When a Bex and a lie down isn't enough

Life is never just plain sailing, but in times of emotional crisis you don't have to cope alone, writes Angie Kelly.

MANY of today's older people grew up in an era where stoicism was expected in the face of life's challenges. When things went wrong, adults tended to have a cuppa or a beer, maybe a Bex or a Vincent's powder and probably a good lie down.

Depression and anxiety weren't discussed freely among friends and were not out there in the media, the way they are today. There was no Oprah or Dr Phil, you didn't ring up talkback radio to unload your problems and the world of psychiatry was viewed by most with great suspicion. If you felt sad or anxious, you just got on with it.

Most professionals agree this is a large part of the reason why older people despite being especially vulnerable to suffering mental health problems are less likely to seek help than people living in the age of the TV talkfest and intimate magazine exposes.

"In the old days it wasn't socially acceptable to get help because psychiatry was still in the dark ages, and there was a perception that there's not a lot you can do anyway," said Dr Gary Galambos , a consultant psychiatrist at Sydney 's St John of God private hospital. "You either coped and managed or you were sent to an asylum, so there was a very good motivation to be stoic.

"When older people today think of getting help for mental health problems they think of poor quality, crude treatments and separation from loved ones, whereas many younger people think making a counselling appointment is as simple as popping into a hairdresser."

Statistics show older Australians are a particularly "at risk" group for experiencing mental health problems due to the fact that major life events can snowball from about the age of 50.

Figures from the Mental Health Foundation of Australia show at least 20 per cent of older people already have a significant emotional problem, with another one in five showing early signs.

Leaving the world of work, financial worries, selling the family home, moving to an unfamiliar neighbourhood, losing a spouse or caring for a seriously ill partner, going through children's divorces and frequently being called upon to look after grandchildren or enduring chronic pain are all issues which put coping skills at risk especially if people have more than one of these going on at once.

"There is still a negative stigma among over-55s about psychiatry but the reality is that we have had an explosion of understanding in these past couple of decades about mental health and the message is 'you don't have to do it alone'," said Dr Galambos. "Getting professional help means you can improve your quality of life."

Professor Graham Burrows, chairman of the Mental Health Foundation of Australia, agreed that the senior years were an especially important time for people to look after their own emotional wellbeing.

"This can be a very stressful time for people, with lots of adjustments, but you can't look after other people if you don't look after yourself," Professor Burrows said. "I'm not talking about selfishness, I'm talking about taking responsibility.

"If you get professional help you can learn a lot about techniques which reduce stress like relaxation, hypnotherapy and even exercise which can prevent problems from getting worse. If you learn how to dealt with your stress when you first notice it you are less likely to go on and get major depression later."

Professor Burrows said signs to look for include a change in normal coping skills, the sudden onset of disturbed sleep patterns, problems with eating more and putting on weight, drinking more than normal or gambling.

He said emotional ill-health could be triggered by a multitude of factors but most people were able to recover completely or learn to manage their illness through therapy.

"Mental health problems are partly genetic, partly environmental, partly social, partly financial," he said.

"You don't necessarily need to rush off to a psychiatrist. If you are stressed, anxious or depressed and experiencing changes in your normal coping mechanisms your first line of approach should be to go and see a general practitioner and they will refer you to a range of organisations which can help."

Dr Nicole Highet, psychologist and spokesperson for Beyond Blue, the national depression initiative, said more than 2 million Australians were suffering from depression or anxiety at any one time.

"The important thing to realise is that depression is treatable," Dr Highet said. "There are very safe and effective treatments available and most people can be treated at home in much the same way as you would treat arthritis or diabetes or asthma it's not a matter of being admitted to a hospital and having to stay for a long time."