Loneliness, anxiety and depression can easily set in as the result of common challenges older adults face, according to two mental health professionals with years of experience working with seniors. “With any type of loss, you can experience bereavement,” says Dr. Charletta Dennis, a board-certified psychiatrist who is medical director of behavioral health for Priority Health.
High on that list of losses might be retirement. “A person had a career that woke them up every day,” she says. “People can lose their sense of self-worth.”
Loss of a partner or other loved one unleashes grief, along with the loneliness of day-to-day life without that person in it, Dennis says. Loss of physical or cognitive function, coupled perhaps with dependence on a home caregiver for the tasks of daily living, can spark frustration, feelings of being a burden, and resentment over the loss of agency, or sense of control over one’s life.
“Older people can get stigmatized and discriminated against, especially when they are seeking help,” Dennis says. If they are experiencing a learning curve with technology, that also can promote a sense of loss, that the world is moving on without them.
‘Depression is not a moral failing’
And then there was COVID-19. The pandemic set in motion what felt like an endless avalanche of tragic events. People who previously may have not admitted they were feeling sad, anxious or lonely, now had something they could point to as a cause, says Daniel Horrigan, LMSW, a private-practice therapist whose company, “Your Story Counseling,” is based in Dearborn. In reality, “many older adults were living under lockdown conditions even before the pandemic,” Horrigan says.
“Depression is not a moral failing,” he says. “It comes from a set of circumstances.”
While depression rates are lower for older adults than other age groups – at between 1 and 5 percent, says the National Council on Aging – seniors experience markedly more life changes that can lead to situational sadness.
Virtual Counseling Care
Here’s the good news: Counseling and other mental health services that became accessible via telehealth during COVID still are available today, from the comfort and privacy of your own home. All you need is a computer or smartphone, and a dependable internet signal.
Not only is virtual mental health care available, often it is covered by Medicare B when provided by a licensed professional. Copays and deductibles may apply, so contact Medicare for coverage information – or your Medicare Advantage plan if that is your insurance type.
Virtual care has significant benefits, says Horrigan, who has a practice that is nearly 50 percent telehealth. He says the from-home sessions alleviate other sources of stress. “With virtual care, transportation is not an issue. Third-party transportation can itself be a source of anxiety,” just waiting for that rideshare to arrive. There is also no waiting room. Older adults find themselves spending a lot of time waiting, and that in itself can trigger anxiety, he observes. Also, if a person has a sense of shame or stigma about seeking mental health care, “telehealth eliminates much of that,” adds Dr. Dennis.
Importantly, while virtual care can address a number of the same issues that could be addressed in person, including long standing challenges or adverse childhood events, it’s not always sufficient on its own. “Sometimes a person might have a complexity of mental health needs that would be better served by in-person visits, or a hybrid of virtual and in-person care,” Horrigan says.
There are consequences to trying to ignore or “tough out” depression. “If someone doesn’t get their depression treated, they may experience physical decline, too. Changes in the brain occur no matter what the chronic condition is. “It’s not ‘all in your head,’” Dennis adds.
Dr. Charletta Dennis worked in geriatrics at Lansing’s Sparrow Hospital and is the author of “Anxiety Unmasked During the Covid-19 Pandemic: A Global Mental Health Concern.” She’s worked for county and state entities, directing psychiatric services.
Before starting “Your Story Counseling,” Daniel Horrigan, LMSW, provided mental health services as a social worker at Detroit’s Hannan Center. He also worked at PACE Southeast Michigan and volunteered at the Alzheimer’s Association. Reach Horrigan at yourstorymi.com or 313.338.8840.
Tips for those seeking virtual mental health care:
If you are seeking virtual mental health care, here are some tips from our experts:
• “Before engaging an online mental health practitioner, you want to know their qualifications, credentials, and what is their area of expertise. You may want to ask what kinds of clients they have worked with in the past,” says Dr. Charletta Dennis. It’s important to ensure their practice is HIPAA-compliant, maintaining full privacy and confidentiality, she adds.
• “The first couple of sessions are getting to know each other. Sometimes you have to ‘date’ to see if there is a relationship. I encourage my potential clients to call other therapists and find the right fit“, says private-practice therapist Daniel Horrigan.
• If your internet signal is insufficient for virtual appointments, ask if the therapist is okay with phone sessions, Horrigan advises.
• What about popular online platforms services such as Talkspace and Better Help? “These can be great tools for the fundamentals of behavioral healthcare but should not replace a relationship that is trackable with a mental health professional who is part of your healthcare system,” Dennis says. “If you are interacting with a live person, it should be trackable.”
The National Council on Aging has published a helpful guide for older adults seeking online therapy. Key questions they suggest:
• How much does it cost? How do I pay?
• Does the provider accept insurance payment, including
Medicare and/or Medicaid?
• What features are included?
• When are therapists typically available?
• What do other users have to say about their experience?
Access the full NCOA guide at https://www.ncoa.org/article/online-therapy-a-mental-health-guide-for-older-adults.
Lastly, Horrigan notes, Psychology Today offers guidance plus a searchable directory of online counselors at https://www.psychologytoday.com/us/basics/online-therapy.
If you are having thoughts of suicide, are otherwise struggling or in a crisis, call or text 988 for Lifeline Chat to talk with a trained crisis counselor.
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