The mental problems of the aged have to be examined along with the prevailing social system. Gradually there is a trend in the Indian families to become nuclear. More and more youngsters are living their family, either for education or occupation, to go to different cities and countries. There has been a movement of younger people from the rural areas to the urban areas. As a consequence, the elderly people are more often left alone. In the West there are special homes for the aged and hostels for the elderly but in our country such facilities are very few. The traditional family system in our country has encouraged the elderly to live with the family. It has always been recognized that the mental health and physical health are perhaps better when the elderly life along with the family. The usefulness or otherwise of the special homes and hostels for the aged in our country is difficult to comment upon. Indeed, one gets affected by the mood of the time. To me the temptation is to reflect on the broader sweep of events. In the recent past rapid changes have taken place all over the world. We are witnessing too much violent self-assertion by people, of their ethnic identity in different corners of the world. Powerful economic forces are deciding almost everything in all areas of human existence, more than at any time in the past. Psychological changes accompany the passing of years. These changes include slowness of thinking, impairment of recent memory, reduction of surgency enthusiasm, increased cautiousness, and changes in sleep patterns with a tendency to daytime naps.
Depression is usually common in later life. Late onset depression is very difficult to treat. The majority of first depressive attack in older age is severe one. The highest incidence occurs between 55 to 65 years in male and 50 to 60 years in female. Basically this follows a severely sad incidences.
In the depressed patient, the mood disturbance is primary and is often accompanied by irritability and hostility. The depressed patient rejects questions with " I don’t know" or "leave me alone", in contrast to the organically ill patient who makes some attempt to response to questions even though his replies may be irrelevant confabulatory. The depressed patients ordinarily does not show signs of a clear neurological deficit or abnormal primitive reflexes as may the patient with an organic disorder.
Case-1: 65 years old retired teacher, father of 2 sons & 4 daughters (all married & established) suffered from sadness, disturbed sleep, irritability, loss of temper even in simple matters for 5 months. After being diagnosed as suffering from Geriatric depressive disorder, he was reluctant to take medicine. After being convinced he has been given Muktapisti (65mg BD) for two months & 12 sessions of psychotherapy
Case-2: 58 years old widow, mother of 1 married daughter, who was living alone felt chest pain, dizziness and lack of concentration for 3weeks. All the investigations elicited medical illness. She has been diagnosed as having Depression with early Dementia. After having 16 sessions of psychotherapy and Brahma Rasayan (orally) she is now all right. Regular follow up has been taken.
Pharmacological treatment was not enough for them. Several spectrums of psychotherapies including Supportive, Suggestive, Emotive, Psychodynamic and sometime Confrontation psychotherapy have been executed to them. 31 patients have been selected as suffering from Geriatric depressive disorder. Keeping view over the nuclear family concept, vulnerable psycho-social picture and increased social stress factors what has been found were that in the contemporary society this illness is a challenge for the psychiatrists.
The details will be discussed at the time of presentation.
M.D., Ph.D. (Scholar)
Lecturer (Basic Principles).
Dayanand Ayurvedic College, Jalandhar (pb)
Member of Indian Psychiatric Society