India is going through a major demographic transition with the rapid swelling of the senior population. Low birth rates coupled with longer life expectancies push the population to an ageing one. According to census 2011, 8.6 % of Indiaтs population is 60 years and above.
Ageing process is not only affected by the physiological changes in the body but also by changes in the psychosocial conditions. Being mentally healthy not only means absence of any psychological condition but the optimum use of our cognitive functions and an optimistic thought process.
In India, mental health issues in elderly population are mostly due to the following causes:
- Urbanization and westernization play a major role in the increasing migration of the younger generation leading to weakening of the social structure and joint family system. As a result the older population is trapped in between the eroding traditional system and lack of social security systems in India.
- Due to the changes in the social structure, older adults have to undergo major changes in their lifestyle and inability to accept and adjust to these changes is one of the important causes of the increasing prevalence of mental illness.
- In the face of life stressors, individuals due to certain personality traits develop maladaptive emotional response which makes them prone to develop mental health issues.
- Old age is characterized by multiple losses in terms of loss of physical and mental capacities, loss of loved ones, loss of authority and importance. So one has to learn to draw a very intricate balance between the physical, social and psychological resources.
- Decline in the capacity of accept and adapt change makes unplanned life events difficult to handle.
- Any physical illness leading to loss of mobility and dependency can lead to elderly depression.
- Loss of loved ones, can lead to loneliness and isolation. Apart from the bereavement, such significant losses are sometimes followed by major life changes like change of residence, social roles.
- At times, even the daily stressors like the activities of daily living can become stressful for the elderly which can lead to anxiety.
Mental illness if not diagnosed at a manageable stage can have serious consequences.Some of the most common signs of mental illness in elderly are:
- Withdrawal from social activities like meeting people, going on outings etc.
- Insomnia or hypersomnia
- Intense sense of guilt most of the time
- Loss of interest in pleasurable things which they earlier liked doing.
- Feelings of hopelessness and worthlessness
- Increased confusions
- Neglecting personal care (grooming, bathing, clothing)
- Constant worry of the unknown future to such an extent that affect their daily functioning
- Frequent complaints of pain in different parts of the body in the absence of any physiological problem.
- Frequents incidents of irritation and agitation leading to anger outbursts.
While there is increasing provenance of mental illness among older adults access to mental health services is very limited. Most of the elderly avoid going to a psychologist or geriatric specialist. A number of barriers like denial of problems, lack of awareness, limited services further worsen the condition.
Combined efforts at individual level and social support system are required to address the mental health issues in elderly.
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