Jennifer Christian Herman, Ph.D., vice president, Mindbody Medicine at Blue Shield of California, shares important points for older adults about behavioral health, mental health stigma, the effect of the pandemic on this health problem and how treatment and self-care can help.

How has the pandemic affected older people?

It became apparent early in the COVID-19 pandemic that people aged 65 and older according to the Centers for Disease Control (CDC) were at risk for their physical health. But the impact of the virus on the elderly goes beyond the physical. This had an impact on their mental health. Whether it’s social and economic hardship or a lack of access to family, friends or even healthcare providers, older adults have experienced an increase in feelings of isolation, depression, anxiety and sleep disturbances, some of which can be attributed to irregular physical activity.

What are some of the common mental health issues older people face?

According to the World Health Organization, more than 20% of adults over 60 suffer from a mental or neurological disorder (excluding headaches) and 6.6% of all disabilities (years of life adjusted on disability – DALY) in people over 60 are attributed to mental and neurological disorders. Dementia, depression, anxiety disorders and substance abuse are the most common. In most cases, these mental health issues can be treated, but older people are less likely to seek or receive care. This is partly due to stigma and the mistaken belief that their symptoms are part of normal aging.

How to detect depression in seniors?

Depression is not just having “the blues” or the sadness of grieving the loss of a loved one. It is a medical condition that can be treated, like diabetes or high blood pressure.

A depressed person has feelings of sadness or anxiety that can last for weeks at a time. He or she may also experience:

• Loss of interest in once enjoyable activities or hobbies
• Noticeable changes in mood, energy level, or appetite
• Difficulty concentrating, remembering and making decisions
• Difficulty sleeping or sleeping too much
• Feeling of hopelessness and/or pessimism
• Feelings of guilt, worthlessness and/or helplessness
• Irritability, restlessness
• Suicidal thoughts, suicide attempts
• Persistent pain, headaches, cramps, or digestive issues that don’t improve, even with treatment

It is important to know the signs and symptoms of depression and to watch for the clues. Ask the person directly if you are concerned. Listen carefully if someone says they feel down, depressed, or empty. The person can really ask for help.

Why do seniors develop depression?

The reasons older people develop depression are usually different from the reasons the problem affects young adults or children. Here are some examples why:

• Social isolation: Concerns about COVID-19 and the need to stay away from others for a long time over the past two years have had a big impact on the mental health of seniors.
• Medical conditions: Older people with a chronic condition like diabetes or heart disease put them at greater risk of depression than healthy people, and aging adults are more likely to have one or more persistent health conditions.
• Significant life events: A traumatic event such as the death of a spouse or partner or another loved family member or friend increases the risk of developing depression.

Health care providers may confuse an older person’s symptoms of depression with a normal or natural reaction to illness, disability, or life changes that may occur with age and therefore may not think that depression needs to be treated. Unfortunately, this means older people are often misdiagnosed, not diagnosed at all, and undertreated when it comes to depression.

Older adults may be less likely to recognize that they are experiencing mental health symptoms and may not realize that they would feel better with appropriate treatment. This may be partially due to the stigma that exists with mental health issues or other reasons. It’s important to check on the older people in your life and ask how they are doing, especially if you notice a change in their behavior and/or mood.

When is the right time to seek help and how can seniors find care?

It’s important to seek help as soon as you or someone you love starts experiencing symptoms. Even severe depression can be treated. Getting treatment as soon as possible is important.

• Start by making an appointment with a primary care doctor or mental health care provider to discuss what’s going on and see if treatment might help.
• If you notice changes in mood or behavior in an older family member or friend, encourage them to speak to a healthcare provider as soon as possible.

How can self-care and a healthy lifestyle help seniors maintain their overall well-being?

Eating well, being active and interacting with others play an important role in maintaining good mental and physical health.

Seniors who have medical coverage with Blue Shield of California have access to Wellvolution at no additional cost, which includes online programs and resources to improve mental well-being, weight loss, smoking cessation, treatment of diabetes, etc. One behavioral health app available to Wellvolution participants, for example, is Headspace, a mindfulness and meditation app that offers hundreds of tools and over 1,000 exercises to reduce stress and improve mental wellbeing. .

If you have a family member or friend with mental health issues:

• Encourage the person to discuss their symptoms with their primary care physician or other healthcare providers and offer to help them find a therapist or other behavioral health clinician if needed.
• Openly discuss issues, such as depression, as you would a physical health issue, such as diabetes or heart disease, to reduce stigma.
• Encourage them to participate in activities like walking, socializing or enjoying nature. Older generations may be less comfortable discussing mental health and offering suggestions to help them can reinforce that you are there for them.

To learn more about Blue Shield of California’s Medicare plans: