We often hear people on the streets use the term “depression” to refer to a particularly tragic situation or their present emotional state. However, clinical depression along with other mental health concerns should not be ignored and left to fester, especially for those in the older age groups. The National Health and Morbidity Survey 2019 found that the national prevalence of depression in Malaysian adults is a significant 2.3 per cent – that’s about half a million of our population. The effects of mental health disorders can alter a person’s ability to function and live a rewarding life, especially for our warga emas. In this article, we debunk the 15 myths with facts about seniors’ mental health.
15 Myths and Facts about Seniors’ Mental Health
Myth 1: “Mental health is all in the mind.”
Fact: Mental health is a serious issue and can have severe repercussions on a person’s daily living and quality of life.
Despite the efforts for mental health advocacy, the stigma and discrimination against people dealing with mental health issues remain widespread. Many tend to label them as “dramatic” or “overly sensitive”.
Why this matters: The reality is that 1 in 3 Malaysian adults have experienced mental health issues in their lifetime, yet mental health is still a taboo in the eyes of many. It’s time to raise awareness about the common mental conditions in our society and seek to build a more informed and understanding community.
Myth 2: “You can self-diagnose your loved one’s symptoms.”
Fact: Self-diagnosis is often inaccurate and can pose detrimental risks.
For instance, you might observe your loved one exhibiting mood swings recently, but that doesn’t mean you can diagnose them with bipolar disorder. While it’s important to educate yourself as a caregiver and recognise the warning signs surrounding mental health, seeking professional help is the best course of action.
Why this matters: A licensed professional such as a psychiatrist or psychologist is equipped to evaluate a person’s symptoms and provide the right diagnosis and treatment of the mental health condition, and can monitor your seniors’ mental health and their road to recovery.
Myth 3: “You don’t have to see a professional for seniors’ mental health until it is serious.”
Fact: Mental health issues can and should be detected early.
Mental health disorders can occur in stages–mild to severe–and can be detected by a general practitioner for early intervention. Unfortunately, the symptoms are often overlooked by healthcare professionals and older people alike. As a result, seniors’ mental health is underdiagnosed and undertreated in the healthcare setting.
Why it matters: Prevention is better than cure. Older people experience mental health symptoms that can worsen over time if left untreated. Seek professional help if you are observing warning signs.
Myth 4: “Mental illness will go away with time.”
Fact: Mental health symptoms or disorders can be temporary or long-lasting, depending on genetic and environmental factors.
Some mental health disorders like anxiety and substance use disorder can be treated and improved after some months of therapy. However, they can be prone to relapsing in which the individual returns to their previous mental state. Others need longer-term therapy coupled with medication.
Why it matters: Feelings of sadness, hopelessness, and worthlessness can occur over prolonged periods. The effects can be so severe that it interferes with their daily lives. One way you can help a loved one battling a mental condition is by spending time with your loved one and providing emotional support.
Myth 5: “Dementia is a mental illness.”
Fact: Dementia is a condition of the brain in which there is a deterioration in cognitive functions.
Dementia is a neurological disorder that can progress over time. Although it is not classified as a mental health condition, some of the symptoms may appear very similar to depression; for instance, demotivation, social withdrawal and difficulty concentrating. It is not uncommon for people living with dementia to experience depression or apathy.
Why it matters: Getting the right diagnosis for your loved one’s condition helps you to get the right treatment for them. Although most dementia is irreversible, the support rendered by family can slow its progression and help improve your seniors’ mental health.
Myth 6: “Depression is caused by a tragedy in one’s life.”
Fact: Several internal and external factors can cause or contribute to depression.
Many people assume that depression is tied to an isolated incident in a person’s life such as the loss of a loved one. This leads them to conclude that the person struggling with depression can move on with time. In reality, several factors could lead to this condition, including hormone or brain chemistry imbalances, family history and lifestyle. A traumatic event in life could however influence the severity of the symptoms.
Why it matters: Understanding what factors contribute to the mental health condition can inform decisions about treatment as well as help destigmatise the condition.
Myth 7: “Mental health problems don’t impact other aspects of life.”
Fact: Mental health problems can in turn significantly impact your physical health.
Mental health issues can affect the physical body, causing the individual’s overall quality of life to decline. Elderly with depressive symptoms are said to have poorer functioning abilities compared to those with chronic medical conditions such as lung disease, hypertension or diabetes.
Why it matters: If your elderly folks are experiencing other health conditions, the impact of mental health could negatively influence their recovery and activities of daily living. Get the proper prognosis by consulting a doctor and home care support where needed.
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Myth 8: “People with severe mental health problems are violent.”
Fact: The majority of people battling mental health issues are not violent or dangerous.
Mental health disorders are often misrepresented in the media. Characters with schizophrenia, for example, are commonly portrayed to tend to impose harm on themselves or on others. In some parts of the world, mental illness is commonly attributed to spiritual influences.
Why it matters: Not only are these misconceptions harmful, but it also masks the fact that people suffering from mental health issues are victims of violence themselves. Studies reveal that victims young and old experience physical or sexual assault, violent threats and physical or verbal abuse, which can, in turn, result in worse psychological consequences in the individual.
Myth 9: “Once you start on antidepressants, you can’t go back.”
Fact: The effectiveness of the medication can vary depending on an individual’s living conditions and bodily response.
Medication does not cure the mental condition itself, but it helps manage the symptoms and could make other treatments like psychotherapy more effective. A longer-term dosage is only required for those who have multiple relapses. Furthermore, antidepressants are generally not addictive but can cause dependence. Consult your doctor for more information.
Why it matters: Although a common treatment for major depression, antidepressants are often frowned upon. Overcoming public stigma includes an openness towards the use of medication and treatment.
Myth 10: “It’s not possible to be diagnosed with multiple mental health disorders at a time.”
Fact: Comorbidity, which is the close relationship between mental health disorders, is not only possible but prevalent in the older population.
Various risk factors for seniors’ mental health issues increase with age. Reduced sensory functions coupled with a loss of connection can significantly affect their self-worth. New retirement can also trigger anxiety and depressive symptoms. As a result, the senior may experience multiple symptoms. Bipolar, for example, can coexist with substance use disorders and ADHD.
Why it matters: Many caregivers report that they would have sought professional help earlier had they known the symptoms
Myth 11: “Depression only affects women.”
Fact: Depression can impact both men and women.
Women are about twice as likely as men to reportedly experience or receive a diagnosis, of depression across ages. This could be associated with hormonal changes, menstrual problems, postpartum, menopause and other women’s health issues. With that said, it’s important to understand that men can experience depression for other factors. However, little is known about whether gender differences persist into late life.
Why it matters: Dividing emotional capabilities based on gender can be damaging for both male and female identities. It also reinforces the falsehood that men are incapable of feeling depressed.
Myth 12: “Depression is common and isn’t serious among senior adults.”
Fact: Depression is common among senior adults and should be taken seriously.
Our vulnerable older population is at risk of many mental health issues, but that does not mean that it is a part and parcel of ageing. Every individual deserves the right to live a rewarding life. Unfortunately, even seniors tend to neglect their health, attributing their mental health issues to common age-associated issues.
Why it matters: Depression and other similar symptoms are not a normal part of ageing and can foist more limitations in their activities of daily living. These symptoms should be managed with persistence. Promoting mental health among the elderly means providing them with the necessary resources that they need to lead healthy, active lifestyles.
Myth 13: “If your family member has a mental illness, so will you.”
Fact: Not all mental health conditions run in the family, and not every person with a family history of mental health issues will develop a condition.
Certain disorders that can be inherited include autism, ADHD, bipolar disorder, major depression and schizophrenia. However, if your grandaunt has bipolar, it does not guarantee that you will have it too. Experts found that if a second-degree relative has the condition, the chance of someone developing bipolar disorder is 5 in 100.
Why it matters: Maybe you grew up watching your grandparent struggle with a mental disorder and wonder if your now-older parent will too. Rather than worrying, take proactive steps to regularly check in with your parents. Make sure you are also caring for your mental health.
Myth 14: “Mental health is not important in older age.”
Fact: Mental health is just as important in older age as in any age.
Globally, around a quarter of deaths from self-harm are among people aged 60 or above. In Malaysia alone, suicide in those 65 years and above accounted for 7.1% of all suicides. Malaysia’s psychiatrist-to-patient ratio was only a tenth of the one per 10,000 and currently has fewer than 10 geriatric psychiatrists. Governments around the world are starting to recognise the need for quality mental healthcare. Healthcare providers play a central role in providing primary care to advocate and deliver psychosocial mental health support and intervention programmes that promote healthy ageing.
Why it matters: Parents, caregivers and educators are rising up as strategic partners to work hand-in-hand with our governments. Your support will make a big difference in the lives of individuals and families and make Malaysia a safer place to live.
Myth 15: “Mental health treatment is expensive in Malaysia.”
Fact: Numerous mental health services are affordable and free in Malaysia.
As the demand for mental healthcare rises in our nation, mental healthcare services in the private sector grew by an estimated 30 to 50 percent in recent times. However, many assume that mental health treatments are costly. Understandably, many struggle with the thought because they simply cannot afford to pay for these services.
Why it matters: Although no one can put a price on their loved one’s mental health and overall wellbeing, many are faced with the reality of financial struggles. There are mental health centres that provide their services for free or at a low-cost rate for a range of mental health disorders. Do not hesitate to reach out.
Changing how we view mental health in seniors
It may be difficult to pick up on seniors’ mental health due to age-related health and life factors. Adding to this is the fact that our elderly folks tend to keep their problems to themselves instead of notifying their caregivers or a medical professional. So how can we help our warga emas?
As a community, we need to stand in the gap with mental health professionals to raise awareness about the importance of mental health for seniors, for early detection and early intervention. Discrimination ultimately results from a lack of understanding. Therefore, make the conscious choice to see the individual, not the problem.
As for caregivers, the best thing you can do is to understand and observe the symptoms and risk factors of mental health disorders common to seniors. Be diligent to regularly check on them and communicate any changes in symptoms to your care professional.
Mental health care is a basic need for all. If you or someone you know is exhibiting symptoms of depression, seek professional help now.
Depression and many other mental health conditions can be long term. While medication and therapy are available, support from family and friends is crucial in the individual’s journey of overcoming mental health issues. However, caregiving can be a lot of added stress for home owners caring for their parents with severe mental health disorders. When the going gets tough, remember that you’re not alone. Help is always available. Don’t hesitate to reach out for support when you need it.
Have you considered engaging in caregiving services? Home care is an option to consider when those facing symptoms that get in the way of doing their daily chores. At Homage, we offer holistic care options including personal care, nursing services, or rehabilitation therapy, starting from one hour to round-the-clock care 24/7.
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