The Shadows of Time: Mental Health in the Aging World

By Saachi Sakhalkar 

It’s a sobering thought that up to 25% of adults 65 and older experience mental health conditions like anxiety or depression (Kathleen Cameron, 2023). You might think that with age comes wisdom and peace, but for many, it’s a time of increasing vulnerability. And yet, less than half of these individuals receive the treatment they need (Kathleen Cameron, 2023). The mental health conditions among older people account for 10.6% of the total disability for this age group (Mental Health of Older Adults - World Health Organization (WHO), 2023). It’s like watching a slow-motion train wreck, knowing that help is available but somehow out of reach. The stigma surrounding mental health can make people reluctant to seek help (Mental Health of Older Adults - World Health Organization (WHO), 2023). It’s as if there’s an invisible wall, preventing people from admitting they need support. And let's be honest, older adults have a lot on their plate such as reduced mobility, chronic pain, frailty, dementia, or other health problems (Mental Health of Older Adults - World Health Organization (WHO), 2023). 

Loneliness and social isolation are key risk factors for mental health conditions in later life (Mental Health of Older Adults - World Health Organization (WHO), 2023). It's not just about being alone; it's about the feeling of being alone, the distressing sense of separation from others (CentralinaRC, 2024). As people age, they may experience life changes that impact their mental health, such as coping with a serious illness or losing a loved one (Older Adults and Mental Health - National Institute of Mental Health, n.d.). Losing loved ones, physical limitations, financial struggles, limited social support, language barriers, living in a community with limited resources, and experiencing discrimination in your community can contribute to social isolation and loneliness (CentralinaRC, 2024). This lack of connection can have devastating consequences, increasing the risk of heart disease, dementia, stroke, anxiety, and depression (Social Isolation and Loneliness in Older Adults - JAMA Network, 2024). It's like being adrift at sea, with no land in sight. Studies have shown that socially isolated older adults are at a higher risk of developing depression, anxiety and cognitive decline (CentralinaRC, 2024). It’s a vicious cycle that can be hard to break. 

The senses, our windows to the world, often begin to fade with age. As Jayant Pinto, MD, so eloquently put it, “When your senses decline, you can’t experience the world as well” (Grace Niewijk, 2024). You can’t hear colleagues or friends at the dinner table; you can’t discern what’s going on in your environment; you may have a hard time reading or making things out when you’re in your neighborhood (Grace Niewijk, 2024). It makes all your cognitive burdens a little harder, and that probably wears you down over time and causes mental health problems (Grace Niewijk, 2024). This sensory decline is associated with loneliness and mental health challenges (Eric W. Dolan, 2024). Vision impairment, in particular, is strongly associated with both loneliness and poor self-rated mental health (Grace Niewijk, 2024). Imagine the world slowly fading, becoming less vibrant, less engaging. It’s like watching a favorite painting lose its color, leaving you with a sense of emptiness. Visual impairment combined with an elevated level of loneliness may produce a more synergistic, deleterious impact on older adults’ cognitive

function than visual impairment alone (2023). The sensory decline could also impact older people with social isolation or other mental health conditions that lead to depression (Association of Sensory Impairments With Cognitive Decline And ..., 2020). It's like a domino effect, one challenge leading to another, creating a cascade of difficulties. 

But even in the face of these challenges, there is reason for hope. Depression is treatable in 65 to 75 percent of elderly patients (Richard B. Birrer, M.D., M.P.H., and Sathya P. Vemuri, M.D., 2004). Effective management requires a biopsychosocial approach, combining pharmacotherapy and psychotherapy (Richard B. Birrer, M.D., M.P.H., and Sathya P. Vemuri, M.D., 2004). It’s like assembling a puzzle, where each piece – medication, therapy, social support – plays a crucial role in creating a complete picture of well-being. Examples of approaches to treat depression include cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT) (Depression and Older Adults | National Institute on Aging, 2025). There are also medications for depression that may help balance chemicals in the brain, such as serotonin, that affect mood (Depression and Older Adults | National Institute on Aging, 2025). Healthcare initiatives, community support, and technology integration can help addressing social isolation (CentralinaRC, 2024). Creating more age-friendly communities by improving access to transportation and information and communication technologies can also help reduce social isolation and loneliness (Reducing Social Isolation and Loneliness among Older People, 2022). It’s about creating a safety net, a network of support that can catch people before they fall too far. Community programs aimed at facilitating social connections among seniors, such as group activities, support groups, and volunteer opportunities, can provide much-needed companionship and a sense of belonging (CentralinaRC, 2024). We need to promote a healthy social and psychological status for older adults with sensory impairment (2023). In many cases, we can mitigate sensory difficulties in ways that might actually improve people's lives, mental health and sense of loneliness (Grace Niewijk, 2024). 

The shadows of time may lengthen as we age, but they don't have to define us. By understanding the unique challenges older adults face and by providing compassionate, comprehensive care, we can help them navigate these years with grace, dignity, and joy. It’s about recognizing their worth, honoring their experiences, and reminding them that they are not alone. At the end of the day, it’s about making sure that everyone has the opportunity to live a full, meaningful life, no matter their age. And honestly, what could be more important than that?

Bibliography: 

Mental health of older adults - World Health Organization (WHO). (2023). https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-adults 

The Effects of Age, Mental Health, and Comorbidity on the Perceived ... (2007). https://pmc.ncbi.nlm.nih.gov/articles/PMC5315032/ 

Practical “Pocket” Guide for Treating Depression in Elderly | NDT. (2022). https://www.dovepress.com/recognizing-depression-in-the-elderly-practical-guidance-and-challe nge-peer-reviewed-fulltext-article-NDT 

Kathleen Cameron. (2023). The State of Mental Health Care for Older Adults. https://www.ncoa.org/article/why-we-must-address-the-rising-mental-health-needs-of-our-growin g-older-adult-population/