At almost 24, I notice that my mental health is significantly better these days than it was when I was 20 or 21. I wonder if the trend is simply due to better coping mechanisms or whether it’s due to age itself. Or is it due to fewer stressors? It turns out that for most people, mental health gets better with age.
I do not want to overstate my personal experience. For most people, the ages of 20 and 21 are highly developmental for many reasons, and I did have personal circumstances in college that did make the time more difficult for me. And the gap between 21 and 23 is much more different than the gap between 23 to 70, so my “aging” is minuscule. I still fall into the category of a young adult.
According to Fran Lowry at Medscape, research supports the notion that mental health gets better with age. One study of over 1000 adults found that adults in their senior years were happiest and more content with adults in their 20s and 30s.
Thomas et al. found in the Journal of Clinical Psychiatry that there was the possibility of “a linear improvement in mental health beginning in young adulthood,” and although more research is needed, the researchers wanted to dispel the notion that aging is a process of decline. Although it is “conceptualized as…physical and cognitive decline,” the authors focused on improving mental health as age increased.
Of course, it’s not a linear path for everyone. Aging is stressful, and part of the reason mood and anxiety disorders are less common as people age, according to the Cleveland Clinic, is that detection rates are lower for older adults, making them less likely to seek assistance for mental health.
The CDC currently estimates that only 1 and 5% of older adults living in the community struggle with major depression, but 13.5% of elderly adults who require more constant care suffer from depression. Havemann says that while elder women are more likely to develop mood and anxiety disorders, elder men develop more substance abuse problems. And the CDC also estimates that less than 30% of older adults who need treatment actually get it. Dr. Sophie Lazarus at the Ohio State University Wexner Medical Center says that a reason for the lower prevalence of depression in old people is due to early mortality or stigma.
The risk factors for older adults developing mood disorders are health conditions that develop with age, including heart disease and high blood pressure.
The senior author of the Thomas et al. paper, Dr. Dilip Jeste, states that older adults had an “improved sense of psychological well-being [that] was linear and substantial.” The group examined trends in physical, cognitive, and mental health cross-sectional data from 1546 individuals in San Diego County, from 21 years old to 99 years old. Generally, people just felt better about themselves and their lives as they aged. The sample also excluded people with a known diagnosis of dementia, and the sampling method used the same method as the Gallup poll to avoid a sampling bias of volunteers who usually have better mental health.
The mean of participants in the study was 66 years old, with about an even spread between men and women. However, one thing I noticed about the study was 60% of the sample had a Bachelor’s education. In the most recent census, only 36% of people have a Bachelor’s degree.
The older people got, the higher their mental health scores were on tests called the Happiness Subscale, Depression Scale, and Anxiety Scale. All the scale scores demonstrated that “mental health distress peaks in younger adults and declines with age.” In particular, Jeste notes that people have the most stress and highest level of depressive and anxiety symptoms in their 20s and 30s.
Vahia et al. found in a November 2020 study in JAMA that older adults have “lower stress reactivity,” better emotional regulation and well-being in general, and even during COVID-19, older adults are less negatively affected by mental health outcomes than other age groups. They’re also reporting lower rates of increased substance abuse or suicidal ideation. Even during a pandemic that disproportionately kills older people, older people cope better with the pandemic. In the words of Vahia et al.:
The answers might be obvious to some, but why does mental health tend to get better with age?
Dr. Brent Forester, the director of the Geriatric Mood Disorders Program at McLean Hospital, said one of the misconceptions people have is that aging is “associated with disability, loneliness, social isolation, and functional and cognitive decline.”
Jeste reiterates that older individuals tend to be more skilled at emotional regulation and complex decision making. Older people also retain fewer negative emotions and memories, and Forester notes that older adults have more resilience to handle adversity.
Ageism is a bias where people project their own feelings about what it’s like to be old. According to the World Health Organization, it is the stereotyping and discrimination against old people based on prejudicial attitudes or institutional policies and practices.
Depression in older adults is usually easier to treat, according to Forester, because it’s sometimes in the context of other medical problems and comorbidities. Forester suggests that medical problems have a biological relationship with mental health issues. Since 80% of older adults have at least one chronic health condition and 50% have two or more, depression becomes a more common risk as comorbidity.
More research still has to be done to understand the nuanced relationship between mental health and age. But one thing is clear — the stereotype that depression is a normal part of growing older should be dismantled.
This post was previously published on Invisible Illness.
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