Saleema Noor (name changed), 70, is a widow for the last four years. She is not attended by any of her relatives, while her lone son has also moved to a foreign country for a job. The loneliness has taken a toll on her mental health and she is now dependent on antidepressants and other medications. “It is hard to live alone. I don't want to leave my home as I have memories of my husband here,” she said. Before Noor's husband died of Chronic Obstructive Pulmonary Disease (COPD), the duo used to go out together for jogging or visiting different places. “My son sends me enough money but every time only money cannot help me to get out of my loneliness and anxiety,” she said. Like Saleema, there are other widows and old age people who are suffering from anxiety, depression and other mental health issues in Kashmir. The Institute of Mental Health and Neuroscience (IMHANS), Srinagar receives 60 elderly patients every day with different mental ailment cases and the number is increasing every day. “The elderly population is suffering badly. We have seen delirious illness which is a confusing state and post covid dementia among elderly people. Loneliness can have a negative effect on elderly patient's mental health,” Dr Yasir Hussain Rather, psychiatrist at IMHANS told Rising Kashmir. He said that elderly people are facing different issues like neurodevelopmental disorders, depression and anxiety, dementia, and new onset dementia.
In addition, the lockdowns imposed after the outbreak of COVID has affected the income of many families which in turn has badly affected their mental state.60-year-old Ghulam Mohammad (name changed), a resident of the old city is finding It difficult to meet the basic needs since the outbreak of COVID-19. He was selling fruits on a cart but his financial conditions weakened further due to the pandemic, which in turn affected his mental health. Dr. Mohammad Maqbool Dar, HOD Psychiatry, IMHANS, told Rising Kashmir that loneliness creates stress and increases the hormones inside the body which decreases the immunity of a person leading to serious ailments. “Elderly people often suffer from emptiness syndrome. Loneliness and social isolation are often found in posh areas of the Valley,” he said. As per the official figures, more than 5,773 psychological testing and psychotherapies, 551 modified ECTs, 1,075 ECGs have been done at the IMHANS from April 2020 to June 2021.
According to the doctors, “Mental health in elderly is a neglected area with inadequate attention from almost all quarters. There is still a lack of awareness about mental health in elderly amongst the general public, caregivers, health planners and administrators.” The doctors said that the mental issues in late life contribute to significant morbidity. “Mental illness in late life could be due to long-standing psychiatric disorders with onset in early life or with late onset after the age of 60 years,” they said. Age is an important determinant of mental health. Old age is a period of transition when one has to deal not only with the physical aging, but also with the challenges affecting the mental and social well-being. Due to normal aging of the brain, deteriorating physical health and cerebral pathology, the overall prevalence of mental and behavioral disorders tends to increase with age. Disability arising due to various illnesses, loneliness, lack of family support, restricted personal autonomy, and financial dependency are other important contributing factors for higher prevalence of mental and behavioral disorders.
Dr. Umar Jan, a Neuropsychiatrist told that among the various mental disorders, depression accounts for the greatest burden among elderly. “Depression decreases an individual's quality of life and increases dependence on others. If depression is left untreated, it can have significant clinical and social implications in the lives of the elderly,” he said. Dr Jan said that early recognition, diagnosis, and initiation of treatment for depression in older people present opportunities for improving their quality of life, preventing suffering or premature death, and maintaining optimal levels of function and independence. “Early diagnosis and effective treatment of depression in old age can also lead to significant reduction in mortality due to suicide and medical illnesses, and health care costs,” he said. “Major depression, dysthymia (long standing depression) and bipolar depression are very common among elderly people in Ganderbal. So, it's mandatory for them to see a psychiatrist at an earliest to improve their quality of life,” Dr. Jan said.
The prevalence of probable major depression among those aged 60 and above (8.3%) was found to be 10 times higher than the self-reported prevalence of diagnosed depression. More women suffered from depression than men in the rural areas. More than two-fifths of those aged 60 and above, who are either currently working or had worked in the past, reported having work-limiting health conditions.