Older adults may be doing better during this pandemic than many people may realize. A new study involving older adults with pre-existing major depressive disorder has found no increase in depression and anxiety during the COVID-19 pandemic. Researchers from five institutions, including UCLA, found that the older adults, who were already enrolled in ongoing studies of treatment-resistant depression, also exhibited resilience to the stress of physical distancing and isolation.
“We thought they would be more vulnerable to the stress of COVID because they are, by CDC definition, the most vulnerable population,” said study investigator Dr. Helen Lavretsky, who is a professor-in-residence of psychiatry and biobehavioral sciences at UCLA, Los Angeles, California. “But what we learned is that older adults with depression can be resilient. They told us that coping with chronic depression taught them to be resilient.”
The researchers conducted interviews with the participants who were over the age of 60 (average age 69) during the first two months of the pandemic. Using two screening assessments of depression and anxiety (PHQ-9 and PROMIS), they found no changes in the participants’ depression, anxiety or suicidality scores before and during the pandemic.
Researchers further determined that participants were more concerned about the risk of contracting the virus than the risks of isolation. While all maintained physical distance, most did not feel socially isolated and were using virtual technology to connect with friends and family. While they were coping, many participants said their quality of life was lower, and they worry their mental health will suffer with continued physical distancing.
Participants were upset by the inadequate governmental response to the pandemic. Based on the findings, the study authors write that policies and interventions to provide access to medical services and opportunities for social interaction are needed to help older adults maintain mental health and quality of life as the pandemic continues.
Dr. Lavretsky said further research is needed to determine the impact of the pandemic over time. The findings offer takeaways for others while weathering the pandemic. “These older persons living with depression have been under stress for a longer time than many of the rest of us. We could draw upon their resilience and learn from it,” said Dr. Lavretsky.
Self-care is key
The study identified several self-care and coping strategies used by the participants, which included maintaining regular schedules and distracting themselves from negative emotions with hobbies, chores, work or exercise. They also employed mindfulness to focus on immediate surroundings and needs without thinking beyond the present. Mindfulness is defined as maintaining a moment-by-moment awareness of your thoughts, feelings, bodily sensations, and surrounding environment, through a gentle, nurturing lens. The idea is that when you practice mindfulness your thoughts tune into what you are sensing in the present moment rather than rehashing the past or imagining the future.
The authors further emphasized that access to mental health care and support groups, and continued social interaction are needed to help older adults weather the pandemic. The American Psychological Association says there are many evidence-based tools to help combat the negative effects of stress. It recommend cultivating strong social support systems and identifying which friends and family members may be good at listening and sympathizing.
Also, relaxing your muscles can make a big difference because stress causes muscles to tense. Stretching and warm baths may be beneficial. Physical activity can cancel out some of the negative effects of stress, including the impact of stress on the immune system. Mental health experts recommend getting outside as much as possible. Studies conducted in multiple countries have shown that green space improves mood.
The American Psychological Association recommends paying close attention to nutrition. It says there is no need to go vegan or swear off cookies, but it suggests consuming a rainbow of fruits and vegetables as part of your daily diet. Avoid using substances such as alcohol to dampen the stress response since substances do not solve the root of the problem and can have serious health effects.
Dr. Eric Lenze, who is a geriatric psychiatrist and professor of psychiatry at Washington University School of Medicine in St. Louis, Missouri, said diet and exercise are two very important factors. “Walking is great exercise. Make a plan, remember that 150 minutes per week is recommended, but any is better than none,” Dr. Lenze told Senior Voice. He said watching too much news can be harmful. He emphasized that heavy alcohol consumption can be harmful and he said moderation is the key, which means just one or two drinks a day.
“Talk to family and talk to friends every day,” said Dr. Lenze. “Physically distance, but don’t socially distance.”
John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute.
