October 24, 2023

Proactively Managing Mental Health As We Age

In the first part of our blog series on healthy aging, we addressed the physical factors that influence and ultimately determine our well-being over a lifetime – the second of three key pillars of the National Institute on Aging’s healthy aging guidelines (read it here). In part two, we’ll delve into the critical importance of caring for our mental health, including ways to identify and improve the behaviors and habits that impact our wellness most.


As a reminder, the National Institute on Aging’s three goals for healthy aging are:

  1. Actively managing physical and mental health
  2. Live as independently as possible
  3. Maintain quality of life

To achieve these three goals, you need to assess the following:

  • Physical health (as addressed here)
  • Mental health (emotional), which includes:
    • Social isolation and loneliness
    • Depression and mood
    • Activities and hobbies

Thanks to COVID, social isolation, loneliness, depression, and mood have become familiar terms and concepts to most Americans. However, the National Institute on Aging, Surgeon General, CDC, and a slew of other public and private institutions agree with us when we say that caring for your mental health as you age is just as important as caring for your physical health, and yes we have the science to back it up!


Social Isolation and Loneliness


No, social isolation and loneliness are not just buzzwords in our post-pandemic world. They are two critically important physical and emotional engagement measures that profoundly impact your physical health and overall aging. While they sound similar, social isolation and loneliness are different. Social isolation is the lack of social contacts and having few people to interact with on a regular basis, and loneliness is the feeling of being alone or separated from family, friends, and your greater community.


While you may have only become aware of these two health measures only recently, they have been seriously studied as factors that impact your physical health and well-being since the 1970s. Recent research shows that older adults experiencing social isolation or loneliness are at a greater risk of developing heart disease, depression, and cognitive deterioration. Social isolation in older adults has also been associated with a higher risk of chronic lung conditions, while loneliness impacts memory and leads to faster cognitive decline.


However, there are an equally positive number of mental and physical health benefits when older adults prioritize social engagement by staying connected to family and friends and actively engaging with their greater community.

Here is how you can proactively manage your social connections:

  • Stay in touch with family and friends by
    • Meeting in-person
    • Talking on the phone
    • Video chatting (learning new skills, like Apple FaceTime, Google Meet, or Zoom also improves your mood and cognition)
  • Meet new people by
    • Learning a new skill
    • Honing a craft or skill you already have
    • Mentoring or tutoring
    • Volunteering in your community
    • Joining a
      • Club (walking, book, dinner, you name it)
      • Gym or sports facility (many trainers and coaches are certified to work with older adults who often have specific needs)
      • Community or faith-based organization
  • Schedule the above interactions and build multiple social interactions into your day and week
  • Ask the social connections in your life to let you know if/when they feel a loss of contact with you
  • Think about where you live and why, as your direct community will impact your physical and social connection as you age
    • As you age, can your community come to you?
    • Is transportation available and affordable for you to see your friends and family?
    • Do you want to live close to or with others?

Stress


We aren’t new here, and neither are you. Stress, your own, others, and communal, is something you have had to deal with and manage your entire life. We're not here to preach or reinvent the wheel; we just want to give you some information about stress and how to minimize the impact as you age.


Constant stress, at any age, can change the brain, affect memory, and increase the risk of developing Alzheimer’s and related dementias. However, older adults are specifically at risk of brain changes due to an increased amount of the stress hormone cortisol. Cortisol steadily increases after middle age. However, for older adults who experience constant stress and anxiety, large amounts of cortisol can rewire the brain's memory, decision-making, and mood. Long-term stress can also cause or worsen various health issues, specifically digestive disorders, headaches, and sleep.


Don’t stress. We have some good news for you. The Baltimore Longitudinal Study of Aging, which followed 2,000 participants for over five decades, found that emotionally stable individuals lived an average of three years longer than their counterparts who tended toward a negative or anxious emotional state. Living longer, independent, and happy lives is the name of the game, is it not?


Here is how you can manage your stress level and evaluate if you need help doing so:

  • Scheduling and participating in exercises you enjoy
  • Keep a journal to identify and challenge negative or unhelpful thoughts
  • Psychotherapy
  • Reach out to friends and family to talk about stresses and have them help you monitor your thoughts and mood


Depression and Mood


While depression is common in older adults, it by no means has to be a given. It is essential to educate yourself, your family, friends, and caretakers about the signs and symptoms of depression and mood instability as you age. For many older adults, sadness is not a major symptom of depression, and it often manifests as emotional numbness, disinterest in activities once enjoyed, and an unwillingness to talk about feelings. Physical symptoms such as lack of sleep, tiredness, malaise, and loss of appetite also indicate depression.


As you can see, depression doesn't just affect your mental health. In addition to the physical symptoms listed above, depression raises your risk of developing heart disease and metabolic disorders such as diabetes and obesity. Depression is also a risk factor for dementia, and research has shown an association between the number of depressive episodes suffered and an increased risk of developing Alzheimer’s.


Mood changes, while different from depression, can also influence your overall well-being as you age. Research shows a demonstrated link between positive mood and finer cognitive function and control. Believe it or not, how you think about aging directly impacts how you age. Studies show that holding negative beliefs about aging as you age increases your risk of undesirable health outcomes, Alzheimer’s disease biomarkers, and cellular aging. However, if you have a positive outlook on aging, your risk for dementia and obesity may very well decrease.


While we need you to know the harsh truths about depression and mood, especially regarding healthy aging, there is plenty you can do to be aware of and treat them.


Here is what you can do to recognize the signs and symptoms of depression and what you can do if you experience them:

  • Schedule a regular check-in with yourself (at least four times a year)
    • Write down or print this list of symptoms
      • Mental
      • Numbness
      • Disinterest in activities usually enjoyed
      • Unwillingness to talk about feelings or anything personal
      • Sadness
    • Physical
      • Lack of sleep
      • Tiredness
      • Malaise
      • Loss of appetite
    • Put the above list somewhere you can access it once a quarter
    • Ask yourself, out loud preferably, if you have been experiencing any of the listed symptoms
  • Schedule a regular check-in with friends, family, and caretakers (at least two people, four times a year)
    • Share this blog and the above list with all of your close contacts, as they may be the first to notice a change in your mental or physical health
    • Listen to what your community has to say; often, we get defensive when someone has something difficult to tell us about ourselves - Remember, you are asking for their help to keep you independent
  • If you do experience any symptoms of depression, suffer a traumatic life event, or suspect you are depressed
    • Contact your physician and explore options that include
      • Talk-therapy (in person or remote)
      • Medication
      • Additional therapies
    • Reach out to friends and family for support
    • Reach out to us, and we can help you find the right professionals to help and support you for as long as you need

Leisure Activities and Hobbies


Congratulations! Yes, you! You deserve our admiration and respect as you are likely already fortifying your health and independence by participating in hobbies and leisure activities. Decades of research show that people who make time for and engage in regular hobbies and social/leisure activities are at a lower risk for many health conditions common in older adults. For example, one study found that older adults who spent at least one hour per day reading or engaged in other hobbies had a decreased risk of developing dementia compared to those who only spent 30 minutes or less. Another study found that older adults who participated in a community choir program reduced their feelings of loneliness, increased their overall interest in life, and participated in other activities.


No, we don’t consider smoking and/or drinking with your friends a hobby or leisure activity, so do not pat yourself on the back for either of those. However, partaking in the participatory arts, including but not limited to music, theater, dance, and creative writing, shows scientific promise in improving quality of life and well-being in older adults and enhancing cognitive function, memory, self-esteem, stress management, and social interaction. Finally, research has shown that hobbies as simple as pet ownership/caring for a pet have been associated with better cognitive and, in many cases, physical function.


So, the world is your oyster, but here are some hobbies and leisure activities we recommend:

  • Hobbies
    • Cooking or Baking
    • Jigsaw and word puzzles
    • Learn/use computer software to communicate with family and friends
    • Legos and model building
    • Photography and computer software used to share and edit photos
    • Reading and audiobooks (can both be taken out for free from the library)
    • Needlework like crochet, cross stitch, knitting, needlepoint, quilting
    • Participatory Arts:
      • Learn/play a musical instrument
      • Take a dance or dance-based exercise class
      • Take a creative writing class
    • Leisure Activities
      • Regularly attend sporting events, try new restaurants, visit museums, go to the symphony, opera, ballet, or theater
      • Join a book club, bridge club, dinner club, game/trivia night, poker game, walking/exercise group
      • Volunteer at a local library, hospital or school

The mainstream message regarding healthy aging in America has focused on physical factors for too long. Our team is heartened to see more and more voices in the American healthcare system speak out on mental health's impact on our overall well-being (more on that soon, too). If any of the above resonates with you or a loved one, we encourage you to pass this blog along. And if you’re in need of support, we’d love to connect with you – click here to contact us today.