Nearly half of the people who are diagnosed with anxiety also suffer from depression or vice versa. This is because people with a primary mental ailment can worsen the symptoms and make recovery difficult, making it essential for both disorders to be treated simultaneously.
It is estimated that about 20% of those aged 55 years and above in the US experience some sort of mental health concern, among which the most common conditions are anxiety and mood disorders such as depression or bipolar disorder.
Unfortunately, depressive and anxiety disorders are under-recognized and often left untreated and more than two-thirds of seniors do not get the treatment they need. Additionally, the stigma attached to mental health issues is more powerful in the elderly, as it prevents them from openly admitting their symptoms.
Some key facts
- Due to the aging of the population, the number of seniors with mental disorders like anxiety and depression is set to double by 2030.
- Depression is the most common ailment among seniors in the US
- People aged 85 years and above have the highest suicide rate of any age group.
- Mental health services for seniors are limited in most countries, including America.
Treatment options for older adults
Many helpful treatments for both anxiety and depression are available to reduce the symptoms and shorten the period of the ailment to last. Like hypertension or diabetes, depression too is a treatable condition and not a normal part of aging, though in older adults the risk of experiencing depression is higher.
While families and friends can offer support in finding treatment, it is best left to a qualified physician to investigate this mental condition. That said a few things close relatives and friends could do are:
- Encourage the person to take medical help
- Help set up appointments and/or accompany the patient to the doctor’s clinic
- Encourage the person to take part in physical activities which are great for boosting mood
Some common forms of treatment include:
- Psychotherapy: Counseling or talk therapy can be of immense help in helping a person to identify troubling emotions, thoughts and behaviors. Psychotherapy is especially of benefit to those who have undergone major life stresses like loss of family members or home relocations. The treatment can be accessed with a licensed clinical social worker, a psychiatrist or any other accredited mental health care professional. It is also helpful for those who cannot take drugs because of the side effects or their interaction with other medicines. If considering this treatment for older adults, it is recommended to augment with a second-generation antidepressant.
- Medications: APAs Clinical Practice Guideline suggests antidepressants for the treatment of depression in older adults. Second-generation antidepressants like serotonin, are often prescribed to balance the hormones that affect the mood. Some other commonly used medications for older adults are selective serotonin reuptake inhibitors (SSRIs) like Celexa or Paxil or serotonin modulators and stimulators like Wellbutrin and Remeron. A primary care physician can help in prescribing and monitoring the medications for potential side effects. Note that antidepressants may take longer in showing positive results with older people than they do with younger people, as the elderly are more sensitive to medicines.
- Electroconvulsive therapy: This process also known as ECT, involves placing of electrodes on the head of the patient to enable a safe and mild electric current to pass through the brain. However, this type of treatment is only used as a last resort when all other types of treatment have failed or when the illness is very severe and interferes with daily functioning. Even then, ECT plays an important part in treating depression in seniors who cannot take traditional medicine.
- Online counseling and therapy: Online therapy works well on anxiety and depression as it addresses the root causes rather than only the symptoms. Online Therapy allows you to work through the stressful life changes arising from loss or bereavement by changing the negative thinking patterns. The two main forms of psychotherapy are cognitive behavioral therapy (CBT) and exposure therapy.
- Anti-anxiety drugs: Anxiolytics, such as Buspirone are anti-anxiety drugs that have proved effective for older adults. These are normally prescribed when a short-term or quick acting medication is deemed necessary. Another effective drug called Benzodiazepines is beneficial but should be prescribed with caution in older adults because of risk of memory impairment and falls. Hence this drug is usually performed for a short period.
- Other measures: There are other steps that one can take to relieve anxiety and depression:# acknowledge your worries and fears. For example, if you are depressed due to financial reasons, consult a financial planner.# Adopt stress management techniques like meditation, prayer and deep breathing exercises # Exercise # Avoid things that can aggravate the symptoms like caffeine, nicotine, drugs, cold over-the-counter medications, herbal supplements, alcohol, illegal drugs and limit social media.
- Natural remedies: A few natural ways to overcome anxiety or depression are: Stress control can be managed by taking time off from professional responsibilities and keeping an eye on demands and commitments. Calming techniques can be of great help to alleviate symptoms of anxiety. You can substitute negative thinking with positive thoughts by making a list of the ideas to be replaced. Support groups are also effective as you interact with like-minded people or a mentor. Finally, physical exercise and a healthy lifestyle will enhance self-image and release the chemicals from the brain that promote positive emotions.
Treatment, especially a combination of medications and psychotherapy has proved their effectiveness in older adults. Having said that, not all therapies are right for everyone and treatment choice differs from person to person and sometimes multiple treatments may be tried to shortlist one which works.
It is therefore important to tell your mental care provider, whether your current plan is working for you or not, and to find something that does. The final option of the physician will depend on the type and severity of the ailment, past treatments and overall health among others.