‘Log Kya Kahenge?’ 

Mental illness in the elderly is often overlooked and challenging to diagnose, and its effects can greatly diminish a senior’s health and well-being

Actor Anil Kapoor recently posted on his Instagram account:

“Some mornings are tougher than others. Some days I would rather hide another hour under the covers. But my work-out, and fitness regime will still be waiting when I roll back the covers. That’s why our mind plays such an important part in any health drive. The long-term solution to fighting microbes like COVID-19 is not complete isolation or endless disinfecting, but building immunity in the body and mind to fight such external aggravators, as this is not the first or the last one…Our mind is the one part of the body we have to work the hardest on, and yet the results of this hard work may not always be manifest to others.”

“Close to 1 billion people are living with a mental disorder, 3 million people die every year from the harmful use of alcohol and one person dies every 40 seconds by suicide. And now, billions of people around the world have been affected by the COVID-19 pandemic, which is having a further impact on people’s mental health” says Dr Charan Teja Koganti, Consultant Neuropsychiatrist, KIMS Hospitals.

Not every older person is ready to retire. They look at life in a perspective from their busy schedule and then there’s a sudden transition to a different lifestyle. With the changes in the physical health, their dear ones advise them to avoid their favourite foods to lead better, and healthier lives.

Mr Bhaskar has retired as a bank manager, loves to travel and makes travel plans with his wife every quarter. Though his family is vegetarian, he loves to eat meat and enjoy alcohol in privacy. He enjoys his life and others frequently join him to share his happiness. Simultaneously, there are elders who withdraw from social life, and engaging with others. The fellow elders may not seem to identify the withdrawal as a form of mental isolation. Even elders who are easily irritable are called out for their apparently rude behaviour, and the failure in recognizing their need to be heard, and thus their exclusion in a natural support system for them to lean on.

According to the World Health Organization, mental disorders affect approximately 15% of the population over the age of sixty, a number that is expected to increase substantially as the population ages.

“Lonely elders are the most effected during the pandemic with all the rules laid to protect them. Mental well-being of dependent elderly even in the pre-pandemic period was quite overwhelming to understand,” Sruthi Sivaraman, Psychologist, Nightingales Medical Trust.

“We’re living in unprecedented times. Fear and anxiety about a new disease and what could happen can be overwhelming and cause strong emotions in adults and children. “The levels of anxiety, hopelessness, fear, isolation, loneliness, uncertainty and emotional distress experienced have become widespread, as the world struggles to bring the virus under control and to find solutions. It’s time that we realise that mental health is a basic human right,” Dr Koganti, notes.

In fact, mental health is one of the most neglected areas of public health. “Countries spend just 2% of their health budgets on mental health,” Dr Koganti laments.

Feeling stressed, depressed, guilty, or angry is common during an event such as an infectious disease outbreak, even when it does not directly threaten you. “In the last few months I have observed certain changes in the mindsets of people — excessive worry about one’s own health and the health of loved ones, and about one’s financial situation or job; changes in eating patterns; worsening of chronic physical problems like hypertension, cardiac conditions, diabetes etc. worsening of mental health conditions like OCD, anxiety disorder, panic disorder etc.; increased use of substances like tobacco, alcohol etc.; and changes in mood, including mood swings, irritability, low mood, low energy levels etc.,” says Dr Koganti

Citing an example, Sruthi, says, “Mr Vinod was feeling anxious during bedtime. Eighty – two years old, and with a slow gait, Mr Vinod realised that he was worrying about a lot of things beyond his control. He approached a therapist to acknowledge this change.  With regular sessions, he began to sleep better, eat adequately and engage in conversation with others to overcome his recurrent distressful thoughts.  Focussing in the early identification of changes in mood can help the elderly undergoing therapeutic sessions to support themselves to cope with the deterioration and work towards stress-free life. This doesn’t need to be done by tagging a diagnosis but addressing the distress that the individual goes through.”

The pandemic has disrupted the daily routines of most people, and has made it harder for people to remain productive. But Dr Koganti feels “Setting a routine is important. This will help you stay productive, even if your productivity level doesn’t remain consistent with pre-pandemic levels. One must also set limits on how much time is spent reading or watching news about the outbreak, as it can fuel anxiety and fear.” While acknowledging that “You will want to stay up-to-date on news of the outbreak,” his advice is, “make sure to take time away from the news to focus on things in your life that are going well and that you can control.”

To meet the demanding nature of addressing mental health issues in the elderly, it might be beneficial to sustain life with pleasant experiences until fate chooses to culminate it.

Dr Koganti suggests a few practical ways to relax, and boost mental health:

• Take deep breaths, stretch, meditate, or engage in pleasurable hobbies – whatever works best for you – often.

• Pace yourself with regard to stressful activities, and do a fun thing after a hard task.

• Use time off to relax—eat a good meal, read, listen to music, take a bath, or talk to family.

• Talk about your feelings to loved ones and friends often.

Stay Healthy

– Eat healthy food, and drink plenty of water.

– Avoid excessive amounts of caffeine and alcohol.

– Do not use tobacco or illegal drugs.

– Get enough sleep and rest.

– Get physical exercise.

Words of caution: 

Reach out for help as soon as you feel you need it. Don’t assume that you will automatically get better with time. A thorough assessment and treatment by a mental health professional is a must.

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