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John Beyer, M.D., who is a professor of psychiatry and director of the Geriatric Behavioral Health Division at Duke University School of Medicine, in Durham, North Carolina, says he sees signs of this regularly in his job. "Our older age group has usually come from a cultural background in which we really did not talk about mental health issues or mental illness,” he says.
Still, the Centers for Disease Control and Prevention (CDC), estimate that nearly 20 percent of people 55 and older experience some sort of mental health concern. Beyer says the top challenges he sees in older patients are depression, anxiety, and neurocognitive problems such as dementia. All of those may be exacerbated by a person’s ability to cope with stress. Beyer shared the following stressors he hears from patients most, which he says can contribute to greater mental health problems:
- Changes in physical health and abilities. Beyer points out that his patients feel stress about the ways the body changes as they age, and those changes can cause stress. According to the National Council on Aging, which serves adults ages 60 and up, nearly 80 percent of older adults have one chronic disease and 68 percent have more than one. Beyer points out that physical illness can take a toll on mental health. “Any physical change in ability challenges how we see ourselves and our own self-esteem,” he says.
- Changes in relationships. Beyer says that as we age, loss becomes more prevalent. Aging adults have to face the death of friends, family, a spouse, colleagues and sometimes even their own children, exposing them to grief and the stress that comes with it.
- Changes in daily structure. According to Beyer, those who have retired from working sometimes struggle with finding a new, fulfilling routine. Gone are the days when you’d show up at the office at 8 a.m. and leave at 5 p.m. The absence of work can often feel like a loss of identity, says Beyer. “Retirement is not just being put out to pasture,” he says. Rather, it presents a challenge to find new meaningful work and/or hobbies.
- A change in living arrangements. It’s not uncommon for older adults to pack up and move when they retire, says Beyer. Some seek warmer weather, others move to be closer to family and many will relocate to a senior community. With that move comes an array of life changes: the desire to meet new friends, find new activities and learn your way around a new community. “It’s a major transition that can cause stress in older adults,” says Beyer.
Beyer emphasizes that experiencing stress from all of the above situations is normal. The challenge comes about when a person’s ability to cope with those stresses becomes overwhelmed. Research has shown that chronic stress and anxiety may lead to depression, dementia or other disorders. According to Beyer, there are a number of signs that indicate when a person may be experiencing depression, anxiety and dementia. He shared those:
Beyer says a person should consider talking to a healthcare professional about depression if he or she experiences the following:
- Feelings of sadness and/or hopelessness for most of the days over a two-week period
- Less interest in the usual activities
- Significant changes in sleep
- Increases or decreases in appetite
- Increases or decreases in concentration
- Increasing feelings of guilt or worthless
- Any thoughts about suicide.
Beyer says a person should consider seeking the help of a healthcare professional for anxiety if he or she experiences the following:
- Excessive worry
- Friends or family are telling them that they’ve changed in how they’re dealing with things
- Worry that is associated with muscular tension, difficulty with sleep, an increased startle reaction or irritability that’s making it challenging to function
Beyer says that a person should consider seeking the help of a healthcare professional for neurocognitive challenges or dementia if he or she is experiencing the following:
- Short term memory becomes much more of a problem with the exception of normal signs of aging . (Beyer says it’s normal as people age to forget certain words or names, or to struggle to remember where you put your glasses or keys, or to forget why you went into a particular room.
- Repeatedly asks the same question over and over again
- Finds it repeatedly difficult to remember how to get from one place to the other while driving
Beyer says there’s help for all of the above mental challenges, and encourages people to speak with a doctor if they’re concerned.
To learn more about geriatric behavior health research at Duke University School of Medicine, visit http://psychiatry.duke.edu/divisions/geriatric-behavioral-health.
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