Ageism and its impact on mental health

It’s no secret that modern society worries about the prospect of aging. We are bombarded daily with messaging for everything from procedures and serums to prevent wrinkles to endless warnings about online scams targeting older adults – all inferring how terrible it is to grow older. 

These messages are often internalized and reinforced by adults who have yet to reach those challenging years, and it impacts the way they treat the older adults in their lives. For those in the workforce, professionals with over 30 years of experience are often passed up for training opportunities or promotions out of stereotypical beliefs about their ability to learn or willingness to work. For older adults lucky enough to have made it into their 70’s and 80’s, normal human behavior like participating in hobbies, dating, or using profanity are suddenly deemed cute or shocking when seen from a person with white hair. In some instances, older adults are infantilized and underestimated based purely on the internal stereotypes  and fears we carry about what it’s like to age.

Each of these consequences is a symptom of the broader issue of ageism, which is the casual or systemic prejudice and discrimination of people based solely on a person’s age.

In short, ageism implies that someone is of lesser value because of their age.

While activists and social justice initiatives have raised a critical eye to other forms of discrimination in recent years, age bias remains firmly ingrained in the very fabric of our society – from our media to our politics, to our healthcare system - and its impact is being felt. One study conducted in 2022 found that 93% of adults 50-80 years old have experienced at least one form of everyday ageism, whether that be in interactions with others, in messaging in media, or in the form of internalized stereotypes, a trend which worsens as people continue to age. For older individuals with other marginalized identities – women, people of color, LGBTQ+ individuals – this discrimination compounds upon itself with even more significant consequences. 

How can ageism impact a person’s health?

The experience of chronic ageism in society leads to serious implications for the physical and mental health of older adults. Research shows that prolonged exposure to ageism can cause a variety of negative mental health outcomes, including:

• Decreased overall psychological well-being and life satisfaction
• Low self-esteem
• Higher levels of loneliness
• Lower overall morale
• Increased depression, anxiety disorders, stress levels
• Decreased cognitive ability

Ageism increases the likelihood that older adults could need or benefit from mental healthcare services. Unfortunately, ageism can also affect older adults’ access to receiving the care and support they need.

How does ageism impact older adult’s ability to receive mental healthcare?

Ageism has led to measurable differences in treatment quality and outcomes within the broader healthcare system. For example, ageist attitudes can influence how a provider communicates with older adult patients and makes medical decisions. For example, a doctor may assume that an older adult won’t understand the complexity of medical guidelines and will defer instructions/decision-making to a younger family member. In other instances, an older adult’s concerns or symptoms aren’t taken seriously even if they might be treatable because they are viewed as inevitable symptoms of aging. For mental health treatment, this can become even more dangerous. 

Many people view depression or anxiety symptoms as a normal part of the aging process. When older adults internalize ageist messaging, it can cause them to avoid seeking help altogether, as they do not believe their suffering is treatable or will be taken seriously. 

If an older adult does feel supported and able to seek treatment for their mental health concerns, they can also face discrimination in the type of support they are able to receive. Stereotypical attitudes about the effectiveness of traditional psychotherapy for older adults date back to the late 1800s, when Sigmund Freud contested that older adults did not have the mental flexibility to truly benefit from therapeutic methods. These attitudes have persisted, and some younger adults hold a belief that older adults are against the idea of therapy entirely (despite research demonstrating the opposite).  

As a result, older adults face a rising trend of over-prescription and overuse of psychiatric and neuroleptic medications to manage mental health conditions. While medication management is an important part of mental health treatment for some, there has been an overwhelming reluctance to refer older adults to psychological treatment. This is particularly prevalent in residential or long-term care settings where residents consume a significantly higher number of benzodiazepines, which calm the brain’s messaging to the body, antipsychotics and antidepressants than other older adults.

The compassion younger adults show today will benefit them later in life 

It’s important for younger adults to recognize and address the systemic forms of ageism that they themselves participate in – not only to prevent further harm today, but to break the cycle of ageism in their own futures. 

Dr. Becca Levy at the Yale School of Public Health has found that children and young adults who are exposed to ageist attitudes often apply these attitudes to themselves when they get older, leading to the same adverse health consequences mentioned above. If younger adults do not take steps to break the cycle of ageism, the same consequences will play out for every generation as they grow older. 

How can we collectively break the cycle of ageism within the mental healthcare space?

For Older Adults

• Know the signs and symptoms of common mental health conditions (anxiety, depression) and monitor yourself to determine whether you might need support.
• Seek out preferred mental health support if you find yourself struggling. Advocate for treatment that best suits your needs and preferences, whether that be through individual therapy, group therapy, medication management, or some combination of all three.
• Address and combat internalized ageist messages, including the beliefs that your value, worth and abilities diminish over time. 
• Develop a growth mindset and remove pressure to perform or behave as others do in order to get your needs met.
• Identify and assert your unique strengths and look for opportunities where you can exercise agency over your environment.
• Seek out support from others and take pride in your age group. Some older adults benefit from finding community within activism through groups like the Gray Panthers or AARP. Others have found support at the local level through meet-up and community groups.

For Younger Adults

• Build “intergenerational solidarity” by building a concern and respect for the experience and issues of individuals of all ages, both older and younger than you.
• Facilitate agency, autonomy and dignity when interacting with and supporting older adults in your personal life.
• Emphasize the strengths and abilities of older adults in order to combat ageist stereotypes.
• Investigate and explore personal biases and assumptions about older adults in order to challenge them (i.e., not assuming older adults have dementia, not assuming older adults need assistance with all tasks and activities).
• Examine your views on your own mortality and aging in order to address fear which may affect your view of older adults.
• Advocate at the local, state, and national level on issues which may impact equity for older adults. This can mean supporting legislation to improve access to mental health services and Medicare coverage on behalf of older adults or advocating for paid family leave for those who provide support to older adults within your community.

Older adults play a critical role in the health and vitality of modern society. Younger adults play a key role in breaking the cycle of ageism now, which will pay off in their own later years. We all have a role to play to ensure that adults of all ages can maintain the highest quality of life.

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SOURCES

^{Abramson, Ashley. “How Ageist Beliefs Undercut Us All.” American Psychological Association, 18 May 2020, www.apa.org/topics/covid-19/ageist-beliefs.}

^{Allen, Julie Ober, et al. “Experiences of Everyday Ageism and the Health of Older US Adults.” JAMA Network Open, vol. 5, no. 6, American Medical Association (AMA), June 2022, p. e2217240. https://doi.org/10.1001/jamanetworkopen.2022.17240.}

^{Hardin, Karen. “AGEISM AND MENTAL HEALTH.” Ohio Psychological Association, 7 Jan. 2019, ohpsych.org/news/432688/Ageism-and-Mental-Health.htm.}

^{Kang, Hyun, and Hansol Kim. “Ageism and Psychological Well-Being Among Older Adults: A Systematic Review.” Gerontology and Geriatric Medicine, vol. 8, SAGE Publications, Mar. 2022, p. 233372142210870. https://doi.org/10.1177/23337214221087023.}

^{Levy, Becca R., et al. “Longevity Increased by Positive Self-perceptions of Aging.” Journal of Personality and Social Psychology, vol. 83, no. 2, American Psychological Association (APA), 2002, pp. 261–70. https://doi.org/10.1037/0022-3514.83.2.261.}

^{Tesch-Römer, Clemens. Contemporary Perspectives on Ageism (International Perspectives on Aging, 19). 1st ed. 2018, Springer, 2018, https://doi.org/10.1007/978-3-319-73820-8.}