Addressing Mental Health: What Kinds of Issues Can Be Discussed in Senior Therapy?

Have you noticed the older adult in your life is more listless than usual? Perhaps they don’t smile or laugh as often, or even refuse to get out of bed. They may hardly eat, seem jumpy or apprehensive, or even voice thoughts of harming themselves. Doctors can’t find a medical cause, and you’re at your wits’ end trying to help them.
The truth is, your loved one may be suffering from a mental illness—the kind that Primary Care Physicians (PCPs) cannot adequately address by themselves. Likewise, talking and spending time with family members may not be enough either. Naturally, you want to offer your loved one the utmost in caring and support, but mental illnesses may require professional help. But how do you know if their issue can benefit from senior therapy?


One of the most common—and treatable—mental illnesses that older adults face is depression. In fact, depression “affects more than 6.5 million of the 35 million Americans aged 65 or older.”[1. “Depression in Older Persons,” October 2009,] In addition to Major Depression, clinical intervention can provide relief for Seasonal Affective Disorder (SAD), dysthymia (a form of “low-grade” depression), and more. Therapy generally revolves around discovering the root causes of the illness, learning new ways to cope, and the possible use of psychotropic medication.


Anxiety is another area in which therapy can be very helpful for older adults. Perhaps your loved one has panic attacks, phobias, Post Traumatic Stress Disorder (PTSD), from an event like a heart attack or stroke, or generalized anxiety disorder (GAD). They may also suffer from paranoia (for example, thinking that caregivers are out to harm them. However, there are unscrupulous caregivers out there, so make sure this is not actually happening to your loved one!). Therapy for anxiety is similar to that for depression: talking through fears, determining how realistic they are, employing coping mechanisms, and in some cases, using medication.

Suicidal thoughts

Both the depression and anxiety listed above can lead to suicidal thoughts, which must be taken very seriously and addressed immediately. There is a difference, however, between suicidal ideation versus intent. Suicidal ideation involves vague thoughts about suicide such as “It would be better if I were dead.” Suicidal intent is when the patient has a plan to carry out his or her suicidal thoughts. Therapy for these ranges from admission to a crisis care center to more careful monitoring by mental health professionals.


Did you know that therapy can also help older adults with substance abuse problems? These can be problems they’re having presently, or ones they need to process from the past. The therapy can take place one-on-one with a clinician, or in a twelve-step program such as Alcoholics Anonymous(AA), Narcotics Anonymous (NA), and more.
Many people are surprised to hear that older adults—especially the homebound—can still suffer from substance abuse. However, addiction is a disease that does not go away with time; it can only be managed through treatment. While addicts may not have access to their drug of choice, they often find substitutes in their homes. For example, the misuse of narcotic painkillers and anti-anxiety medications is especially prevalent among this population.[2. “Use of Narcotic Painkillers Among Elderly Rising Sharply,”]

Get Your Loved One Senior Therapy as Soon as You Notice a Problem

Senior therapy works best when it’s started early. If not, symptoms have a tendency to snowball, and can be harder to resolve in the long-term. Not to mention the fact that delaying therapy may make your loved one suffer through the symptoms longer than they need to. And as mental illnesses are extremely unlikely to disappear on their own, prompt treatment is usually best. The typical guidelines say to seek help if symptoms last more than six weeks, though for urgent situations (such as addiction and suicidal ideation), immediate intervention is better. Talk to your loved one’s PCP for a referral to a mental health professional, and help them start getting well today.
If you are unsure of how to best help an aging loved one, the trained and compassionate staff at the Institute on Aging is here to help you make that decision and gain the best in at-home care for older adults. Contact us to find out more.

Institute on Aging

Institute on Aging

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