Understanding Mental Health in Older Adults

Jul 6, 2021

According to the World Health Organization, at least one in four older adults experiences some mental disorder, such as depression, anxiety, or dementia. Among the elderly, depression is a major public health concern leading to increased disability and morbidity. Mental health challenges are common among older adults and may include anxiety disorders, dementia, and psychosis, among others.

According to Heidi Billitier, director of older adult services at Compeer, isolation is a huge problem and mental health challenges can sneak in and stir up feelings that lead to depression and anxiety.

“Depression and anxiety are not a normal part of aging. It’s a myth that older adults should expect to be depressed or anxious,” Billitier said. “Stigma is a barrier for seeking help and many in this generation were taught that you manage your mental health at home with your family.”

Older adults share information about physical ailments but are less likely to seek help for mental challenges. Those who experience loss of friends and loved ones experience situational anxiety, and this can be treated.

Billitier notes that during the pandemic, more older adults sought help when they concluded that without support, they were not going to move forward. The ability to access telemedicine was a silver lining during quarantine periods.

The Health Foundation of WNY is working to address social isolation. Social isolation refers to objectively fewer social contacts and social relationships, while loneliness is the subjective emotional experience of feeling alone. According to a 2020 study by the National Academies of Sciences, Engineering and Medicine, approximately 24 percent of people 65 years old and older are considered to be socially isolated, with 43 percent of adults over 60 reporting that they feel lonely.

The effects of social isolation and loneliness have a major lasting impact on the mental and physical health of older Americans, as well as family caregivers. Chronic loneliness is closely associated with the onset of depression, sleeping issues, impaired cognitive functioning, hypertension, and physiological and psychology stress, in addition to other mental and physical health issues.

Impact of Stigma

Stigma associated with mental illness continues to be a significant barrier to older adults seeking help, leading to negative attitudes about mental health treatment which deters individuals who need services from seeking care. Kelsie Earle, outreach aide, Erie County Senior Services, says many depressed older adults experience a high level of stigma and were not likely to be currently engaged in, nor did they intend to seek mental health treatment.

This affects quality of life greatly. Without appropriate mental health intervention, older adults with mental health challenges experience significant disability and impairment, including impaired quality of life, increased mortality, and poor health outcomes.

Melissa Abel, deputy director, Amherst Center for Senior Services, states that the misconceptions of ageism and mental health issues, social isolation, high healthcare costs, and limited geriatric doctors are challenges for the older population. Their physical and chronic conditions may take precedence at a doctor’s appointment. They may feel embarrassed or feel they are a burden to their family or friends and by believing so will lead to a dangerous situation of social isolation.

“They can further withdraw from activities, families, friends, further increasing their social isolation,” Abel said. Mental health challenges can cause changes in eating habits, lack of exercise, and changes in sleeping habits, inability to cope with daily problems, stress, and failure to deal with daily responsibilities, such as paying bills, taking care of their home or personal care needs. They may also have excessive anger, hostility or experience suicidal thoughts.

She encourages older adults to reach out to social case workers or outreach staff who are trained to listen, offer support and guidance, and refer to local agencies as needed.

Family and Caregiver Support

If you notice changes in your loved one, don’t hesitate to seek help. Billitier suggests watching for changes in behavior such as neglecting hygiene or new difficulties with independent tasks. “Depression and anxiety have a way of creeping in,” she said. “Mental health is very real, treatable and manageable.”

Abel, who works with older adults in Amherst, encourages families to listen, be patient, be non- judgmental, and encourage their loved ones to seek help from a mental health care provider or their primary care professional with whom they may be more comfortable.

Community Services

Erie County Senior Services provides many services for the senior population such as case management, insurance counseling, family caregiver assistance, transportation, wellness and nutrition and home care. There are initiatives and programs within these services such as Combat Social Isolation, University Express, Volunteer opportunities (RSVP), Go and Dine and more. Visit erie.gov/seniorservices, or call 716-858-8526.

Compeer matches trained volunteers with older adults living with a mental health challenge. Individuals 60 and older can be linked with a friend who will support them through their mental health journey. Visit compeerbuffalo.org

Jewish Family Services offers Aging Care & Connections to help older adults remain as independent as possible for as long as possible in the environment of their choosing. This includes a full range of programs, including care management, homemaker services, counseling, and educational and recreational activities.

The Anti-Stigma Coalition also lists other resources for seniors at letstalkstigma.org

How Depression is Different for Older Adults

  • 80% of older adults have at least one chronic health condition, and 50% have two or more. Depression is more common in people who also have other illnesses (such as heart disease or cancer) or whose function becomes limited.
  • Older adults are often misdiagnosed and undertreated. Healthcare providers may mistake an older adult’s symptoms of depression as just a natural reaction to illness or the life changes that may occur as we age, and therefore not see the depression as something to be treated. Older adults themselves often share this belief and do not seek help because they don’t understand that they could feel better with appropriate treatment.


“At least one in four older adults experiences some mental disorder, such as depression, anxiety, or dementia.”

World Health Organization

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