Psychiatrist Elena Žigová, M.D., who has been working with seniors since 1984, speaks of a significant shift in the attitude of older people towards seeking psychological help. In an interview for Zoznam.sk, she shared her experience and views on the mental health of older generations.

What do you consider to be the biggest change in the approach of Slovak seniors to psychological care?

“We see that today’s seniors are more open-minded than they were in the past. It used to be that a visit to a psychiatrist was often seen as a sign of weakness, but today that view is changing,” said Žigová. Nevertheless, she adds that there is still some resistance among older men. “It is still difficult for these men to admit they need help. They struggle with the feeling that it makes them weak, and that’s a challenge we’re trying to overcome,” she explains.

What problems do seniors in Slovakia most often encounter?

The problems plaguing Slovak seniors are multidimensional. “Above all, they are plagued by health problems, which results in the problem of access to health care, especially from specialists,” Žigová says. At the same time, she mentions the unavailability and increasingly high cost of medicines, which is financially unaffordable for many pensioners. “Their pension is not enough to cover this, because in many areas their financial burden is increasing, which is why they feel very badly about the additional payments for medicines,” she adds.

Do you see an increase in psychological problems in seniors in practice?

According to Žiga, psychological problems among the elderly seem to be increasing. “This is also because the population in Slovakia no longer has the same resistance or prejudice against psychiatry as it did 20 years ago,” she explains. He points out that the increase in the number of mental disorders being treated is also linked to the increase in the average age of life expectancy.

What psychiatric illnesses are most common among seniors?

MUDr. Žigová deals mainly with seniors with serious mental health problems, often associated with somatic diseases. “Organic disorders, i.e. brain damage from various causes, predominate,” she says, adding that depressive disorders accompanied by anxiety states, various psychoses and dependencies on drugs or alcohol follow.

Can psychological problems be treated with medication alone, or are conversations also important?

In psychiatry, these two procedures are applied together. “If there is an indication that it might be an organically caused mental problem, I recommend starting with a neurologist first,” explains MUDr. Žigová, stressing that treatment with interviews falls more within the competence of a psychologist.

Do seniors also seek psychiatric help on their own, or do their children initiate the first conversation?

“About a quarter of patients are more aware, have more information and come spontaneously. Even with incipient dementia,” says Žigová. Three-quarters, however, come only at the suggestion of family or neighbors who notice changes in behavior. “Sometimes it takes a long time, and at the beginning, loved ones also have to fool the patient and say they are going to a neurologist, not a psychiatrist,” she adds.

Could poor access to healthcare be the reason for the poor mental state of the elderly?

MUDr. Žigová admits that these factors can affect the psyche of seniors, especially those who do not have sufficient adaptive skills. “I would not overestimate these negative factors, but they cannot be underestimated either. It is a burden on the psyche for sure, people perceive with a sense of guilt the low standard of living not caused by them,” she states.

When is it necessary to seek help from a psychiatrist?

Manifestations of depression, which may outwardly look like laziness or passivity, should not be underestimated. “Psychoses with morbid suspiciousness are common, especially in elderly women living alone,” warns MUDr. Žigová. She also stresses the need for early intervention for personality changes, memory or orientation disorders, which can signal the onset of dementia.

How are Slovak seniors doing with addictions?

According to Zigova, M.D., addictions at this age often involve alcohol or drugs. “Withdrawal treatment tends to be most effective with hospitalization in a specialized psychiatric unit,” she says. You can watch the full video interview here: https://youtu.be/EAqOiJUMgII