This paper examines mood disturbances — encompassing bipolar and depressive disorders — in the elderly Australian population (aged 65 and over). Drawing on national data from the Australian Institute of Health and Welfare and the World Health Organization, the paper outlines the prevalence and healthcare burden of mental illness in older Australians. It explores the bio-psychosocial framework underlying mood disorder development, including biological, cognitive, and social risk factors such as chronic illness, rumination, and elder abuse. The paper then discusses observable changes in mood, behavior, cognition, and physical functioning, before reviewing the concept of clinical and personal recovery. Finally, it evaluates therapeutic approaches — primarily cognitive-behavioral therapy (CBT) and interpersonal psychotherapy (IPT) — assessing their relative effectiveness and limitations in treating mood disorders in this population.
The paper demonstrates effective integration of a conceptual framework (the bio-psychosocial model) with empirical evidence. Rather than listing symptoms or statistics in isolation, the author consistently ties each claim to a theoretical cause — for instance, linking rumination as an ineffective coping mechanism to depression risk, or connecting social determinants such as marital status and living arrangements to mood disturbance prevalence. This technique shows how academic writing can move beyond description toward analytical explanation.
The paper follows a clinical essay structure: an introduction establishing prevalence and national context; a bio-psychosocial framework section covering risk factors; a section on observable changes across behavioral, cognitive, and physical domains; a discussion of recovery concepts (clinical vs. personal); two substantial treatment sections covering CBT, IPT, and combined approaches; and a conclusion summarizing key disorder types and treatment options. Each section builds logically on the last, making the argument easy to follow.
Mood disturbances refer to a category of mental health issues used by mental health practitioners to broadly describe all kinds of bipolar and depressive disorders. A large number of individuals in the senior population (aged 65 and over) fall into the high-risk group for developing psychological illnesses, substance abuse issues, neurological disorders, and other health conditions such as osteoarthritis, diabetes mellitus, and hearing loss. With age, individuals also display a greater likelihood of experiencing several health issues simultaneously (WHO, 2017). More than 15 percent of individuals in the senior age group are diagnosed with a neurological or psychological illness, with the latter group of illnesses accounting for 6.6 percent of all disabilities — measured in disability-adjusted life years (DALYs) — in this population group (WHO, 2017). This essay examines the mood disturbance problem in the geriatric population (aged 65 and over), focusing in particular on the senior population of Australia.
In 2016–17, the senior Australian population received a total of 950,000 mental healthcare services subsidized by the Medicare program. These services made up nine percent of the overall eleven million mental healthcare-linked services that were Medicare-subsidized that year (AIHW, 2018). The year 2015–16 witnessed 46,500 healthcare facility separations for the senior Australian population who had received admitted mental healthcare overnight, accounting for 19 percent of all mental healthcare-related separations. Roughly 10–15 percent of older Australians living within the community are diagnosed with depression or anxiety (AIHW, 2015). Regarding community mental healthcare services in the same year, elderly individuals accounted for 779,000 mental healthcare service contacts — that is, 8 percent of the overall patient population (AIHW, 2015). Females continue to display a greater tendency than males to develop mood disorders.
In addition to the life stressors commonly experienced by all individuals, elderly persons may also be subject to biological stressors more commonly encountered in later adulthood — for instance, continuous and significant losses of functioning. Such biological risks encompass cardiovascular, endocrine, neuroanatomical, and immune or inflammatory elements (Tseng et al., 2019). Aged individuals may suffer decreased mobility, weakness, chronic pain, and other health challenges requiring some form of long-term care (WHO, 2017). This population group also displays a greater likelihood of experiencing events such as the loss of a loved one or a decline in socioeconomic standing following retirement. All such stressors may give rise to feelings of loneliness, isolation, and emotional distress among the aged population, further increasing the need for long-term healthcare services.
Mental and physical wellbeing have reciprocal effects on one another. For instance, older adults suffering from physical illnesses such as heart disease are more likely to experience depression than healthy aged individuals (WHO, 2017). Moreover, depression left untreated among elderly heart disease patients may adversely affect health outcomes. Avoidance and rumination have both been linked to depression across the lifespan. The term rumination describes ineffective coping characterized by passive, repeated mulling over one's distress. Among the geriatric population, a ruminative coping style has been specifically linked to depression (Fiske et al., 2009).
With respect to major factors linked to mood disturbances, Abdul Manaf and colleagues (2016) utilized multiple logistic regression and identified three societal determinants: being single, poor overall health, and living with one's family. The last of these was found to be the single most significant factor in relation to mood disturbance. These findings were comparable to those of other scholars (Imran et al., 2009; Rashid et al., 2011; Taqui et al., 2007), all of whom found increased mood disturbance risks among single older persons — that is, those who were unmarried, widowed, or divorced. The United Nations classifies living arrangements as: (1) single; (2) living only with one's partner; (3) living with children, grandchildren, or children-in-law; (4) living with some other relative; and (5) living only with unrelated persons (United Nations, 2005; Tseng et al., 2019).
Moreover, older persons are susceptible to abuse in various forms — physical, psychological, verbal, sexual, and financial abuse; acute loss of respect and dignity; desertion; and neglect. Existing evidence indicates that one in six elderly individuals is a victim of some form of abuse (WHO, 2017). Such abuse can result in physical injuries as well as serious and sometimes enduring mental health consequences, including anxiety and depression.
A person diagnosed with a mood disorder may experience various behavioral, mood, communicative, cognitive, and physical changes depending on the specific disorder they have and their individual personality.
Mood disorders may bring about changes in conduct and impair an individual's ability to manage everyday tasks related to school or work (da Costa Lane Valiengo et al., 2016). In the initial stages following the onset of a disorder, behavioral changes may include irritability, sleep disturbances, and emotional lability.
Cognitive changes associated with mood disturbances include impaired social judgment, difficulties with attention, and feelings of hopelessness or worthlessness. Co-occurring signs such as fluctuating attention, confusion, or autonomic dysfunction may be indicative of delirium.
Mood disturbances may also produce changes in the emotional state of older adults, manifesting as sluggishness, loss of energy, disinterest in hobbies and pastimes, or, conversely, prolonged and intense feelings of excitement, euphoria, or joy.
Physical changes associated with mood disturbances include an inability to remain standing, lying down, or seated for extended durations; confused or rapid speech; constipation; diarrhea and other digestive complaints; and muscular or bodily aches and pains.
Clinical recovery refers to the absence of symptoms, or a significant reduction in their severity. Personal recovery, by contrast, means leading a meaningful life as defined by the individual, within the context of their own experience with serious mental health difficulties. Personal recovery fosters individual wellness, including the setting of personal recovery goals, the development of self-respect, confidence, resilience, a sense of purpose, and the capacity to maintain relationships (Healthtalk Australia, n.d.). Clinical and personal recovery are not mutually exclusive; rather, they can work together and complement one another.
For the individual living with a mental health problem, recovery means acquiring and maintaining hope, living an active life, understanding one's strengths and limitations, achieving personal independence, and developing a positive sense of self, social identity, and meaning in life (Department of Health, 2010). The term recovery denotes both internal conditions — such as hope, healing, connection, and empowerment — experienced by those who self-identify as being in recovery, and external conditions that facilitate recovery, such as recovery-oriented services, a positive recovery culture, and the exercise of human rights (Jacobson and Greenley, 2001, p. 482).
Mood disorders are generally treatable. Treatment options include therapeutic processes such as psychotherapy — the most commonly employed treatments being interpersonal and cognitive-behavioral therapies — which focus on modifying the inaccurate beliefs an individual holds about themselves and their environment (Picardi & Gaetano, 2014). These therapies also facilitate the development of relational and interpersonal skills and the identification of environmental stressors, including strategies for avoiding them.
Interpersonal psychotherapy (IPT) and cognitive-behavioral therapy (CBT) are both strongly supported by empirical research. Existing research indicates that CBT — particularly cognitive therapy (CT) — is specific and effective in treating mood disturbance disorders (Picardi & Gaetano, 2014). Reliable evidence exists for its enduring specific and effective impact in preventing both relapse and recurrence. The effectiveness of IPT as a therapeutic approach is equally well supported by research when delivered by qualified therapists. This treatment strategy has been found to be specific and effective in reducing acute distress and potentially preventing relapse and recurrence, provided that treatment is maintained.
Stronger evidence exists for contextual strategies such as contingency management and behavioral activation, which have been tested against other active treatments in fully clinical samples. Less robust support exists for the problem-solving therapeutic approach, as supporting studies were largely conducted with general practice patient samples or recruited volunteers (Picardi & Gaetano, 2014). On the whole, when delivered by qualified and experienced therapists, behavioral therapies, CBT (particularly CT), and IPT have been found to be as effective as medication in treating mood disturbance patients.
Setting aside procedural and principle-based differences, all CBT approaches offer patients problem-focused, collaborative therapy that examines how events and circumstances are perceived and interpreted, the patient's attitudes about themselves and the world, and the behaviors and skills they use to interact with their environment. CBT approaches are inherently educative, whether implicitly or explicitly. Compared to other approaches, they place greater emphasis on the present than on the past (Picardi & Gaetano, 2014). Research-based treatment protocols often involve a defined time limit, typically consisting of 12 to 16 weekly sessions. In clinical practice, however, the therapist may tailor treatment to each patient's individual needs by adjusting the number and frequency of sessions accordingly.
Over the past few decades, psychotherapy has increasingly been recognized as a primary therapeutic option in the treatment of mood disorders. Empirically supported therapies for acute depression include CBT, behavioral therapy, IPT, and psychodynamic psychotherapy (the last particularly for short-term use and to a lesser degree). Meta-analytic findings confirm the clinical relevance and value of psychotherapy, though they do not reveal equally large effects in cases of chronic depression (Picardi & Gaetano, 2014). Psychotherapy with the chronically depressed geriatric population must account for several important differences compared to acute depression — including more pronounced social skill deficits, greater identification with the illness, persistent hopelessness, and a longer period of adjustment needed to adapt to improvements.
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