Republic of Ireland news

Older people afraid to seek help for mental health problems

A psychiatrist has sad many old people believe mental health issues may be perceived as weakness
Cate McCurry

MANY older people are afraid to seek help for mental health problems over fears it will be perceived as a sign of weakness, a psychiatrist has said.

Figures show that one in 10 adults in the Republic of Ireland aged 65 and over in primary care has clinically significant depression which requires clinical intervention.

Dr Declan Lyons, a consultant psychiatrist, said about half of the cases are recognised and diagnosed and only about half of those receive a form of treatment.

The population of older people in the Republic of Ireland is rising with the 65 years and over age group experiencing the largest increase in population since 2011, rising by 102,174 to 637,567, a rise of 19.1 per cent by 2017.

The National Risk Assessment 2019 said the proportion of the population aged over 65 will increase from one in eight in 2019 to one in six by 2030.

Dr Lyons, who works at St Patrick's University Hospital's mental health services in Dublin, said there is a sense of stigma around emotional issues for the older generation.

According to the consultant psychiatrist, older people are more reluctant to broach emotional difficulties.

"I come across two types of people in my work – people who develop the condition for the first time after the age of 65 and people who have had the illness for a long time before they are 65," he said.

"They feel that psychological issues and emotional complaints are the stuff of the younger generation. They feel like like they're not quite kosher for an older generation that have come through all sorts of strife, conflicts, recessions, turmoil and who have life experience.

"On the one hand they feel they have lived and acquired a lot of wisdom in ups and downs in life, yet here they are going through some sort of emotional crisis.

"People often perceive it as a sign of weakness or character flaw and feel like they would be negatively appraised. People are more comfortable talking about physical problems. Older people do suffer from bodily functions which could be hard to adapt to."

Older people often have atypical symptoms when suffering from mental health issues.

He said they may present with complaints about their physical health, nuance complaints of abdominal pain, headaches or back pain or believe they have a serious illness.

"Often older people disengage with activities or conversations and become withdrawn," he added.

The triggers of depression later in life are different from the younger generation. Among these are medical and physical health problems as well as bereavement.

"Isolation is a huge one. Being in an institution [nursing home] is a risk factor for depression as well as alcohol misuse," he added.

Dr Lyons, who spoke at Aware's conference Future of Depression and Bipolar Disorder, at University College Dublin, said there is an epidemic of age denial.

"We live in morbid dread of it for fear of the cosmetic aspects of ageing and we distance ourselves from the older generation," he added.

The older generation are often treated as not having a particular role in society, with many people "very ambivalent" about their contact with the elderly.

"They can be treated negatively as bed blockers or even in the housing crisis some were seen as home blockers," Dr Lyons added.

After retirement, the elderly can often struggle within society, particularly around their changed role in life.

According to the psychiatrist, it's important that the older generation remain interested, opinionated and involved in everything.

"Keeping up to date with technology is also very important for older people," he added.

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