Longevity Part 4 — maintaining mental wellness into the late adult and senior years
Mental illness is just a part of life for longtime Glenwood Springs resident Lynne Jammaron.
It’s something she deals with both personally and in her efforts to help others through their own struggles.
Diagnosed with bipolar disorder at age 19, Jammaron has lived with mental illness all of her adult life. Her experience runs the gamut: ups and downs, manic moments, mood swings, breakdowns — and the returns to well-being.
Now 56, she doesn’t let the illness define her. But her willingness to share her experiences can provide a defining moment for others struggling with their own mental health.
“People need to know, first and foremost, that they’re not alone, and that they’re not the only one dealing with something that isolates them and fills them with fear and dread …,” Jammaron said.
Jammaron leads a weekly Connection Recovery peer support group in Glenwood Springs through the Roaring Fork Valley chapter of the National Alliance on Mental Illness (NAMI).
In her own journey, Jammaron had the strong support of family, including husband Glen, along with a good network of friends and a caring church family. But she recognizes that not everyone has that level of support, which is why she became involved with NAMI.
Glen, in particular, was a rock in her life during the tough times.
“We did this together as a team, just trying to find a balance, a good state of mind and a good relationship,” she said.
Outside of family, there was also NAMI and its support groups.
“It was amazing to me to see that there were a lot of other people who dealt with what I was dealing with,” Jammaron said. “We want people to know that they can come to a place of hope, health and healing, just as I have done.”
Those who attend Jammaron’s and other support groups in the Valley span the age spectrum. But she has also observed that the vast majority of people who regularly take part tend to be older adults who have learned through the years to manage their condition.
Millions of adults in the United States with a mental health condition have adapted through medication, regular psychiatric care and any of a variety of support mechanisms. It’s something they will continue to live with and adapt to as they get older.
According to statistics compiled by NAMI, one in five adults in America will experience a mental illness on some level, and nearly one in 25 (10 million) adults live with a serious mental illness.
Half of chronic mental illness starts around age 14, and three-quarters by age 24, according to that same set of statistics. But the stress and anxiety of later adulthood and post-retirement can also be a concern on the mental health front.
“Depression is not more common in the elderly, but it often does present itself for the first time when a person is older,” said Dr. Jules Rosen, a geriatric psychiatrist from Summit County who recently retired as chief medical officer for Mind Springs Health.
Rosen spent the last six years with Mind Springs, while also teaching as a professor of psychiatry at the University of Colorado. Prior to that, he was a professor of medicine and chief of geriatric psychiatry at the University of Pittsburgh for 32 years.
“Late-life depression can strike out of the blue,” Rosen said.
There are late-life stress factors to be aware of — final career advancement, the transition to retirement, financial security, health concerns and physical limitations that come with aging, and the sense of mortality when friends or loved ones die.
But there doesn’t have to be a specific cause for depression or late onset of a more serious mental health condition, Rosen said. A condition may have gone undiagnosed for many years, but only shows itself later in life.
In any case, “without treatment, it can be a very serious and even fatal condition,” Rosen said.
“Of all the fatal illnesses late in life, though, depression is the most treatable. When I see somebody with straight-forward major depression late in life, my expectation is 100 percent recovery. It may take four weeks, or it may take four months, but it can be treated.”
Short of a clinical diagnosis for a more serious condition, a person’s mental wellness associated with aging issues can benefit from a visit to a mental health counselor, Rosen added.
Oyen Hoffman, a family therapist and member of the behavioral health care team at Mountain Family Health Centers in Glenwood Springs and Rifle, said he works with a lot of people in their 50s and 60s who are struggling with the transitions that come with that period in a person’s life.
“That’s when people start to evaluate their life — where they are, where they thought they would be, where they’re headed,” Hoffman said.
Oftentimes, those concerns revolve around finances, and whether they’ve properly prepared for retirement, he said.
“But they tend not to think about purpose and meaning and the values in their life,” Hoffman said. “Their job might be their identity … then they retire, and they don’t have that purpose.”
Boredom and depression can set in during early retirement. There’s also an uptick in alcoholism and suicide rates during that period of life, he noted.
“There are a lot of things that aren’t in the retirement brochure,” Hoffman said, adding that it’s healthy to have the conversations around that transition well ahead of time.
Medical challenges that come with age can also affect a person’s mental well-being, Hoffman added.
“Hearing loss can be a real contributor to depression, and if we’re not able to catch that we could be missing something,” he said of Mountain Family’s focus on integrative health care that looks not only at a person’s physical health but the mental side of it, as well.
If a person can’t hear well, they’re more likely to isolate and shy away from social settings, which can lead to depression, he said.
“Isolation is the worst thing — for everyone and everything,” adds Gary Schreiner, also a family therapist at Mountain Family and head of behavioral health services for the multi-county network of community health clinics in Garfield, Eagle and Pitkin counties.
“We’re social animals, so when a person feels isolated, whether they’re depressed or bipolar, whatever, it’s going to make it worse,” Schreiner said.
Keeping people active and involved in social settings is important, whether it’s therapy for someone with a diagnosed mental health condition, or someone just looking to stay active and engaged in late life, he said.
Being single as one ages is a common struggle, whether it’s the result of losing a spouse to death or never having married in the first place, or remarried after a divorce.
“I can’t tell you how many folks in retirement tell me they just wish they had someone to share their life with,” Hoffman said.
“The lack of a close personal relationship is the health equivalent of smoking a pack of cigarettes a day. So, we have to have relationships. We’re hard-wired for relationships.”
MENTAL HEALTH IN ELDER CARE
For people diagnosed with a mental illness earlier in life, whether it’s clinical depression, a mood disorder or severe psychosis, continued psychiatric care later in life is crucial, according to Dr. Rosen.
It’s also important for patients, and their medical doctors, to understand the possible conflicts between medications intended to control a mental health condition, and those prescribed for medical conditions such as high blood pressure.
“I’m 68 now, and so many of my contemporaries are on six to eight different medications,” Rosen said. “Different drug interactions can cause side effects that can affect both mood and cognition.”
Over-the-counter medications can also be a concern, which is why a comprehensive approach to a person’s health care is critical, especially later in life, he said
“We need to know every single medication that our patients are on,” he said.
As a person ages, the lines can also be blurred from a layman’s perspective between what might appear to be a psychotic episode, but which might actually be the onset of dementia, Rosen also emphasized.
That’s where integrated treatment is important, and something for families to consider when a loved one starts to show signs of decline.
“Bipolar late in life can look like Alzheimer’s Disease, so it’s important to know what we’re dealing with,” Rosen said.
“As people age, treating bipolar is really an art,” he added, noting that doctors have to stay on top of medication dosages to avoid toxic reactions due to a lifetime of using a particular drug, such as lithium.
Left untreated, late-life depression can also speed the physical decline, Rosen said.
If an older person constantly says, “I don’t feel well,” that alone can be a sign of depression, he said.
Again, finding ways for older people to stay active and engaged in social settings is critical, Rosen, Hoffman and Schreiner all three concurred.
BEYOND THE STIGMA
A few years ago, NAMI partnered with suicide response agency Aspen Hope Center and Aspen Strong to raise awareness and start a conversation in the region about mental health issues.
An educational event at the Wheeler Opera House in Aspen drew a standing-room-only crowd, said Linda Spencer, another NAMI group organizer and board member for the organization.
A separate meeting with area police chiefs and sheriffs followed, which focused on the difficulties law enforcement agencies contend with in dealing with someone who has a mental illness.
“We had no idea when we started this that it was going to grow so fast,” Spencer said of the peer-to-peer and family support groups.
Jammaron would like to expand her own outreach to area churches, as her own church family has been one of the places where she found support and understanding.
She and Glen have also become advocates for expanding mental health services on the Western Slope.
“It’s very hard for someone dealing with a mental health break, and there’s no place to go,” she said.
West Springs Hospital in Grand Junction, which is the only psychiatric hospital on the Western Slope and is operated by Mind Springs, expanded last year. Already, it has a wait list, Jammaron said.
“When you have a loved one needing 24/7 care, and you have to go to Denver … you lose that intimacy,” she said. “We need those resources here.”
Striking a Conversation: Mental Health for the ages
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