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Mental Illness, Undiagnosed
and Untreated in Many Older Americans

by Betty Soldz

Mental health needs of older Americans have long been ignored. People mistakenly believe that mental health problems are a normal part of aging. This is false. When mental illness occurs, it is real and should be treated. The more we learn about our mental health the more we will be prepared to help ourselves.

One of the most undiagnosed but treatable mental illnesses is depression. The American Association for Geriatric Psychiatry indicates that 15 of every 100 Americans over 65 suffer from depression. There is no one cause of depression. For some people only one event can bring on the illness. It may be triggered by a loss such as the death of a spouse, friend or relative, retirement, change in one's living situation, and decline in one's health status. Depression is sometimes triggered by prescription drugs. Scientists also think some illnesses can cause depression. Genetics may also play a role. Studies show that depression may run in families. Left untreated the impact of depression on elderly individuals can be devastating. Older adults have the highest suicide rate of any age group in this country. The National Institute of Mental Health (NIMH) states that adults over the age of 65 accounted for 18 % of all suicide deaths in the year 2000.

According to OWL, the Voice of Midlife and Older Women, the nation's mental health system is geared toward people who recognize they have a problem and seek help. Many elders do not fit this description. They do not seek help because they do not know what is wrong, they only know they feel bad. Also, depression may mask itself as a physical problem such as lack of sleep, a stomach ache, lack of energy, loss of weight or other physical problems.

Everyone gets the blues once in a while. It is a part of life but when you can find little joy in life at times when you should be feeling joy there may be a problem. Being depressed without letup can change the way you think or feel.

The National Institute on Aging lists the following signs of depression and suggests that if these last for more than two weeks a person should see their doctor.

An "empty" feeling, ongoing sadness, and anxiety.
Tiredness, lack of energy.
Loss of interest or pleasure in everyday activities, including sex.
Sleep problems, including very early morning waking.
Problems with eating and weight (gain or loss).
A lot of crying.
Aches and pains that won't go away.
A hard time focusing, remembering, or making decisions.
Feeling that the future looks grim; feeling guilty, helpless, or worthless.
Being irritable.

Thoughts of death or suicide, a suicide attempt.

The subject of mental health makes some people uncomfortable but the first step to getting help is to realize that help is needed. Some people think they will "snap out of it" but it is important to seek help if your symptoms don't go away. Start by talking with your family doctor who may suggest you see a mental health specialist. Many doctors have not been trained in geriatric medicine and the special problem of depression in elders; therefore, if your physician does not take your concerns seriously seek the opinion of another doctor.

One of the barriers to care is the discrimination in payment for mental health treatment by Medicare. While Medicare pays 80 percent of the doctor's fee for treatment of "physical" illness, it pays only 50 percent of the fee for mental health care. This leads many elderly on a tight budget to avoid seeking care. It also leads society to downplay mental health needs. This inequality in Medicare payments needs to be addressed by Congress.

OWL suggests that there are several myths regarding older Americans and mental health. The following are a few of these myths.

1. Older Adults are like everyone else. Therefore they don't need specialized service.

2. Older adults' doctors take care of them; their needs aren't overlooked.

3. Depression is a part of aging; older people with depression won't get better.

4. The system is doing all it can to help older adults with mental illness.

Information debunks these myths. Current Medicare policy does not promote the mental health of older Americans. Only one in 20 depressed Americans over 65 get help because depression and anxiety are often masked as physical problems. There is also a shortage of geriatric doctors who understand the health needs of elders.

Depression is not a normal part of aging. Seek help. Mental illnesses are real, common and treatable. Mentally healthy adults continue to learn and grow, enjoy life and contribute to society.

Many organizations can offer you more information on mental health. The following are some of them.

The National Institute of Mental Health 1-800-421-4211

The National Mental Health Association 1- 800-969-6642

The National Institute on Aging 1-800-222-2225

The National Alliance for the Mentally Ill 1-900-959-NMHA

OWL, The Voice of Midlife and Older Women 1-800-825-3695


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