacy (taking multiple medications) is common in older adults, and some drugs or their interactions can cause or exacerbate symptoms of depression and anxiety.
• Social Isolation and Loneliness: Reduced mobility, loss of driving privileges, or living alone can lead to diminished social interaction, a significant risk factor for both conditions.
• Loss of Independence and Role Changes: The inability to perform previous activities, giving up driving, or moving into assisted living can lead to feelings of helplessness and a loss of identity.
• Financial Worries: Concerns about living costs, healthcare expenses, or the adequacy of pensions can be a substantial source of stress and anxiety.
• Fear of Falls or Illness: A heightened awareness of physical vulnerability, particularly the fear of falling, can lead to severe anxiety and avoidance of activities, further compounding isolation.
• Cognitive Decline: The onset or progression of cognitive impairment can be deeply distressing, leading to depression, and the confusion it causes can also trigger anxiety.

The Overlap and Nuance in Old Age

It’s common for anxiety and depression in older adults to co-exist, and they can often fuel each other. An older person might be anxious about their health, which leads to withdrawal, exacerbating feelings of loneliness and depression. Conversely, depression can make someone less inclined to socialise or engage in activities, thereby increasing anxiety about leaving the home.

The subtle presentation of anxiety and depression in old age means that these conditions might be overlooked or misdiagnosed as other health issues. For instance, memory complaints might be attributed to dementia rather than depression, or physical pains to age rather than an underlying mood disorder.

How Do You Stop Anxiety in the Elderly and Offer Support?

The good news is that depression and anxiety in seniors are highly treatable. Knowing how to stop anxiety in the elderly and support depression requires a multi-pronged approach:

• Seek Professional Help: The first and most crucial step is to encourage the senior (or, if appropriate, make an appointment on their behalf) to see their GP. The GP can rule out physical causes for symptoms and refer to appropriate mental health services.
• Psychological Therapies: Cognitive Behavioural Therapy (CBT) and counselling are highly effective. These therapies help individuals identify and challenge negative thought patterns, develop coping mechanisms, and learn relaxation techniques. They can be adapted for older adults, even those with mild cognitive impairment.
• Medication: Antidepressants or anti-anxiety medications may be prescribed by a doctor or psychiatrist, especially for moderate to severe cases. Dosages are typically started low and increased gradually to minimise side effects. Close monitoring is essential.
• Promote Social Engagement: Encourage participation in social activities, clubs, or volunteer work. Regular visits from family and friends are invaluable. Combatting loneliness is a powerful antidote.
• Encourage Physical Activity: Gentle exercise, such as walking, gardening, or chair exercises, can significantly boost mood and reduce anxiety. Even short, regular bursts of activity can make a difference.
• Healthy Lifestyle: Ensure adequate sleep hygiene, a balanced diet, and limit alcohol consumption.
• Structure and Routine: A predictable daily routine can provide a sense of control and reduce anxiety, particularly when major life changes occur.
• Purposeful Activities: Encourage engagement in hobbies or activities that provide a sense of purpose and achievement. This could be anything from crafts and reading to learning new skills or engaging in light household tasks.
• Support Groups: Connecting with others facing similar challenges can provide a sense of community, shared coping strategies, and reduced feelings of isolation.

Sources:

• https://www.england.nhs.uk/mental-health/adults/older-people/
• https://www.england.nhs.uk/2017/10/half-of-adults-aged-55-and-over-have-experienced-common-mental-health-problems-say-age-uk/
• https://www.ageuk.org.uk/information-advice/health-wellbeing/conditions-illnesses/depression-anxiety/
• https://www.rcpsych.ac.uk/mental-health/mental-illnesses-and-mental-health-problems/depression-in-older-adults