As our parents age, they may need more emotional support than ever. Photo / 123rf
Older people’s mental health is often overlooked. Here’s how one writer is helping her mother cope with her crippling anxiety and low mood
“Old age is not for the fainthearted.” I can still hear my mother chirping this phrase as she wrapped up anecdotes about sore knees and sick friends. It was a phrase she picked up from her own mother, who, armed with enviable stoicism, soldiered on to 98.
Unfortunately, my mother has not had quite the same “heart” for old age. Six months ago, aged 76, she suffered a mental breakdown, resulting in suicidal depression. It seemed to happen so quickly – one minute she was enjoying Christmas with my family; then less than a week later my brother went to stay with her and she could barely get out of bed. There was also the crying, the small voice, the despairing utterances... all familiar signs.
This was not the first time my mother had spiralled into depression. Previously, though, her bouts of the (severe) blues were triggered by calculable events such as birth or bereavement. This time the trigger seems to have been none other than ageing and its attendants: physical diminishment, social isolation and lack of confidence, each feeding the other in perpetuity.
This vicious cycle is a problem for many. A recent report by Age UK examines the link between mental and physical wellbeing in older people: as we decline physically, becoming naturally less dynamic and mobile, we limit the number of events and interactions; this leads to isolation and subsequent loss of confidence, meaning that for older people life can shrink all too rapidly.
No wonder older people are experiencing poor mental wellbeing in ever greater numbers, according to the report.
“But the main problem is that it’s massively under-recognised,” says Age UK’s policy manager Jenny Lippiatt. “Low mood, depression and anxiety often are just accepted as part of old age,” she explains. And sometimes the symptoms of poor mental health are even confused with signs of dementia because, “the diagnosis for dementia is not where it should be [plus] when it comes to poor mental health the focus is overwhelmingly on young people.” (It’s true, my mother has symptoms that are more commonly associated with a teenage girl: she is crippled with anxiety, relies on others to rally her and spends most of the time glued to a screen.)
Another problem, she points out, is the current older generation “aren’t as good at talking as the younger generation.” That’s definitely true for my mum. She has always been unwilling to talk about her childhood or anything emotional, really, and her parents were very much of the stiff upper lip/head in the sand generation. It’s only now that my mum is opening up and sharing painful, personal things she has never spoken about before.
Despite her initial resistance and finding it “very uncomfortable”, she has also started therapy (me and my siblings insisted on this and helped find someone), a process which is enabling a more meaningful recovery compared to before when, by her own admission, she buried her feelings, and seemed to spring out of her depression overnight. “I’ve been masking my whole life,” she told me recently.
What made it different this time? An excellent psychologist from whom I sought advice for my mum explained that along with joints, muscles and everything “physical”, our neural pathways weaken too and with that comes a diminished ability to “keep it together”.
In other words, my mother no longer has the necessary brain strength to construct whatever persona she was using to cope with a childhood’s worth of unresolved insecurities and emotional issues. In other older people, this also means that something as “simple” as meeting a friend for lunch or parking the car can feel like a huge hurdle, even when you aren’t depressed.
So how can we support our parents if they seem more down or insular than usual? It goes without saying that checking in regularly is important. Personally, I would go one further to make sure that’s via phone calls – not WhatsApp. For a while we had a family WhatsApp group into which my mum would post a short message each day (mainly emojis) and to which my brother and sister would respond. While this was deemed “good” for my mum, in the end the support it offered was of no real value and it’s no coincidence that after her breakdown the WhatsApp group went cold and was replaced by phone calls and visits. Communication via apps and social media can give a false sense of connection, so utilise with caution.
Calling and Facetime, on the other hand, can be wonderful. As part of my efforts to help mum, I started a “book club”, which consists of me phoning my mum every Sunday at 11am and reading Thomas Hardy to her down the phone while she follows along in her own copy of Far From The Madding Crowd. It’s simple, but it works as a way of connecting without necessarily having to converse.
Me and my siblings have upped our physical presence as well. In fact my sister now spends some of her time living with my mum and I’m trying to make more effort to bridge the M3-sized gap between the two of us as well.
My mum’s low self-esteem means that she doesn’t reach out or ask for help and that makes it easy to opt out when she says things like, “Oh don’t bother” or “I don’t want to disturb you”. This year she didn’t want me to “bother” visiting her on her birthday and it would have been convenient, with everything I had on my plate, to go along with that. But a bit of extra effort made all the difference: I found a way to make it down to Dorset and back in time for prior commitments – and she was delighted.
Then there’s medication. Under the guidance of a psychiatrist and mental health nurse (the latter visits her at home regularly), my mum has been prescribed a cocktail of antidepressants and anti-anxiety drugs. However, it’s very hard to tell how effective they have been, as when she first became ill, we all swooped in and cocooned her in human care and contact.
Whether she would have made the same recovery if left on her own with a few bottles of pills is anyone’s guess, but surely there’s no amount of serotonin or diazepam pumping through your system that can compensate for nobody there. That said, people should be made aware which drugs could help. “There is a stigma among the older generation which means they’ll see their GP for a bad knee but not depression – we need to make them aware that medicine is available for emotional as well as physical pain,” Lippiatt says.
How’s my mum now? Better, thank goodness. But the road to recovery is a long one, especially when a) you fell so far down the well and b) you no longer have the benefits of youth. I would add here that while I think old age can be ripe and rich for some, you kind of have to have it all on board before the decrepitude sets in, otherwise it’s extra hard. We all have our inner wounded child, but while mine has been strapped into the back seat since my early forties, my mum’s is still at large and has recently crawled into the boot and thrown the last of the supplies out of the window.
Indeed, another key focus, alongside human care and medication, has been to replenish my mum’s “supplies”. My sister has been great at encouraging her to get out for a walk every day and to eat more healthily. My brother has encouraged her to take up crochet again (partly by announcing the birth of his first child, who obviously will be in need of a blanket). She has started to see the odd friend for coffee and has been persuaded to come up to London to take my kids to the theatre – a very big deal as the last time she entered a crowded space, she had a panic attack.
So my granny was right: old age really isn’t for the faint hearted. In fact it’s brutal. The truth is that old people need younger people as much as we need older people when we’re young; aged people need us to care for them, coax them and maintain their confidence, otherwise, the descent into poor mental health can be all too rapid.
For me, it’s an uncomfortable truth as that role reversal of having to care for my mum doesn’t come as naturally as it does to some people, who look after aged parents with aplomb. The solution for me has been rekindling things in common. We’ve discussed a “cooking club”: my mum used to throw three-course dinner parties for 30 people, but she has lost all her confidence in the kitchen. However, I happen to know she has some excellent recipes up her sleeve, so once Bathsheba’s safely married to Farmer Oak, we’ll start making some together.
And hopefully her world will start to grow again, one recipe, one novel, one walk, one visit at a time.
Let’s take a look at the science.