Blog,  Health

Mental Health Matters: Depression and Anxiety in Older Adults

– What I want to tell you right now, whether you are 10 years old, a high school student, a university student, whether you are a professionalin the middle of your life or whether you're older than that, it does not matter.

Depression, and most mental illnesses, rob us of our self esteemand our confidence.

And that's the one thingthat people don't often talk.

'Cause everybody wants to think that, you want people to think that, hey, you know, I goteverything under control.

I'm cool, I'm not nervous.

I'm this, I'm that.

So we all walk around with this swagger.

Very seldom do we hear people say you know what, when I'm struggling, I do not believe in myself.

Point number two.

Besides the fact that we lose self esteem when we suffer from a mental health issue, we all do the same thing.

We wear the mask.

And it is so incredibly frightening when you realise thatthe people around you, the person that's sleeping beside you, the person that's down the hall, at your dinner table, wherever you are, that person is only showing you what that person wants you to see.

So I could be up here on a bad day, and you'd think hey, what'sthat guy talkin' about with his mental health issue? Man, that guy, you know, like, doesn'tseem to have that at all.

He's not depressed.

We wear the mask.

we show you what we think you wanna see.

I have suffered from a mentalhealth issue for 18 years.

I've suffered fromanxiety most of my life.

But 18 years ago, I had a major fall into the hole that I wouldrefer to as depression.

That deep, dark hole, when you look up you can't see anything.

And you can't imagine any possibility that you can make it up there.

To me, the hole was, if you look up at theceiling, at the top there, could I climb up there? No.

If you told me the onlyway I could survive was to go up there, I would think, I'm dead.

And that's what I thought 18 years ago.

I thought I was dead.

I thought my life was over.

Because in a lot ofways, my life was over.

Because a day spent severelydepressed is no better than a day that you are dead.

The only difference isthat you can come back from a bad day.

So 18 years ago, I get hit by this thing.

But it doesn't hit me like bam, like that.

Depression is more the cumulativeeffect of little changes.

So for me it was likea little tap on the arm that I didn't even know was happening.

A little tap on the arm.

And if you do this enough times, you will bruise yourself.

And after a couple of days of doing this, it'll start to hurt.

I mean, it's not really realistic.

Well, I mean, you'd have tohave other problems going on if you're doin' thisfor two straight days.

But the point is you don't notice one tap, but you notice a thousand taps.

It's like you're in the bath, and the water is warm, and it feels good.

And you think wow, the water's warm.

It feels good.

I'm not a bath guy, by the way.

Just so you know, you know.

I'm not.

So, I don't wanna beperceived as being a bath guy, but I have taken baths before.

And the water, all of a sudden, you feel it and youthink, it's kind of cool.

What happened? You didn't notice it changing.

You noticed the cumulativeeffect of tiny, tiny changes.

And that is depression.

One day I woke up and said oh my gosh.

I'm thinkin' back, what happened to me? The person I was is gone.

The person I am, I don't wanna be.

That's what depression did to me.

It took me, Michael.

And replaced me with me, Michael.

And I hated that person.

I hated that person, because that personcould experience no joy.

That person had no belief in himself.

That person, all the thingsthat Michael wanted to be, wanted to do with his life, that person couldn't be.

And that is at the heartof mental health issues.

That is at the heart of depression.

It robs you of who you are and replaces you with someone else.

And the worst thing about it is it makes you feel like it's your fault.

So now you've fallen in this hole.

And I'm in this hole and I'm looking up, and I'm thinking, how the hell am I gonnaget out of this hole? There's no way I can climb up there.

And worst of all, this is my fault.

I put myself into this hole.

And even worse than that, it's my fault that I can't climb up.

That's what depression is.

It's this feeling of being totally lost, having lost yourself andblaming yourself for it.

So, my name is Michael Landsberg.

I suffer from a mental health issue.

Depression, anxiety, you couldthrow a couple others on.

But for me, it's mostly depression with a little bit of anxiety.

I have suffered this for 18 years.

I am on medication today.

I will be on medication tomorrow.

And I will be on medicationthe rest of my life.

Those are words that youseldom hear people say in front of a crowd.

And that is one of the reasonswhy I wanna be here tonight.

Because I wanna say it, Iwanna say it a few times, I wanna show you that I'm not ashamed.

I'm not embarrassed.

I am not weak.

And if we, as a society, could believe that, if everyone thought, you know, mental issues areexactly like physical issues, like the difference betweenParkinson's and depression is we call Parkinson's a brain disease and we call depression a mental illness.

Why is that? I got a buddy, he lives in Niagara Falls, Steve Ludzik, played in the NHL, coached the Tampa Bay Lightning.

He has Parkinson's.

He has a brain disease, but I got a mental illness.

I want a brain disease.

You don't want a mental illness, because you don't knowwhat a mental illness is.

I don't know what a mental illness is.

So, I think as a world, as a society, if we could all do simply this.

I have this thing.

I'm not ashamed of it.

I'm not embarassed by it.

And you know what? I kind of proud of the fact that I'm willing to get uphere and tell you about that.

If we could do that, thenwe would all go for help.

Then we would all get out of the hole.

Or at least we wouldhave the best possibility of getting out of the hole.

How many of you struggle with a mental health issue like I'm talk, whoa! That was like, people usually, usually this is the way it is.

Hands up, really slowly, looking around.

So let me ask you again.

How many of you strugglewith a mental health issue like I do? Well, this is the most honest room that I've ever been in front of.

And it does my heart good.

All I want from people who say, “Hey, what can I do for you, Michael? “I know that at times, you have really struggled.

“What can I do whenyou're in that position?” Really, what I want isI just want you to say, “I don't understand what that's like.

“And therefore I won'tpropose to understand.

“And I won't make suggestionsbased on my own reality.

” That, for me, when people say, as a caregiver, what can I give tosomeone who's struggling, that's the biggest thing.

Is the understanding that wedon't speak the same language.

And there is a barrierthat exists between us that will never come down.

How many of you either sufferfrom or care about someone who suffers from a mental health issue? Pretty much everyone in the room.

What other heath issue would there be that would be that widespread, that would still be under the table? That we would still, as a society, know that more than 1/2 the people that suffer from theillness that I suffer from, and many of you success from will never tell anyone about it.

Will not go for help, willnot share with their family.

They will live in pain and suffer.

My words to you are fight for your happiness.

Mental brain disease, thank you, brain disease is not often easily treated.

Let me tell you the storyof how my life got changed.

Because it was 2008, I had my last fall into this really deep, dark hole of depression.

And I can remember being inthe Marriott hotel, room 521, sitting on the edge of thebed at 4am in the morning and thinking I am in so muchpain that I don't wanna live.

Now, there's a difference.

I was not contemplatingtaking my own life.

Because I had been through this before.

I had suffered that deeply, and had been brought back.

Now, I lost confidencethat I'd be brought back, which is part of the illness.

You always think, well, thistime it's not gonna help.

Or I'm the one of ones that won't.

It makes you very pessimistic.

But I remember sitting onthe edge of the bed thinking, this pain is terrible.

But I'd never talked about it publicly.

Everybody in my life knew.

My family knew.

My friends new.

People at work knew.

But I never talked about it on TV.

I never used the platforms that I had to be able to talk about it.

And in 2009, we had a guest on the show who was a former Montreal Canadian.

Anyone familiar with thename Stephane Richer? So, when Stephane Richer asa guest on Off the Record, I had never met him before.

We had a chat outside our green room.

I said look, Stephane, I never met you before, you don't owe me anything, but I know that in the 1990syou suffered from depression.

And I'd like to ask you if you're okay, how you're doing.

And he thought about it, and I'm gonna pause now, because this pause, andthis whole scenario, changed my life.

I said to him, well, if it will make you morecomfortable when I ask you, I'll share with the factthat I, too, have struggled.

Okay.

We went on the air, and wetalked for maybe 90 seconds tops.

Maybe it was less than that.

The next day, I start getting emails.

And the emails say, essentially, the same thing: “Michael, I'm gonna tell you something “I've never told anyone before.

“I've been suffering from depression “or anxiety or undiagnosed something “for six months or a year “or five years or 10 years.

” And one person sent me this message that said, “I've suffered all my life, “and my dad suffered all his life, “but never told anyone.

“But I'm telling you “because I saw you on television “talking about your own struggles.

“And you didn't seem ashamed.

“And Stephane Richer wastalking about his problems.

“He didn't seem embarassed.

“And he sure as hell didn't seem weak.

“So now I have the confidenceto share this with you.

” – That's why I have a numberof different roles in my life.

I am a family doctor, as Michael mentioned.

I'm a family doctor to my patients.

So, if you're not mypatient, just call me Doug.

I'm also a father to my children.

I'm a husband, I'm a friend.

I'm a son.

I am a brother, I'm an uncle.

A lot of different things, right.

And in each of those roles, (clears throat) I can promise you that I've had failuresand I've had successes, as all of you probably have in a number of differentroles in your lives.

And the one consistent thing I will say, in the brighter moments, whether they're attachedto a success or a failure, is they always had something to do with me acknowledging that Ididn't have all the answers.

That I needed help.

So, if you're an older adult living with a mentalillness in our society, you've got two problems according to societal norms.

You're ageing and you havea mental health issue.

And you are susceptible to alarge degree of discrimination and stigma for those two reasons.

People may act differently towards you.

They may speak differently to you.

They may project the idea thatyou are less whole than me because you're older.

You are less whole than me because you have a mental illness.

Somehow you're damaged.

I'm gonna challenge thatthought related to ageing.

Being older somehow meansyou're less capable.

That is categorically false.

And here's the proof.

I'm 44 years old.

If you're in this audience and you're 84, you've lived on this planetfour decades longer than I have.

You've acquired more knowledge and more wisdom than I havehad an opportunity to acquire.

You've made more relationships.

You've had more successes andmore failures in your life than I've had a chance to be touched by.

And somehow you're less whole than me.

That's an odd way to think about ageing.

70% of adults that are livingwith mental illness today say that they had symptomsbefore the age of 18.

And they didn't tell anybody about it.

We heard a story about that tonight.

And interestingly, 40% of theparents of those adolescents say that they would never, under any circumstances, tell anyone in their life, including their own doctor, that their child was sufferingfrom a mental illness for fear that they'dbe stigmatised against.

So we've gotta do better in it.

So, as a healthcareprovider, the best way, or the only way I know how to start, and what I would promote to any healthcare providerin the audience tonight, we can battle our ownprojected discrimination by putting the personahead of the illness.

Make a connexion with theperson behind the diagnosis.

Do your best to findout who that person is.

I said I would talk aboutdepression, anxiety, and ageing.

Those are three words.

One of them is a diagnosis, one of them is a symptomuntil properly categorised, and I'll explain that, and one of them is a success.

And I'm gonna start with the success.

In Canada, ageing is a success.

Ageing is not a disease.

Stop talking about getting old like it's something we need to treat.

Any country in the worldwould give almost anything to have an average lifeexpectancy of 82 years and a quality of lifelike we have in Canada.

When I hear phrases like what are we gonna doabout this ageing crisis, it makes me wanna pull my hair out.

This is not a crisis.

This is a victory.

Yes, there are problems with the system.

There are challenges thatwe acquire as we get older.

But the language we use, talking about a white waveand a silver tsunami coming, like this whole cohortof ageing baby boomers is somehow a huge problem thatwe just have to deal with.

No, these are the people that have contributed most to our society.

Ageing is a success.

And it's part of our cultural as Canadians that we should be most proud of.

I know Suzanne Labarge wasnot able to be here tonight.

But it is because of people like her, not just her generous gifts, but through her vision that we're able to realisethe promise of a society that truly values itsolder adult citizens.

I think the work she is doing, and the projects she ishelping to coordinate are just unbelievable, and really deserve our respect.

A lot of people think that depression is an inevitable part of growing older.

That is no.

With capital letters, bold, underlined, four exclamation marks at the end.

Depression is not aninevitable part of ageing.

They do not have to go hand in hand.

5% to 10% of older adultsliving in our communities, yes, do have depression.

And that's a big number and we need to have a systemin place that can support them.

But that means that the majority of older adults living in our society do not have depression.

So, when you see it as a friendor a healthcare provider, it is not normal.

And it needs some attention, or it could benefit from that.

What factors increaseour risk of depression as we get older? Well, one of them is social isolation.

That's a big one.

Social isolation is anindependent risk factor for major depression as we age.

And that's importantto think about, right.

As a family physician, that's important for me to reflect on.

But it's far more important that I know you have somebodyin your life that loves you than I know what your blood pressure is.

Another big factor of risk for major depression aswith get a little older are the accumulationof medical conditions.

So, if i've had a chronicdisease like diabetes or cancer, heart disease, if I've had a stroke before, these are all things that are gonna exponentiallyincrease my risk of depression.

So be on the lookout.

And interestingly, you know, cure rates succeed 80%.

So what's the relevanceof identifying people who are suffering withdepression in older adult years, is that there's treatment available.

And it may involve physical activity and nutrition, medication.

It may involve individualor group counselling.

Mindfulness based stress reduction yoga.

There are all kinds ofdifferent treatment options that might suit you andsuit your individual needs.

And we can't access themif we can't find ya.

Why is it so hard for meto pick up in my office? Well, depression looksa little bit different in an older age group.

Older adults tend toexpress their emotional pain more as physical symptoms, and we need to be on thelookout for that as well.

Transforming our system doesn't just mean our healthcare system.

It means the way oursociety is structured.

A society that does nottolerate discrimination based on age or medical conditions.

And a society that's creative and innovative in theways that it supports all the potentially vulnerable people that we've talked about tonight.

The piece about individualstories is really important.

And what works for one individual might not work for another.

And I have a number ofpatients in my practise for whom medication has been a lifesaver.

An absolute lifesaver.

And other individuals that we've tried medicationafter medication, and literally, sometimes itwill be years down the road, the thing that made the difference is going out and buying a dog.

You know, that changedthis person's life around.

Picking up a musical instrument.

Like, it could be anything, and it's so unpredictablein any given individual.

So I would just echo and advocatefor try different things, talk to different people.

There is a lot of goodevidence for medication, for cognitive behavioural therapy as a type of psychotherapy.

For pet therapy, music, mindfulness based stress reduction.

There are a a lot of great options, yeah.

– [Voiceover] I wannashare with you my story.

I have been suffering from depression.

My daughter's 25.

So that was postpartum.

But also, I had post traumatic stress.

My little brother died when he was three.

And so what happened was, I was hospitalised inevery hospital in the city.

I even went to HPH.

I was there for about three months.

So, what I'm saying to everyone here is do not give up.

I dug and dug.

I was at the bottom, like you said, and today I'm here.

And I had to have nine ECTs.

I almost lost my family, because nobody understood.

They said, “Well, youhave everything, Rose.

” I did, but guess what, I didn't have happiness.

I didn't have joy.

I felt empty.

And once I took all my pills, and thank God, I got saved.

My husband got me therapy.

my family became closer.

So now I'm enjoyingfour beautiful children, three grandchildren, and I say don't give up.

And my doctor, he said to me, “One day, Rose, I wanna seeyou go up to that podium.

” And you know what, Ifeel this is the moment.

So, to me this is, (applause) I'm like wow.

So thank you.

You, you made me say this.

So I admire you.

And please, please don't give up.

.

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