Emotional Health And Aging
Does mental health affect how well I will age?
Is there a connection between physical and mental health?
If you have a serious illness you're much more likely to be depressed. If you're depressed, you have a much increased risk of having heart disease and lots of other conditions. So mental health and physical health are closely linked.
How is emotional health affected by aging?
Emotional health is very, very important. With aging you have losses. You lose a spouse, you lose your friend, you lose a job, and you lose your home in many cases. So these are tough loses and how you deal with these loses is critical to how you age successfully.
Is depression common among the elderly?
Depression is very common in older people because they have such serious losses. They lose spouses, friends, contacts and jobs, and other things connected with aging; perhaps even a child. They have these devastating losses. So depression is a very serious condition that needs to be dealt with immediately if it occurs. And the other thing that is important is to separate appropriate depression from inappropriate depression. If you lose, and I have had many, many patients lose a child, this is very serious and probably the worst loss you can have. You should be depressed. If you are not depressed, there is something wrong. It doesn't go away the next week. It may last for months, and even years. But then, if it starts affecting every aspect of your life, which I've seen, where these people now develop a variety of symptoms and conditions and can no longer function, then this becomes clinical depression and needs to be treated.
Does stress affect my mental health as I age?
Absolutely. It's not really how stress affects you, but it's how you respond to stress. Everyone has stress every single day of their lives. I know of very few people that can avoid stress, except perhaps monks or nuns living in convent houses. But life is stressful. The issue is how you deal with the stresses, and that's the critical issue.
How can I better manage stress?
It's critical that people come up with strategies to deal with the stresses that they face. For example, I drive from my home to the Jewish Home here in Los Angeles on L.A. freeways. I am stressed by the freeway situation. How do I deal with it? I have books on tape, I download a book on my computer and then as I'm driving here, I read this book on the road and I pull into the parking lot of the Jewish Home, and I want to stay in my car for another 5 minutes because the chapter is so exciting. I've figured out a strategy to deal with the stress of driving in Los Angeles. I think people need to figure out how to deal with their stresses as successfully as they can. They're not going to go away. It's how to respond to the stresses that's critical.
What is 'psychopharmacology'?
Psychopharmacology is a mouthful. It is the use of drugs to deal with psychological conditions like depression. Ten years ago or even twenty years ago, we had great difficulty in coming up with antidepressants because they had terrible side effects. But today we have many different antidepressant drugs. Here at the Jewish Home, we can tailor the needs of an older individual with depression using psychopharmacology by considering if they need a drug that makes them more active, or should they have an antidepressant that perhaps helps them sleep. So we can tailor the antidepressant to the individual. That's psychopharmacology.
What are 'SSRIs'?
SSRIs are the group of the most common anti-depressants that are now used. These are serotonin, selective re-uptake inhibitors. What does that mean? Serotonin is a critical neurotransmitter which is a brain chemical. So your brain uses serotonin to help with its moods. So you want to have good serotonin levels. And SSRIs help to maintain the right level of serotonin in your brain. That's how they work.
What are some common SSRI's?
Here are some examples of SSRI's: Prozac and Zoloft and Paxil. These would probably be the main SSRI's.
What are some good anti-depressants?
We have a group now. We have the SSRIs, and then we have other anti-depressants that affect other systems. SSRIs are serotonin-specific; they act on that one brain chemical, serotonin. Others act on serotonin plus other brain transmitters, like norepinephrine. SSRIs would be Paxil and Zoloft and Prozac, and the ones that act on others would include Celexa and Wellbutrin and other anti-depressants.
How common is suicide among the elderly?
There are two groups at risk of suicide, teenagers and older men. It's interesting that there's more men than women. It is older men rather than women that are at risk for suicide, and it's very common for older men to commit suicide. The sad thing about this is that they're more successful than, for example, younger men.
Is alcohol and substance abuse a concern among the elderly?
There are two types of alcohol abusers among the older population. One group's been abusing it for their whole life and they've been lucky enough to survive to old age. The second group are a group that's been depressed in old age, and started taking alcohol. These two groups have to be dealt with or treated differently, because the basis for their alcohol abuse is different.
