Mental health: Reducing stigma is the key to healthy aging

The Baby Boomer generation has redefined what it means to grow older – working longer and living more active lifestyles than their parents ever imagined.

But while Boomers enjoy better physical health than previous generations, many struggle to address a key part of their overall wellness – their mental health. Rates of mental health disorders are rising fastest among Baby Boomers. It’s estimated that 20 percent of people age 55 or older experience some type of mental health issue, and the number of older adults with depression is expected to double between 2010 and 2030.As a society, we have seen examples of this play out on a grand scale, with the high-profile suicides of Anthony Bourdain, the celebrity chef, author and television personality, as well as Kate Spade, fashion designer and businesswoman made famous by her iconic handbag line.

According to Dr. Anne Schuchat, deputy director of the U.S. Centers for Disease Control and Prevention, “depression is not a condition that’s related to success or failure.” In other words, no one is immune to suicide.

Older people may experience stresses common to all people, but stresses can be more common in later life. For example, older adults may experience reduced mobility, chronic pain, frailty or other health problems, for which they require some form of long-term care. In addition, older people are more likely to experience events such as bereavement after the death of a partner or close friend, or a drop in economic status with retirement.

And, as our brains age, the blood supply and brain chemicals that affect our moods change, leaving older adults more susceptible to depression. All of these factors can result in isolation, loneliness or psychological distress.

In my own experience as a physician, I have observed that life changes that can trigger mental health issues can take different forms and present different challenges.

One example is a 72-year-old woman who I began seeing in 2006. In addition to multiple chronic conditions such as high blood pressure, chronic kidney disease, high cholesterol, chronic lung disease, thyroid disease and depression (previously under the care of her psychiatrist), what has bothered her the most is having to constantly deal with chronic back pain, despite numerous back surgeries and procedures that she had done in the past. Making the matter worse is her reliance on opioid medications which gives her marginal relief at best, a somber reminder that she needs pain pills every day to have some semblance of function. While she does not visit her psychiatrist on a regular basis, her constant pain – which affects her activities of daily living – is an area of awareness and focus on my part as her physician. Pain and depression create a cycle in which pain worsens symptoms of depression, and then the resulting depression worsens feelings of pain – we always look for this in chronic pain patients. During one of our visits earlier this year, she was a bit fearful but excited about the idea of travelling to attend her grand-daughter’s wedding in Spain. She has something to look forward to despite physical limitations. I am happy to say that she is managing the stresses in her life. She has been referred to our pain management department and receiving injections for pain as well as regular physical therapy. I see her frequently for support.

Other patients can become quite overwhelmed by negative events in their life and they respond by denying the reality and gravity of the situation. “Ms. X” is a 70-year-old patient whom I have been seeing for more than 10 years. Late last year, she was diagnosed with invasive breast cancer. After this life-changing diagnosis, instead of complying with recommendations for additional tests and follow up, she instead chose to follow a special diet which she hoped would cure her breast cancer. In the meantime, outreach was made by letter and by phone, sadly with no response. Recently I reached out again by phone, and I am happy to say she returned the call. She has now resumed her care and is responding to our recommendations. She is also involving her family now – her two adult children and a friend who know about her situation. Her journey is in progress.

Symptoms of mental health problems can be misunderstood. There are many different mental health problems, so symptoms can be common to more than one diagnosis (for example: depression and anxiety). Here are five lesser-known signs of the two most common mental health conditions (depression and anxiety). If you find you are experiencing these signs, don’t ignore it:

Avoiding social situations

If you notice that you’re canceling social occasions with your friends and family that you would normally take part in, give this some thought.

Having a “bad day” is a perfectly normal part of life, and usually these feelings will pass without any real problem. But if these feelings don’t go away after a few weeks – or if they get worse or keep returning – it could be a sign that you’re experiencing depression.


Feeling “numb”

With mental health problems like depression, or post-traumatic stress disorder (PTSD), it’s possible to feel a sense of “unreality” or “depersonalization.” This can mean that you find it difficult to connect to your surroundings and connect with other people.


Physical complaints

As a physician, I have often found that people will mention a physical pain that is later found to have its roots in depression or anxiety. Many people with depression experience fatigue and find it difficult to look after themselves. People with anxiety often experience physical symptoms like panic attacks, nausea and sweating.


Trouble concentrating

You may find it more difficult remembering certain things or concentrating. If you find your concentration is worse than usual, or that you’re having trouble with things like showing up on time or making decisions, this could be a symptom of living with a mental health problem.


Trouble sleeping

Many people with depression can find it difficult to wake up in the morning and find themselves sleeping more than usual. This can result in feeling exhausted and having a difficult time carrying out everyday activities.

Consider it a red flag when someone:

Changes their eating habits. This can mean a sudden change with corresponding weight changes.

Displays frequent anger or irritability. A depressed person can find it a struggle just to get through the day. The everyday challenges others may face will become more difficult for them and this can lead to frustration.

Expresses negative thoughts. You might be excited or happy about something and your friend or loved one might come back with a “downer” response, such as “who cares,” or “it doesn’t really matter.”

Loses interest in activities and pursuits that were previously pleasurable. Your friend or loved one may stop pursuing their usual activities and gravitate only toward the few things that are easily enjoyed and require the least amount of effort, like watching television or surfing the internet.

Expresses suicidal ideas. Always take statements like these very seriously. Not only are statements like these key elements of depression, they suggest that such treatment is urgent.


How to help them (or yourself) get the care needed

If you suspect depression, encourage your friend or loved one to seek consultation and treatment with a qualified person. The same goes for yourself if you suspect that you may be depressed. Your doctor (primary care physician) is a great place to start. It is very common for physicians to initiate treatment for mental health issues like anxiety and depression.

For anyone dealing with depression or suicidal thoughts, or who has a loved who is struggling, it can be difficult to know what to do. One of the best things you can do is express concern and willingness to help, and then let them do most of the talking. Don’t attempt to solve the problems yourself.

If you’re worried someone may be suicidal, don’t hesitate from asking about suicidal thoughts if you think that person may be at risk. Talking about suicide won’t plant the idea in a person’s mind and telling someone you care and want to help is always a good idea. Don’t ever use guilt or threats to try to prevent a suicide.


If you notice these warning signs in a friend or loved one, don’t wait. Contact the National Suicide Prevention Lifeline at 800-273-8255 without delay. This national network of local crisis centers offers free and confidential help to people who are contemplating suicide and their loved ones.

You can also take your loved one to an emergency department if you think they are not safe. Also, don’t leave them alone. Make sure there are no firearms in the house and secure any medications.

The more we as a society are willing to discuss and understand issues related to depression and suicide prevention, the more likely we are to reduce the stigma of mental illness and see the rate of suicide begin to decrease. Ultimately, we need to create a culture that is open to talking about mental health and suicide prevention.

The column does not constitute medical advice and is not meant to diagnose, treat, prevent or cure disease. Please contact your doctor. The information provided is for informational purposes only.


Dr. Samuel Bauzon is the senior medical director, Southwest Medical Associates