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 professional
in 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 esteem
and our confidence. And that’s the one thing
that people don’t often talk. ‘Cause everybody wants to think that, you want people to think that, hey, you know, I got
everything 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 that
the 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’s
that guy talkin’ about with his mental health issue? Man, that guy, you know, like, doesn’t
seem 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 mental
health issue for 18 years. I’ve suffered from
anxiety most of my life. But 18 years ago, I had a major fall into the hole that I would
refer 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 the
ceiling, at the top there, could I climb up there? No. If you told me the only
way 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 of
ways, my life was over. Because a day spent severely
depressed is no better than a day that you are dead. The only difference is
that 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 cumulative
effect of little changes. So for me it was like
a 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 to
have other problems going on if you’re doin’ this
for 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 be
perceived as being a bath guy, but I have taken baths before. And the water, all of a sudden, you feel it and you
think, it’s kind of cool. What happened? You didn’t notice it changing. You noticed the cumulative
effect 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 person
could experience no joy. That person had no belief in himself. That person, all the things
that Michael wanted to be, wanted to do with his life, that person couldn’t be. And that is at the heart
of 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 gonna
get 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 and
blaming yourself for it. So, my name is Michael Landsberg. I suffer from a mental health issue. Depression, anxiety, you could
throw 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 medication
the rest of my life. Those are words that you
seldom hear people say in front of a crowd. And that is one of the reasons
why I wanna be here tonight. Because I wanna say it, I
wanna 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 are
exactly like physical issues, like the difference between
Parkinson’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 know
what 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 up
here and tell you about that. If we could do that, then
we would all go for help. Then we would all get out of the hole. Or at least we would
have 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 struggle
with 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 when
you’re in that position?” Really, what I want is
I just want you to say, “I don’t understand what that’s like. “And therefore I won’t
propose to understand. “And I won’t make suggestions
based on my own reality.” That, for me, when people say, as a caregiver, what can I give to
someone who’s struggling, that’s the biggest thing. Is the understanding that we
don’t speak the same language. And there is a barrier
that exists between us that will never come down. How many of you either suffer
from 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 the
illness that I suffer from, and many of you success from will never tell anyone about it. Will not go for help, will
not 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 story
of 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 in
the Marriott hotel, room 521, sitting on the edge of the
bed at 4am in the morning and thinking I am in so much
pain that I don’t wanna live. Now, there’s a difference. I was not contemplating
taking my own life. Because I had been through this before. I had suffered that deeply,
and had been brought back. Now, I lost confidence
that I’d be brought back, which is part of the illness. You always think, well, this
time it’s not gonna help. Or I’m the one of ones that won’t. It makes you very pessimistic. But I remember sitting on
the 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 the
name Stephane Richer? So, when Stephane Richer as
a 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 1990s
you 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, and
this whole scenario, changed my life. I said to him, well, if it will make you more
comfortable when I ask you, I’ll share with the fact
that I, too, have struggled. Okay. We went on the air, and we
talked 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 was
talking about his problems. “He didn’t seem embarassed. “And he sure as hell didn’t seem weak. “So now I have the confidence
to share this with you.” – That’s why I have a number
of 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 my
patient, 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 failures
and I’ve had successes, as all of you probably have in a number of different
roles in your lives. And the one consistent thing I will say, in the brighter moments, whether they’re attached
to a success or a failure, is they always had something to do with me acknowledging that I
didn’t have all the answers. That I needed help. So, if you’re an older adult living with a mental
illness in our society, you’ve got two problems according to societal norms. You’re ageing and you have
a mental health issue. And you are susceptible to a
large 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 that
you 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 that
thought related to ageing. Being older somehow means
you’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 planet
four decades longer than I have. You’ve acquired more knowledge and more wisdom than I have
had an opportunity to acquire. You’ve made more relationships. You’ve had more successes and
more 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 living
with mental illness today say that they had symptoms
before the age of 18. And they didn’t tell anybody about it. We heard a story about that tonight. And interestingly, 40% of the
parents of those adolescents say that they would never,
under any circumstances, tell anyone in their life,
including their own doctor, that their child was suffering
from a mental illness for fear that they’d
be stigmatised against. So we’ve gotta do better in it. So, as a healthcare
provider, the best way, or the only way I know how to start, and what I would promote to any healthcare provider
in the audience tonight, we can battle our own
projected discrimination by putting the person
ahead of the illness. Make a connexion with the
person behind the diagnosis. Do your best to find
out who that person is. I said I would talk about
depression, anxiety, and ageing. Those are three words. One of them is a diagnosis, one of them is a symptom
until 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 world
would give almost anything to have an average life
expectancy of 82 years and a quality of life
like we have in Canada. When I hear phrases like what are we gonna do
about 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 that
we acquire as we get older. But the language we use, talking about a white wave
and a silver tsunami coming, like this whole cohort
of ageing baby boomers is somehow a huge problem that
we 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 was
not 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 realise
the promise of a society that truly values its
older adult citizens. I think the work she is doing, and the projects she is
helping 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 an
inevitable part of ageing. They do not have to go hand in hand. 5% to 10% of older adults
living in our communities, yes, do have depression. And that’s a big number and we need to have a system
in 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 friend
or a healthcare provider, it is not normal. And it needs some attention, or it could benefit from that. What factors increase
our risk of depression as we get older? Well, one of them is social isolation. That’s a big one. Social isolation is an
independent risk factor for major depression as we age. And that’s important
to 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 somebody
in your life that loves you than I know what your blood pressure is. Another big factor of risk for major depression as
with get a little older are the accumulation
of medical conditions. So, if i’ve had a chronic
disease like diabetes or cancer, heart disease,
if I’ve had a stroke before, these are all things that are gonna exponentially
increase my risk of depression. So be on the lookout. And interestingly, you know,
cure rates succeed 80%. So what’s the relevance
of identifying people who are suffering with
depression in older adult years, is that there’s treatment available. And it may involve physical activity and nutrition, medication. It may involve individual
or group counselling. Mindfulness based stress reduction yoga. There are all kinds of
different treatment options that might suit you and
suit your individual needs. And we can’t access them
if we can’t find ya. Why is it so hard for me
to pick up in my office? Well, depression looks
a little bit different in an older age group. Older adults tend to
express their emotional pain more as physical symptoms, and we need to be on the
lookout for that as well. Transforming our system doesn’t just mean our healthcare system. It means the way our
society is structured. A society that does not
tolerate discrimination based on age or medical conditions. And a society that’s creative and innovative in the
ways that it supports all the potentially vulnerable people that we’ve talked about tonight. The piece about individual
stories is really important. And what works for one individual might not work for another. And I have a number of
patients in my practise for whom medication has been a lifesaver. An absolute lifesaver. And other individuals that we’ve tried medication
after medication, and literally, sometimes it
will be years down the road, the thing that made the difference is going out and buying a dog. You know, that changed
this person’s life around. Picking up a musical instrument. Like, it could be anything, and it’s so unpredictable
in any given individual. So I would just echo and advocate
for try different things, talk to different people. There is a lot of good
evidence 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 wanna
share 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 in
every 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, you
have 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 enjoying
four beautiful children, three grandchildren, and I say don’t give up. And my doctor, he said to me, “One day, Rose, I wanna see
you go up to that podium.” And you know what, I
feel 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.

About the author


  1. Thank you for sharing your experience, Michael. I am sure you are helping many, many people with your openness. Thank you Dr. Oliver for your wise words on how professionals can help those who are struggling with mental illness (brain disease). Ending stigmatization of mental health issues includes focusing on education, support and treatment while instilling hope in those affected.

  2. A brave man to admit where he's been and is.I really appreciated his ability to describe his experience and I can relate to much of what he says and simple direct way he can articulate his journey. Thankyou for giving this illness a voice.

  3. The Bible says "anxiety in the hearts of man causes depression!"   We don't need all of this medical nonsense, the intention of which is to keep an influx of stimulus money flowing into a system that no longer helps those in need.    While you're sharing such facts as these, it would be helpful to bring other facts to peoples attention as well, such as, …did you know that over 12 Million Americans a year, are being misdiagnosed in outpatient treatment facilities such as Parkland Hospital!  Did you know that the medical industry has become a CASH REGISTER, along with all the OTHER cash registers these money changing aristocrats have created for their own benefit.   Pain is what's being prescribed in the food we eat, with Genetic Engineering, and the EPA now regulating how much pesticides are safe for human consumption, so that they can provide the remedies of which no one can afford!    Let's stop spreading the lies, and start spreading the TRUTH.   Wake up America!!!

    How can there be a better tomorrow, if we are not fighting and winning the battles that are destroying us today?!

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