Mental health issues are not exclusive to any demographic. People of any age can be dealing with either psychological or physiological issues that impact their mental health. Advocacy groups and medical professionals continue to try and break down the stigmas surrounding mental health to allow people the courage, safety, and comfort to seek help. Here we are going to outline some of the considerations to do with mental health in the senior population, specifically anxiety, bipolar and personality disorder.
The feeling of anxiety from time to time is normal. For example, starting a new job, moving, or a relationship ending are all situations that can produce higher levels of anxiety. However excessive and chronic anxiety, worry, and fear, may be considered a disorder when it starts to interfere with your everyday life and disrupt or prevent regular tasks. This can look different in different age groups and research is supporting the idea that age needs to be factored into treatment decisions in regards to mental health.
Anxiety disorders don’t necessarily worsen or progress with age, but anxiety can develop at different stages in life. This can be a result of several factors, including changes in the brain and nervous system, and being more likely to experience stressful life events that can trigger anxiety. The forms of anxiety that people face may also vary with age. Phobias are more common in children, panic disorder is more common in middle-aged adults, and older adults are more likely to experience what is known as a generalized anxiety disorder.
Adults 60 and above are more likely to experience physical symptoms of anxiety than younger groups. This age group also has a higher risk of other medical issues, which can increase the risk of developing serious anxiety. Along with constant and debilitating worry, older adults with anxiety often show physical signs like weakness, fatigue restlessness and poor concentration. However, they may be reluctant to talk about their feelings or admit they’re dealing with an emotional issue. It’s important to be aware of this because older adults with anxiety tend to experience other mental health issues, like depression, at the same time.
Factors that can increase the risk of anxiety in older adults include medical problems, chronic pain, limited and reduced physical function and ability, loss of family, friends and network, financial changes due to retirement, and sadly, elder abuse. Treating anxiety in older adults may include psychotherapy and/or medication along with practicing relaxation strategies to reduce stress can also be helpful. Routine, structure, and predictability can also help reduce anxiety.
Does bipolar get worse with age?
Bipolar disorder is a mental health condition that causes wide fluctuations and variances in mood and energy levels and demeanor. Symptoms of this disorder can appear at any age, but most experience symptoms beginning in their late teens or early adolescence.
While everyone experiences mood swings at times, a person with bipolar disorder experiences extreme differences in mood that can affect their ability to think rationally and can interfere with their day-to-day life. This can lead to erratic and sometimes reckless and dangerous decisions.
Symptom severity can vary from one person to another. Mood swings include episodes of both mania and depression, which may occur in rapid sequence or may seem to go away for sometimes months or years. Mania is a hallmark symptom of bipolar disorder, and a person must have experienced at least one episode of mania or hypomania to be diagnosed with this condition. Symptoms of mania include, racing thoughts, talkativeness decreased need for sleep, agitation, increased energy and a sense of euphoria or exaggerated self-confidence
Like many mental health conditions, it is possible to effectively control symptoms of bipolar disorder by following a treatment plan created by a doctor or mental health professionals. While symptoms may worsen with age, obtaining effective treatment can help manage any progression of symptoms. In most cases, bipolar disorder is a lifelong illness that will continue to require treatment.
While there has been increased research in the complexities of Bipolar Disorder, there is limited data when it comes to the senior population. Variables such as concurrent illness, early or late diagnosis, and any other form of cognitive impairment that can be a result of aging. Some research suggests that older adults may be more susceptible to rapid cycling, defined as four episodes of depression or mania over the course of twelve months.
When managing Bipolar later in life it is key to keep up with medications and therapies. As well, it is important to recognize if treatments may be losing effectiveness. This could indicate a need for a change to medication, a different therapy approach, or an assessment of living situations to determine if outside factors could be contributing to a worsening of symptoms.
Do personality disorders get worse with age?
A personality disorder is a type of mental health disorder traditionally characterized by a firm and unhealthy or dangerous pattern of behavior and thoughts. People with a form of personality disorder generally have trouble observing and connecting to situations and people. Personality disorders usually begin in the teenage years or early adulthood. There are many types of personality disorders and a generalized list can be found here.
Personality disorders unfortunately do appear to progress and worsen with age. The prevalence remains consistent however with 10%-20% of people age 65 or older having a personality disorder, studies suggest. Personality disorders do not appear or get diagnosed for the first time in old age, statistically speaking. A personality disorder is a lasting pattern of behavior of long duration, and persistent, and causes clinically significant impairment by producing behavior that markedly deviates from social expectations. That is, patterns of thinking and actions that may seem normal to the person with the condition but are disruptive to those around them.
Personality disorders that have been shown to progress negatively with age include paranoid, schizoid, schizotypal, obsessive compulsive, borderline, histrionic, narcissistic, avoidant, and dependent disorders. Some are particularly susceptible to worsening in response to specific stressors and influencing factors. For example, a reliance on strangers and caregivers poses a risk for aggravating paranoid, schizoid, schizotypal, and avoidant personality disorders. Loss of looks, attractiveness and the physical results of aging can be a stressor and problem for people with histrionic, narcissistic, or borderline disorders, where physicality and appearance is important.
Dealing with the progression of a personality disorder is a delicate matter which will require professional intervention. When evaluating an elderly patient with a personality disorder, working with the patient is incredibly important. Caregivers and mental health professionals should identify what is treatable and what is an achievable goal that the patient agrees to work toward. Treatment should be respectful and aim to produce the most symptom relief, allow interdependence, accommodate change, and support healthy narcissism.
Lastly, a personality disorder can interact with dementia, what is known as a comorbidity. It is possible that whatever the type of personality disorder, it may adapt to the memory loss of dementia and may respond to negative societal feedback. Drugs used to slow progress of dementia also can affect a personality disorder.
It is important to recognize the patterns and any changes to your or your senior loved one’s mental health. Vigilance and care will be helpful in preventing decline and progression of some serious conditions, and alleviate the symptoms and seriousness of anxiety and depression.