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Depression on the rise in the elderly

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Saleema Noor (name changed), 70, has been a widow for four years. She is not assisted by any of her relatives, while her only son has also moved to a foreign country for a job. The loneliness took a toll on her mental health and she is now dependent on antidepressants and other medications.

“It’s hard to live alone. I don’t want to leave my house because I have memories of my husband here, ”she said.

Before Noor’s husband died of chronic obstructive pulmonary disease (COPD), the duo would go out jogging or visit different places.

“My son sends me enough money, but every time, money alone cannot help me get out of my loneliness and anxiety,” she said.

Like Saleema, there are other widows and elderly people who suffer from anxiety, depression and other mental health issues in Kashmir.

The Institute of Mental Health and Neuroscience (IMHANS) in Srinagar receives 60 elderly patients with different cases of mental disorders every day and the number is increasing every day.

“The elderly population suffers enormously. We have seen delusional disease which is a confusing condition and post-covid dementia in the elderly. Loneliness can have a negative effect on the mental health of elderly patients, ”said Dr Yasir Hussain Rather, psychiatrist at IMHANS, in Rising Kashmir.

He said that the elderly face different issues such as neurodevelopmental disorders, depression and anxiety, dementia and newly onset dementia.

Additionally, lockdowns imposed after the COVID outbreak affected the incomes of many families, which in turn severely affected their mental state. Ghulam Mohammad, 60 (name changed), an old town resident has struggled to meet basic needs since the COVID-19 outbreak. He was selling fruit on a cart but his financial conditions weakened further due to the pandemic, which in turn affected his mental health.

Dr Mohammad Maqbool Dar, HOD Psychiatry, IMHANS, told Rising Kashmir that loneliness creates stress and increases hormones inside the body which lowers a person’s immunity leading to serious illness.

“Older people often suffer from vacuum syndrome. Loneliness and social isolation are often found in the upscale neighborhoods of the valley, ”he said.

According to official figures, more than 5,773 psychological and psychotherapeutic tests, 551 modified ECTs, 1,075 ECGs were performed at IMHANS from April 2020 to June 2021.

According to doctors, “The mental health of the elderly is a neglected area with insufficient attention from almost all quarters. There is still a lack of awareness of elderly mental health among the general public, caregivers, health planners and administrators. “

Doctors have said mental problems at the end of life contribute to significant morbidity. “Mental illness at the end of life could be due to long-standing psychiatric disorders with onset early in life or late onset after age 60,” they said.

Age is an important determinant of mental health. Old age is a period of transition where one must face not only physical aging, but also challenges affecting mental and social well-being. Due to normal aging of the brain, deteriorating physical health and brain pathology, the overall prevalence of mental and behavioral disorders tends to increase with age.

Disability resulting from various illnesses, loneliness, lack of family support, limited personal autonomy and financial dependence are other important factors contributing to a higher prevalence of mental and behavioral disorders.

Neuropsychiatrist Dr Umar Jan told Rising Kashmir that among the various mental disorders, depression is the greatest burden in the elderly. “Depression decreases an individual’s quality of life and increases their dependence on others. If depression is left untreated it can have important clinical and social implications in the lives of older people, ”he said.

Dr Jan said that early detection, diagnosis and initiation of treatment for depression in older people provide opportunities to improve their quality of life, prevent suffering or premature death, and maintain optimal levels of function and independence. “Early diagnosis and effective treatment of depression in the elderly can also lead to significant reductions in mortality from suicide and medical illnesses, as well as health care costs,” he said.

He added that at the Ganderbal District Hospital, since 2019, elderly patients (men and women) enter OPD with severe insomnia, fear of death, bad mood, lack of appetite, multiple joint pains and somatization.

“Major depression, dysthymia (long-standing depression) and bipolar depression are very common in older people in Ganderbal. It is therefore mandatory for them to consult a psychiatrist as soon as possible to improve their quality of life, ”said Dr Jan.

In India, 30 percent of the 103 million people over the age of 60 show symptoms of depression, according to a recent government survey. It is estimated that 8.3% of the country’s senior population is likely to suffer from major depression. This means that one in 12 older people in the country suffered from depression.

The prevalence figure is 10 times higher than self-reported diagnosed depression by 0.8% in the elderly population, underscoring the burden of undiagnosed cases, according to the report.

Among people aged 45 to 59, 26% have symptoms of depression.

According to the results of the Longitudinal Study on Aging of India (LASI) published by the Ministry of Health, one in five older people in India has mental health problems. About 75 percent of them suffer from chronic illness. And 40 percent have one or the other disability.

The survey found that more than one in 10 people aged 60 and over suffers from a “likelihood of major depression”.

Growing by around 3% per year, depression in the elderly will rise to 319 million in 2050, up from 103 million in the 2011 census, according to estimates by the United Nations Population Division, 2019.

The prevalence of probable major depression in people aged 60 and over (8.3%) was found to be 10 times higher than the self-reported prevalence of diagnosed depression. More women suffered from depression than men in rural areas.

More than two-fifths of people aged 60 and over, who are currently working or have worked in the past, reported having health problems that limit work.

Prevention of mental health problems in the elderly

According to Dr Yasir Hassan Rather, the psychiatrist of the Institute of Mental Health and Neurosciences (IMHANS) older people are more vulnerable to mental health problems and this is the reason why they do not only need medication. once the mental health disorder has developed, but they need to follow preventative behaviors for better mental health.

In old age, as there is less professional work or housework, a lot of free time is available, so they have to keep busy.

At this age, since feeling depressed is one of the main complaints, people should be more interactive within the family, engage in conversations, and not isolate themselves. Being calm or isolated can start the spiral of depression in them.

A certain amount of physical activity is important because physical activity is seen to release endorphins, which will make you feel good.

Neuropsychiatrist Dr Umar Jan told Rising Kashmir that there are many lifestyle changes and stress management techniques that can be used to prevent or prevent depression from relapsing, even if you have had one in the past. previous episode. Stress management techniques include:

Exercise

Getting regular exercise is one of the best things you can do for your mental health. It increases your body temperature, which can have a calming effect on the central nervous system. It also releases chemicals like endorphins, which can improve mood in addition to reducing immune system chemicals that can make depression worse.

Build a strong relationship

Having a strong support system and an active social life is important for our mental health. Make sure to connect with your friends and family regularly, even when your life is busy. Being part of a network of friends gives you a sense of belonging and self-worth, which can help you through difficult times.

Reduce stress

Not all stressors are under your control, but some are. Being selective about what you do – and saying no to things that will add unnecessarily to your load – can reduce your stress levels.

Maintain the treatment plan

If you’ve been through one episode of depression, there’s a good chance you will have another. This is why maintaining your treatment plan is so important. You should always take your medicines as directed by your doctor and should never stop them suddenly. Equally important is having “follow-up” visits.

Have had plenty of sleep

Quality sleep is necessary for both mental and physical health. To sleep better, you should watch all screens for two hours before bed (including your phone) and avoid caffeine in the afternoon.

Eat well and maintain a healthy weight

Poor nutrition can rob your body of essential nutrients that are needed to maintain physical and mental health. Eat balanced meals with lean protein, lots of fruits and vegetables, and cut down on foods high in sugar and fat.


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