{"id":7114,"date":"2022-11-02T06:19:02","date_gmt":"2022-11-02T10:19:02","guid":{"rendered":"https:\/\/www.silvercentury.org\/?p=7114"},"modified":"2022-11-01T20:22:43","modified_gmt":"2022-11-02T00:22:43","slug":"older-peoples-mental-health-undermined-by-the-pandemic","status":"publish","type":"post","link":"http:\/\/78.142.243.82\/~silvercentury\/2022\/11\/older-peoples-mental-health-undermined-by-the-pandemic\/","title":{"rendered":"Older People\u2019s Mental Health Undermined by the Pandemic"},"content":{"rendered":"

In early 2020, Sarah Crouch started a tally on her cell phone: a list of names of family members and friends who died since the pandemic began. As of July 2022, there were 51 names. About half died due to COVID-19. <\/span><\/p>\n

\u201cSome weeks there were two deaths of close friends in one week,\u201d said Crouch, 72. \u201cOne person would die, and I barely had time to grieve before the next one hit.\u201d <\/span><\/p>\n

On top of all that, her father-in-law almost died in November 2020. He spent two weeks in the hospital alone, because visitors weren\u2019t allowed. Around the same time, her husband contracted COVID. Thankfully, both recovered, but with all the stress, Crouch\u2019s own health started to suffer. Her thoughts raced. She couldn\u2019t sleep. <\/span><\/p>\n

\u201cI had sudden hearing loss,\u201d she said. \u201cI spent six weeks in bed with vertigo. My body just quit on me. Because of all of that, one of my doctors said, \u2018You know what? I think you should probably talk to a counselor.\u2019\u201d <\/span><\/p>\n

Crouch was reluctant. She worried therapy was too costly. She\u2019d tried it in the past; it didn\u2019t help. But she took her doctor\u2019s advice and contacted a psychologist. <\/span><\/p>\n

Isolation and Loneliness<\/b><\/p>\n

Crouch wasn\u2019t alone. In the United States at the beginning of 2021, an estimated one in five older adults, ages 50 to 80 were experiencing mental health symptoms, such as depression, anxiety, insomnia or substance abuse, according to the University of Michigan National Poll on Healthy Aging. When asked about the last two weeks before they were surveyed, 28 percent said they had felt depressed or hopeless, 34 percent had been nervous or anxious, and 44 percent had recently felt stressed. Almost two-thirds reported trouble falling asleep or staying asleep, twice the percentage who reported sleep problems in a similar poll in 2017. <\/span><\/p>\n

Nora Gravois, a licensed social worker and counselor at the nonprofit Wellness Center for Older Adults in Plano, TX, witnessed these effects of the pandemic firsthand.  <\/span><\/p>\n

\u201cWe got calls from neighbors, church members or family, asking us to check on an older adult who hadn\u2019t opened their curtains for ages, or whose mail was piling up,\u201d she said. \u201cOlder adults were isolated, and some didn\u2019t have the emotional resilience to call us for help themselves.\u201d <\/span><\/p>\n

Even before the pandemic, older people were at higher risk of social isolation and loneliness than younger age groups. Studies show that loneliness can trigger anxiety, anger and emotional instability or contribute to physical problems like hypertension. For some, the restrictions imposed by the pandemic led to even deeper isolation.<\/span><\/p>\n

\u201cWhat we saw in our grief support group was almost like a trauma response,\u201d Gravois said. \u201cOur clients were not able to physically touch or say goodbye to their loved ones at the time of death. Grief and loss became a traumatic experience for them.\u201d <\/span><\/p>\n

An Outpouring of Sadness and Worry<\/b><\/p>\n

Susan Rebillet, a geriatric psychologist in Dallas, saw a dramatic uptick in physician referrals beginning in the summer of 2020. <\/span><\/p>\n

\u201cSo much had happened,\u201d she said. \u201cOn top of the pandemic, there was political turmoil and the Black Lives Matter movement. It was a chaotic time.\u201d  <\/span><\/p>\n

Some patients needed help from a child or grandchild to connect online with Rebillet, but once they did, there was an outpouring of feelings of grief, loss, sadness and worry. <\/span><\/p>\n

\u201cMany people had a real fear of dying themselves or losing someone to the virus,\u201d she said. \u201cThere was a lot of information out there that wasn\u2019t helpful or accurate. I told many patients, \u2018Do not watch the news 24 hours a day.\u2019\u201d <\/span><\/p>\n

Everyone was affected by the disruptions and restrictions of the COVID pandemic, but some older adults were hit especially hard, according to Lisa Murray, a social worker with OhioHealth\u2019s John J. Gerlach Center for Senior Health in Columbus, OH. <\/span><\/p>\n

\u201cIf you\u2019re an older adult who\u2019s living alone, or who cannot drive because of mobility or cognitive issues, then COVID meant you no longer had access to services that provided transportation,\u201d said Murray. \u201cWe saw people falling out of their normal routines that helped sustain their mental health, whether it was going to church or being involved with family dinners.\u201d <\/span><\/p>\n

For older people, the psychological work of this life stage is stymied without social connections.<\/b><\/p><\/blockquote>\n

\u201cWhile depression is not a normal part of aging, there were so many changes during the pandemic that increased the risk of depression,\u201d said Lakshmi Rangaswamy, DO, a geriatrician at OhioHealth Riverside Methodist Hospital in Columbus, OH. <\/span><\/p>\n

She added that depression and anxiety in older adults can manifest in unexpected ways. She saw patients during the pandemic with pseudodementia, in which anxiety or depression triggered symptoms that mimicked dementia. <\/span><\/p>\n

\u201cIn those cases, when we treated the anxiety or depression, the cognitive impairment improved,\u201d she said. <\/span><\/p>\n

While the media highlighted concerns about the effects of the lockdown on children and youth during their formative years, Gravois says, \u201cThe pandemic was a disruption for older people too, because every stage of life has its own challenges.\u201d <\/span><\/p>\n

Gravois cites Erik Erikson\u2019s stages of psychological development, which span the entire lifespan from birth to death. Just as young people must grow and mature in childhood and adolescence, older adults face their own psychological challenges in later life. Retirement, for example, demands that older adults find new ways to contribute and stay engaged, once a career is over. Older people often reflect on their lives and look to find peace with the past, rather than feeling stuck in despair or regret. But without social connections, the work of this life stage gets stymied. <\/span><\/p>\n

Janet Pyne, 66, saw that in the spring of 2020, when she retired from her job as an assistant principal in Austin, TX. As they had planned for years, she and her husband, Rick, moved shortly after her retirement to be near grandchildren in the Dallas area. <\/span><\/p>\n

Because school was virtual due to COVID, \u201cI never got to tell my co-workers and students goodbye in person,\u201d she said. \u201cIt was a sad and depressing way to leave a job I loved.\u201d <\/span><\/p>\n

Overcoming Hesitations <\/b><\/p>\n

Another complicating factor affected older adults\u2019 mental health during the pandemic: reluctance to seek mental health care. Past research showed that many older adults who need that don\u2019t get it. One 2012 study, for example, showed that 70 percent of older adults with mood and anxiety disorders did not use mental health services.  <\/span><\/p>\n

But more recent research suggests that the pandemic may have moved the needle. A voluntary survey of nearly 4,000 Medicare recipients, published by eHealth, found that more people were willing to seek mental health care two years into the pandemic. Nearly half (48 percent) were willing to consider talk therapy or another form of mental health care, up from 35 percent pre-pandemic. <\/span><\/p>\n

Similarly, the 2021 University of Michigan poll indicated that older adults were now more open to seeking mental health, with 71 percent saying they wouldn\u2019t hesitate to see a mental health professional in the future and 13 percent saying they had talked with their primary care provider about a new mental health concern since the pandemic began. More than 85 percent reported feeling \u201cvery comfortable\u201d or \u201csomewhat comfortable,\u201d talking about their mental health.  <\/span><\/p>\n

\u201cMost older adults do feel comfortable discussing their mental health and understand that it\u2019s an important component of overall health,\u201d said Lauren Gerlach, DO, a geriatric psychiatrist at Michigan Medicine who worked with the University of Michigan poll team. <\/span><\/p>\n

Among those who were unsure or who had reservations about seeking help, the most common reasons cited were the belief that therapy or other interventions would not help, feeling embarrassed and the cost. (According to the eHealth survey, many older adults don\u2019t know that Medicare provides mental health care benefits.)<\/span><\/p>\n

Gerlach sometimes sees a perception among older patients \u201cthat they should just be able to pull themselves up by their bootstraps and get better on their own.\u201d When she encounters hesitancy, she tries to normalize patients\u2019 experiences of anxiety, depression or other symptoms. <\/span><\/p>\n

\u201cI tell them that many people are experiencing significant mental health symptoms, and explain that, just like diabetes or hypertension, mental health conditions are real illnesses, with treatments that can really help,\u201d she said. <\/span><\/p>\n

I try to explain that anxiety and depression, for example, can be due to a chemical imbalance in the brain, and not a sign of weakness.<\/b><\/p>\n

\u2014Lakshmi Rangaswamy<\/b><\/p><\/blockquote>\n

Rangaswamy observes that some of her older patients seem more willing to take medication for mental health conditions than to engage in counseling or psychotherapy. <\/span><\/p>\n

\u201cI think there\u2019s a stigma attached to needing help,\u201d she said. \u201cPatients will say they don\u2019t want to talk to a \u2018head shrink.\u2019\u201d <\/span><\/p>\n

She added that older patients who experience symptoms, such as frequent crying, decreased appetite, inability to sleep, racing thoughts or a case of the \u201cnerves,\u201d may not frame them as mental health conditions.<\/span><\/p>\n

\u201cI try to explain that anxiety and depression, for example, can be due to a chemical imbalance in the brain and not a sign of weakness,\u201d Rangaswamy said. \u201cI\u2019ve even told patients that I\u2019ve sought counseling at times myself and that it was beneficial to me. Normalizing things is very important.\u201d <\/span><\/p>\n

Rangaswamy believes that reluctance may be a generational issue too. Many older adults who lived through the Great Depression or World War II prize self-reliance.  Working through feelings isn\u2019t part of their coping toolkits. <\/span><\/p>\n

Ellen Edwards, 63, sees that with her own parents, ages 90 and 92. Edwards (not her real name) didn\u2019t hesitate to seek counseling herself when she began feeling overwhelmed by the challenges of caring for them during the pandemic. But her parents won\u2019t consider counseling, even though they\u2019ve struggled with isolation and a series of health problems. <\/span><\/p>\n

\u201cThey have a very strong, independent spirit,\u201d she said. \u201cMy mom\u2019s father died when she was four. My dad was placed in an orphanage during the Great Depression. Their feeling is, if you\u2019re having trouble, you\u2019ve got to take care of it yourself.\u201d<\/span><\/p>\n

COVID-19 caused mental health problems but also helped to destigmatize them.<\/b><\/p><\/blockquote>\n

Even older patients who do overcome their hesitations and see a counselor may struggle with the process itself. <\/span><\/p>\n

\u201cSome people can\u2019t engage because they don\u2019t know how,\u201d Rebillet said. \u201cThey don\u2019t want to complain. They say things like, \u2018I know it\u2019s going to work out\u2019 or \u2018It just takes time.\u2019 This is a coping strategy they saw their parents use, and it\u2019s their way of getting through challenges. They never got the message that it\u2019s OK to talk about your feelings.\u201d <\/span><\/p>\n

Despite those challenges, research suggests that older adults still experienced significantly less depression, anxiety and stress-related conditions than younger adults did during the pandemic. In a survey conducted early in the pandemic by the Centers for Disease Control and Prevention, nearly 50 percent of adults ages 18 to 24 reported anxiety, depression and\/or stress-related disorders. Researchers believe many adults 65 and older, having lived through crises or difficult times in the past, possessed resilience and wisdom that enabled them to withstand the stresses of COVID-19. <\/span><\/p>\n

Many mental health experts also believe that the pandemic increased awareness of mental health in general. News reports about the virus often included information about the effects of isolation and stress. <\/span><\/p>\n

\u201cCOVID-19 did more than increase the prevalence of mental health issues; it also accelerated positive momentum to raise awareness about these issues \u2026 and accelerated long-term efforts to destigmatize mental health issues and normalize the search for help for these kinds of problems,\u201d writes psychologist Michele Nealon. <\/span><\/p>\n

That awareness also spurred more older adults to practice self-care during the pandemic, Gerlach added. In the University of Michigan poll, one in three people reported making lifestyle changes\u2014such as exercise, diet or meditation\u2014to improve their mental health since the start of the pandemic.<\/span><\/p>\n

\u201cAs a culture, we are talking so much more about mental health as part of our overall well-being,\u201d said Murray. \u201cIf we can really normalize this and acknowledge that we\u2019ve all gone through difficult times, that opens the door to conversation.\u201d <\/span><\/p>\n

Sarah Crouch overcame her initial hesitancy about counseling, and she\u2019s glad she did. <\/span><\/p>\n

Weekly sessions with Rebillet\u2014Crouch was surprised to discover they were covered by Medicare\u2014proved incredibly helpful. She continues to see Rebillet, although less often. If she were to give her mental health a grade, Crouch says, it\u2019s up from a D in the midst of the pandemic to a B+ or an A- these days. <\/span><\/p>\n

While she was never suicidal, Crouch believes she wouldn\u2019t have made it without help. <\/span><\/p>\n

\u201cI think I would have ended up more isolated, more unhappy and sicker if I hadn\u2019t done counseling,\u201d she said. \u201cI still have moments of fragility, but I’m a whole lot further along than I was. Counseling was really a lifeline.\u201d  <\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

In early 2020, Sarah Crouch started a tally on her cell phone: a list of names of family members and friends who died since the pandemic began. As of July 2022, there were 51 names. About half died due to…<\/span><\/p>\n

Read more Older People\u2019s Mental Health Undermined by the Pandemic<\/span> ›<\/span><\/a><\/div>\n

<\/p>\n","protected":false},"author":13,"featured_media":7115,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0,"_FSMCFIC_featured_image_caption":"","_FSMCFIC_featured_image_nocaption":"","_FSMCFIC_featured_image_hide":"","footnotes":""},"categories":[49,7,4,20],"tags":[],"class_list":["post-7114","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-featured","category-healthspan","category-issues-in-aging","category-supports"],"cc_featured_image_caption":{"caption_text":"","source_text":"","source_url":""},"wps_subtitle":"But it also taught many where to find help\u00a0","_links":{"self":[{"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/posts\/7114","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/users\/13"}],"replies":[{"embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/comments?post=7114"}],"version-history":[{"count":1,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/posts\/7114\/revisions"}],"predecessor-version":[{"id":7116,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/posts\/7114\/revisions\/7116"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/media\/7115"}],"wp:attachment":[{"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/media?parent=7114"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/categories?post=7114"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/78.142.243.82\/~silvercentury\/wp-json\/wp\/v2\/tags?post=7114"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}