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According to the CDC and the National Institute of Mental Health, 20 percent of adults age 55 and older have experienced a mental health condition. Sadly, many of these people do not get the help they need.

Psychiatric symptoms in older adults are often overlooked because they are confused for dementia, medication side effects or apprehension toward the aging process. However, mental illness is a very real concern for older adults. By recognizing the signs and getting an accurate diagnosis, treatment can be very effective.

Are you concerned about yourself or a loved one? Here are 10 symptoms that may indicate a psychiatric condition such as depression or anxiety.

1. Sadness or depression lasting more than two weeks. It’s normal to feel down at times, even for several days at a time. If you continue to feel sad or depressed, it’s time to see a doctor.

2. Withdrawal from social activities. Some people are naturally more social than others, but we are all social creatures. Socialization is especially important for older adults because it prevents isolation. If you’re not interested in being with anyone, this is a cause for concern.

3. Unexplained fatigue or energy loss. Again, it’s normal to feel tired some days, but consistent fatigue means something is wrong. It could be depression holding you back, or it could be a medical problem that needs to be addressed.

4. Changes in appearance and hygiene. Are you indifferent about the way you look? Losing interest in your physical appearance is a red flag. What is stopping you from dressing up, putting on makeup, wearing jewelry or showering each day?

5. Feelings of worthlessness. Do you feel that you have no place in society? Feelings of helplessness or worthlessness can put you at risk for suicide. Persistent guilt should be addressed by a geriatric psychiatrist.

6. Confusion or disorientation. If you’re having trouble making decisions or following conversations, medication side effects should be ruled out. If the confusion doesn’t go away, you may be having trouble focusing due to depression.

7. Short- or long-term memory loss. Memory loss is another potential side effect of certain medications, so it’s important to have this ruled out. But, depression and anxiety can also interfere with your ability to retain and recall information.

8, Trouble working with numbers. Has it been more difficult to manage your finances? Maybe you struggle to pay your bills or read the receipt from the grocery store. PTSD or bipolar depression can make it hard to work with numbers.

9. Unexplained aches and pains. One of the more common side effects of mental illness that older people complain of is unexplained aches and pains. These discomforts may seem like a normal part of aging, but they are sometimes related to a mental health disorder.

10. Changes in appetite. Are you unusually hungry or not hungry? Some older adults eat more when they are depressed, though it’s more likely to stop eating. This is especially common for those who have no one to share meals with.

If you are concerned about yourself or a loved one, talk to a doctor right away. It may hard to spot the signs of mental illness in seniors; however, once a diagnosis is made, treatment can be effective and improve quality of life.