Melancholia: When ageing takes its toll

India is home to 135 million senior citizens. About 17,000 people turn 60 every day, the highest rate of increase in the population of elderly persons compared to anywhere else in the world. While China leads with the maximum number of elderly people, India ranks second. With the dynamics of the rise in population, caring for the elderly is of the utmost importance. While physical impediments are often discuss in detail, psychological issues go largely unnoticed, depression being one such illness.

One out of every five individuals who commit suicide is above 65 years of age, according to a study that tapped risk factors for suicides in the elderly. Similar studies have shown that 21.9 percent of senior citizens suffer from depression. According to Dr Radha S. Murthy, Managing Trustee, Nightingales Medical Trust, “It is unfortunate that depression not only goes unnoticed by caregivers and family but also by elderly persons themselves. There is very little awareness about this concern and largely results in them not being able to seek help.” Dr Murthy emphasises that depression is not a normal or common condition in senior citizens and says that those suffering from it should definitely seek professional help.

Mental illness among the elderly tends to either go unnoticed or is dismissed due to its being associated with other ageing processes like physical impairment, depleting sight, reduced hearing and other capabilities. Malavika Chatterjee, a Counsellor who specialises in Geriatrics says, “Creating awareness about the mental health of elderly persons is paramount. Unlike depression in younger age groups, older people are subject to psychological challenges that arise with physical ailments. Therefore, while we address the physical concerns, it is also important to look into their mental health as well.” Depression usually manifests with symptoms like certain behavioural changes, like talking more or less, Chatterjee explains, sudden outburst of aggression, withdrawal from activities one enjoyed or  engaging in self blame or guilt. These are red flags that care givers can identify, so they can intervene and seek counselling aid.

Lifestyle and family structural changes have taken their toll on psychological health. “Migration is taking place at such a fast pace that elderly persons are affected emotionally,” says Himanshu Rath, Founder, Agewell Foundation. “Moving to a new place with their children can cause isolation because then they have to depend solely on their families for socialisation. If they choose to remain where they are while the children move away, they become isolated from the family. This has been triggering depression among elderly persons.”

Agewell Foundation conducted a study on the isolation of elderly persons in India and found that 83.71 percent of them felt lonely or isolated in their old age, that is, over the age of 60. Level of isolation in elderly people living in urban areas is much higher in comparison (89.8 percent) is markedly higher than those who live in rural areas, where around 77.62 percent reportedly feel isolated.

Speaking about active ageing, Chatterjee said, “As old age approaches, one should pay attention to financial, social and emotional security, as well as in terms of health. If this is not taken care of, there will be a constant underlying fear that creeps into their daily lives.” She says that making and keeping social engagements and an active physical lifestyle do keep a person relatively free from emotional and psychological ailments.