Better Days Ahead: 5 Ways to Regain Mental Balance

One week after Marcia D. lost her husband of nearly 53 years to COVID-19 in April 2020, she tested positive for the virus. With no time to grieve her husband’s death, Marcia, 76, was thrust into her own nightmare, including two weeks in the ICU. The losses kept coming. 

Her beloved greyhound, who accompanied Marcia on walks to regain her strength after hospitalization, died suddenly. To make matters worse, her daughter and two grandchildren, who live in Ireland, weren’t allowed into the U.S. to support Marcia.

“It was very difficult that we couldn’t gather as a family to mourn David’s death or have a service, which has made the grieving process longer,” says Marcia, a retired elementary school art teacher. “And I don’t think my long-term symptoms from COVID will get any better, which is a source of depression and anxiety. I still can’t catch my breath sometimes, and I have to go much slower than I am used to, which is maddening.”

“We’ve all lived through a difficult time with COVID, but older adults have seen more of their friends or their spouses become sick or die of the virus,” says Kumar Dharmarajan, MD, MBA, cardiologist, geriatrician, and Chief Scientific Officer at Clover Health. “And people who struggled with anxiety prior to COVID now have a scary virus to add to their other fears, which may make it more difficult for them to leave their homes or engage with other people.”

However, while we are seeing a significant rise in depression among older adults, as a whole they appear to be emotionally weathering the COVID crisis better than younger people. Research from the Centers for Disease Control and Prevention (CDC) indicates that from August 2020 to February 2021, adults reporting symptoms of anxiety or depression increased from 36 percent to 42 percent, with the youngest adults hardest hit and those age 60 and older faring the best.

“There are aspects of aging that build emotional resilience. Older people have been through adversity before and have developed coping strategies that work for them,” says Suzanne Meeks, professor in the Department of Psychological and Brain Sciences at the University of Louisville, and editor in chief of The Gerontologist.

Challenges to Support

Having social connections and a support network are vital to a good quality of life always, and this was especially challenging during the pandemic. About a quarter of older adults

don’t have computers with high-speed internet or a smartphone, preventing them from connecting with family and friends through Zoom or FaceTime.

“People without computers were at higher risk for isolation, worry, fear, and anxiety,” says Dolores Gallagher Thompson, professor emerita, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine.

Travel plans were shelved, bucket lists untouched. It’s been more than a year since many have seen their children and grandkids in person.

“People may be feeling grief and anger at all the lost opportunities,” says Gallagher Thompson.

Another source of sadness has been the inability to participate in mourning rituals for those who have died. Although people are creating new rituals at the one-year anniversary of a loved one’s death, grieving may have been prolonged by people not being able to gather in person soon after a death, says Meeks.

5 Ways to Regain Mental Balance

If you’re depressed or anxious, reengaging with the world will help you begin to feel better, says Dr. Dharmarajan. Don’t worry if you can only take baby steps toward feeling happier.

“Try to do a little bit more each day and be open with your family about how you’re feeling,” he says. It can be very empowering to take steps to make your life better instead of feeling you are a victim of a crisis beyond your control, adds Gallagher Thompson.

1. Stay engaged. 

Take part in activities that bring you joy. Listen to music. Read a book. Try new hobbies to create a sense of accomplishment. Log on to YouTube to learn the latest crafting trend. Download an app like Rosetta Stone or Babbel to learn a new language.

“Many people get positive reinforcement from their relationships with other people, which have been limited recently,” says Gallagher Thompson. “Find that positive reinforcement from within yourself to lift your mood.”

One of Gallagher Thompson’s patients is making albums from 30 boxes of photos. “She is proud of having accomplished this big project and for creating a history that she can share with her family,” she says.

2. Get outdoors. 

If you are able, walk outside every day for exercise, suggests Norman Abeles, professor of psychology at Michigan State University and a former president of the American Psychological Association.

Try to connect with people on your walks. For example, ask dog owners you meet the names of their dogs. “After a while, you will be conversing with your dog-owning neighbors about more than their pets,” says Abeles.

3. Download a mood-boosting app. 

There are many programs designed to help you reduce anxiety through breathing exercises or mindfulness, including Calm and Headspace. Others guide you through steps to improve sleep. No smartphone? Call your local library or bookstore and ask for suggestions about books.

4. Start your autobiography. 

Your life story can be helpful in times of stress because  it reminds you of previous adversities and challenges that you’ve conquered, says Gallagher Thompson. 

“You will be reminded of your strength, resilience, and coping skills you’ve developed over a lifetime.” Your history may also make a cherished gift to give to younger generations.

5. Schedule time to connect. 

Find someone or something that needs you. Set up regular dates to speak with a friend or drop off donations to a local charity. Marcia D. and her son adopted two greyhounds, Jinx and Gatsby. “The dogs demand lots of attention, which has helped me immensely because they need me and occupy my time, so I don’t dwell on the sad things,” she says.

Getting Help

If you’re not feeling better despite your efforts, it may be time to talk to a mental health professional—which you can do without leaving your home.

Today many mental health services are provided remotely. Many Medicare Advantage plans may offer telehealth services that connect you with a social worker or psychologist over the internet or by phone. Medication prescribed by your doctor can also be very effective in treating depression and anxiety.

Two signs that you might need professional help: Your negative mood persists from the time you wake up to the time you go to sleep and lasts for several weeks. You no longer find pleasure in the things you once enjoyed.

There is no shame in experiencing depression or anxiety. Both are medical conditions, like heart problems and diabetes. “It’s not a personal failure to be depressed any more than it is to develop diabetes,” says Meeks. “Depression and anxiety are responses to events in your life.

“As you return to activities that were important to your well-being before the pandemic, life will get easier.”

Worried About Someone Else? 

If you suspect a friend may be struggling, reach out. Tell your loved one that you’re available to listen.

“Older adults don’t want to be a burden, so they may be hesitant to talk about their feelings,” says Kumar Dharmarajan, Chief Scientific Officer at Clover Health. “Express your love. Reassure them that you will not judge. And remember, getting someone to open up about their mental health takes time.”

Keep an eye out for changes in behavior. “Older adults who are depressed often have different symptoms than younger people,” explains Dr. Dharmarajan.

“Seniors may be more confused, lethargic, or irritable. Their personality might change.” Other typical warning signs of depression include a lack of interest in usual activities, chronic worrying, weight loss, sleeplessness, and not maintaining personal hygiene.

Pay attention to your loved one’s ability to carry on a conversation. “If your friend wants to get off the phone after a minute or so and that’s not typical, it can be a sign of depression,” says Norman Abeles, professor of psychology at Michigan State University.

Help a loved one engage by doing a project together. Craft or cook together—even over Zoom. Provide an opportunity to teach you how to make a beloved family recipe. Invite him or her to a virtual dinner party.

If you believe a loved one could benefit from talking to a mental health professional, recommend that he or she talk to a “counselor,” which is a more neutral term than psychologist or social worker, says Abeles. “If appropriate, share that you saw a counselor during a difficult time and found it helpful,” he suggests. Some seniors may be more comfortable talking to a rabbi, minister, or other clergy member.

 

Illustrations by Francesco Ciccolella. This article was originally published in the summer 2021 issue of Clover Living magazine. If you aren't already subscribed, sign up for a free subscription to Clover Living magazine here!

This article was medically reviewed by Dr. Kumar Dharmarajan

Published on 1/9/22