“We can’t carry the weight of the whole world”: illness experiences among Peruvian older adults with symptoms of depression and anxiety

Abstract

Background Despite the high levels of depression and anxiety symptoms in old age, the use of mental health services in this population is low. Help-seeking behaviors are shaped by how an individual perceives and experiences their illness. The objective of this study was to characterize the illness experiences of Peruvian older adults with depression and anxiety symptoms in order to lay the foundation for tailored community-based mental health interventions. Methods In this qualitative study, we conducted in-depth interviews with a purposively selected sample of older adults (≥ 60 years) from peri-urban areas of Lima, Peru. We included individuals with only depressive symptoms (Patient Health Questionnaire-9 ≥ 10), only anxiety symptoms (Beck Anxiety Inventory ≥ 16), with depressive and anxiety symptoms, and older adults who mentioned they had received mental health treatment/care. The interview guide included the following topics: perceptions and experiences about depression and anxiety; perceptions about the relationship between physical chronic diseases and mental health; experiences with mental health professionals and treatments, and coping mechanisms. Data collection was conducted between October 2018 and February 2019. Results We interviewed 38 participants (23 women, 15 men) with a mean age of 67.9 years. Participants’ ideas and perceptions of depression and anxiety showed considerable overlap. Participants attributed depression and anxiety mainly to familial and financial problems, loneliness, loss of independence and past traumatic experiences. Coping strategies used by older adults included ‘self-reflection and adaptation’ to circumstances, ‘do your part’, and seeking ‘emotional support’ mainly from non-professionals (relatives, friends, acquaintances, and religion). Conclusions Illness experiences of depression and anxiety set the pathway for tailored community-based mental health interventions for older adults. Overlapping narratives and perceptions of depression and anxiety suggest that these conditions should be addressed together. Mental health interventions should incorporate addressing areas related to depression and anxiety such as prevention of loss of independence, trauma, and loneliness. Good acceptability of receiving emotional support for non-professionals might offer an opportunity to incorporate them when delivering mental health care to older adults.

Religiosity/Spirituality and Mental Health in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies

“…This scenario is based on the perception that the Divine is taking care of peoples' lives and that everything occurs according to a better purpose, even if sometimes humans cannot understand God's plan ( 37 , 178 ). This scenario was well-illustrated in the discourse of a 61-year-old Peruvian Woman examined by Flores-Flores et al ( 179 ), who explained that God was her psychologist and that she prayed to him every night to take her negative feelings away from her , and, according to her, little by little, they went away ( 179 ). In other cases, believing in the occurrence of spiritual experiences seemed to provide comfort and conciliation.…”

Sociodemographic and Clinical Determinants of Suicidal Ideation: An Analysis in a Peruvian Consultation-Liaison Psychiatry Unit

“…In the Peruvian context, the reality of retirees can be a crucial factor in uencing their mental health and suicidal ideation during hospitalization. The transition to retirement in Peru may be marked by economic, social, and adaptational challenges to signi cant changes in daily routines (39). The availability and accessibility of social security systems, as well as post-retirement socio-economic conditions, could play a fundamental role in retirees' mental health.…”

Screening for Generalized Anxiety Disorder in Older Adults who visited an Outpatient Clinic in a Low-Resource Setting

“…This is the main weakness in our research. However, some investigations such as the study of Flores et al [40] could try to answer this association. In their study, the main causes of anxiety and depression in Peruvian older adults are due to family and economic problems, loneliness, loss of independence and post-traumatic experiences [40].…”

“…However, some investigations such as the study of Flores et al [40] could try to answer this association. In their study, the main causes of anxiety and depression in Peruvian older adults are due to family and economic problems, loneliness, loss of independence and post-traumatic experiences [40]. Further, Failoc-Rojas et al found that older adults in another city of Peru with social problems had four times the prevalence of depressive symptoms compared to those with adequate social support [34].…”