Geriatric Psychiatry

People of any age can benefit from mental health support, and older adults over 65 years of age are often at a high risk of mental health and cognitive conditions. In these cases, geriatric psychiatrists may offer support. Whether you are a senior seeking mental healthcare, a psychiatry student looking to specialize, or a loved one hoping to help your aging family member, you can learn the basics of geriatric psychiatry and how it relates to mental and emotional disorders below, as well as ways to find support.  

What is psychiatry?

Psychiatry is the medical study of mental illnesses and disorders, both acute and chronic, in which psychiatrists then attempt to diagnose and treat. It is an area of medicine, much like oncology or cardiology. For this reason, psychiatry often looks at mental health from a medical standpoint, unlike psychology, which focuses on the psychological aspects of mental health. 

Derived from Greek, the words psykhe and iatreia mean "mind" and "healing," respectively. Psychiatry focuses particularly on identifying and addressing the mental health needs of an individual, with the goal of “healing” an individual’s “mind.”

Psychiatric treatment methods

Psychiatrists use varied evaluation and treatment methods, from talk therapy to electroconvulsive therapy (ECT). However, because they are medical doctors, psychiatrists are mostly known for their ability to prescribe medications to treat mental health conditions, like depression, bipolar disorder, anxiety, and obsessive-compulsive disorder (OCD), to name a few. Unlike psychotherapists, as medical students, psychiatrists must complete medical school training programs as part of their education and are trained in residency programs just like general practitioners or physicians. 

The BetterHelp platform is not intended to provide any information regarding which medication or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. Do not take any action (including starting, stopping, or changing medications) without consulting a qualified medical professional. 

Psychiatric diagnosis

To diagnose and treat mental illness, a psychiatrist will typically meet with a potential patient to discuss their presenting problem(s) at length. Psychiatrists then may order or conduct a physical examination to rule out medical conditions such as hyperthyroidism, metabolic syndrome, and syphilis that can cause symptoms that may be otherwise confused with mental illnesses. After ruling out a medical condition, the psychiatrist may give the client a diagnosis and a treatment plan.

What is geriatric psychiatry?

While all psychiatrists may treat elderly patients, a specific certification through the American Board of Psychiatry and Neurology focuses only on geriatric psychiatry. Specific populations, like the young or the elderly, often need more specialized care for psychiatric disorders. Just as a child and adolescent psychiatrist addresses the specific needs of young people, these psychiatrists specialize in providing psychiatric care to elderly patients.

Qualifications geriatric psychiatrists need to treat older adults

According to the American Psychiatric Association, geriatric psychiatry professionals are experts in the biological and psychological aspects of aging. These psychiatrists understand that certain neurological disorders and mental illnesses can appear due to aging—and that, in many cases, these conditions can be comorbid. For example, mild cognitive impairment and Alzheimer’s disease are closely associated with depression in late life; and Lewy body dementia commonly develops alongside anxiety disorders. 

Additionally, geriatric psychiatry specialists may have expertise on how to handle other types of mental illness that can evolve and become more pronounced, depending on the individual’s age and life circumstances, such as a substance use disorder or bipolar disorder. Not only do these professionals specialize in treating the symptoms of the psychiatric disorders at hand, but they're also often required to address the underlying issues and provide prevention strategies, just as psychologists and counselors do.

How do geriatric psychiatrists treat older adults?

In later life, anxiety often arises because of memory loss or a new medical diagnosis such as Alzheimer’s Disease. Similarly, the loss of family and friends could make depressive symptoms more pronounced or incite a descent into substance use. Older individuals often have a set of worries that are unique to their age group, like the state of the world, a fear of mortality, or feelings of grief that can contribute to their mental state. Because of the interconnectedness of these issues, geriatric psychiatry practitioners work to understand the problems that may be facing senior citizens.

Geriatric psychiatric emphasis on physical and mental health

Mental illness in elderly patients can also be intertwined with physical health as later-in-life health tends to diminish. Because these professionals are medical doctors, they can make assessments about their patients that consider the person's emotional and medical history while providing clinical care to improve their well-being. An individual’s depression, for instance, could be the result of a cancer diagnosis or an unnoticed interaction of medications. It is a geriatric psychiatrist's job to consider all these factors when making decisions regarding a patient’s mental health care.

Where do these professionals practice?

With the growing population of older adults in America, the profession of geriatric psychiatry has also continued to grow, so they work in many locations. To some extent, these psychiatrists might practice in the same places as any other psychiatrist. These locations include practices and hospitals where individuals can make appointments to receive services or receive services as part of their stay in the hospital. However, these professionals might also provide mental health services in facilities unique to their specialized fields, such as assisted living facilities, nursing homes, and veterans' homes where clients may be residents.

Geriatric psychiatric mental health support demand in residential facilities

Because of the high concentration of older adults in these types of facilities, psychiatrists are often part of the healthcare teams in nursing homes and assisted living centers. In a community like this, psychiatrists might also be on call throughout the day and night to serve these unique residential populations. 

However, clients do not have to live in one of these specific facilities to receive specialty services from geriatric psychiatry psychiatrists. They can visit these psychiatrists in their offices and hospitals, and some may make house calls. 

Geriatric psychiatry research opportunities

According to the American Association for Geriatric Psychiatry, geriatric psychiatry is a field that offers a number of opportunities for cutting-edge research. Specialists in geriatric psychiatry can help facilitate scientific discovery in their field by conducting studies, analyzing details, or developing surveys. They may choose to practice in a research lab, where they can help develop new treatment options for aging patients. In the field of psychiatry, geriatric psychiatry is one of the newest specialties, so there are many opportunities for clinicians to practice almost anywhere they are interested in working.

Treating mental health disorders in older individuals

Those practicing geriatric psychiatry offer similar treatment options to those presented by a general psychiatrist. Medication, behavior plans, and talk therapy are all options that one of these professionals might explore with their clients.

Start by diagnosing older individuals

Before treatment can occur, these psychiatrists must go through the process of diagnosing their patients. Due to the increasing number of physical ailments in elderly patients, these professionals may have greater difficulty diagnosing and treating them. Psychiatrists specializing in older medicine must be aware of the ways psychiatric symptoms may manifest differently in older patients. For example, individuals with late-life depression often report more cognitive impairments than younger people with depression.

Some physical issues present with psychotic or depressive symptoms, and some mental disorders can result in physical symptoms like lethargy, for example. Those practicing geriatric psychiatry conduct extensive physical assessments and psychological questionnaires to distinguish the causes of certain symptoms. Before deciding on a treatment plan, geriatric psychiatrists may consider:

• Will the client remember to take their medication if memory-related issues are present?

• What type of support system does my client have?

• How will treatment interact with any other medications or medical conditions that my patient has?

• Is the individual living alone, with family, or in an assisted living facility?

• How can the side effects of psychiatric medication be neutralized?

• Will my client be open to psychiatric services?

Although attitudes are changing, some of these psychiatrists find that older generations may still carry the stigma of receiving psychiatric or psychological care. Some clients may resist treatment or deny that they require it in the first place. Being respectful while working through these barriers is another element of the treatment plan that these professionals may consider.

Focus on the interpersonal relationships of older adults

Diagnosis and treatment in geriatric psychiatry address the interpersonal context of the care of older individuals. Older adults may have a strong network of support around them, made up of family and other medical practitioners. For this reason, these professionals typically work as part of a larger care team.

The client's family may be more actively involved in treatment than would be typical of an adult client. Geriatric psychiatrists often collaborate with families to ensure treatment can be delivered successfully and to help them grapple with their elderly family's issues. To gather information that a patient is unable to give them and to get a larger picture of the patient's psychological issues are also reasons that one of these psychiatrists might work with a patient's family.

Navigating mental disorders with online therapy

Seeking mental healthcare can be difficult, especially for seniors. Between mobility concerns and potential social stigma, many older adults may have trouble getting care. Similarly, caretakers of elderly patients can have trouble finding time to receive care themselves. If you’d like more information on mental health care for the elderly, visit the Substance Abuse and Mental Health Services Administration’s Resources for Older Adults page. No matter what your situation, receiving mental health care can be expensive, overwhelming, or inaccessible. If care from a medical doctor is out of reach, there is still a way to seek professional help for your problems.

Through an online platform like BetterHelp, you can find convenient counseling. With various flexible digital counseling options, an online platform can provide discrete and accessible help on your schedule. Users of these platforms can communicate with their counselors via phone, video, or live chat sessions and message their therapist through the chat throughout the week. Research shows that online therapy can be particularly helpful to older adults, especially as they may have mobility issues or worry about leaving the house to seek out therapy in person.