Laura Lambert, LCSW-C, is a clinical social worker and the Clinic Director at Columbia Mental Health’s Bowie, MD office. With more than 15 years of experience across inpatient and outpatient settings, she brings deep knowledge—and deep compassion—to her work with older adults. Geriatric mental health, she says, is not only her clinical focus but her calling.

In this spotlight, Laura shares what she wishes more people knew about aging and mental health: what it looks like, what gets overlooked, and how Columbia Mental Health helps older adults thrive.

Mental health conditions in older adults

What mental health conditions do you most often see in this population?

Laura: Depression and anxiety are by far the most common issues I see.

Older adults are dealing with the same things that most of us are dealing with—it just might look a little bit different.

Sometimes those conditions have been present for years and become more noticeable with age. Other times, they emerge in response to late-life transitions—retirement, physical decline, isolation, or the loss of a spouse or close friends. These can be huge emotional shifts, and they’re often overlooked or dismissed as “just part of getting older.”

Recognizing the signs

How can family members tell when something is wrong?

We tend to think of depression as sadness, but with older folks, it can look more like apathy—the clinical term is “anhedonia,” that lack of desire to do anything. What might look at first like just “slowing down” can actually be an indicator that an older person is withdrawing from life.

Other symptoms might include irritability, poor sleep, low appetite, or physical complaints like fatigue or stomach issues. These often get written off as medical issues or aging-related changes, but they can be signs of something deeper.

Does anxiety look different in older adults too?

Definitely. The concerns shift. Instead of being about career or social dynamics, they tend to be about physical health, financial security, or worry for others. Some are caregivers for a spouse, others are grieving close friends. That grief can turn into anxiety about their own future—or a deeper sense of vulnerability.

You’ll also see more somatic complaints. For example, some people may (rightfully) go to the ER thinking they’re having a heart attack, and it turns out to be a panic attack. In older adults, anxiety is just as real—but it often hides behind physical symptoms and age-related concerns, making it easier to miss.

Ageism and misdiagnosis

Isn’t this just part of aging?

We make a lot of assumptions about older adults. That they’re slowing down because they’re old. That they’re sleeping more because they’re old. That they don’t want to go out because they’re old.

We tend to assume they’re sleeping more because they’re older. But what if that’s a symptom of depression?

Just because one part of someone’s body isn’t working the way it used to doesn’t mean they don’t want to engage or contribute. And when we start assuming they can’t or shouldn’t, we risk ignoring real symptoms that could be treated.

Assumptions about what older people can and can’t do often mask treatable symptoms. And by making these kinds of age-based judgments we risk missing the real problems—and the real opportunities for help.

Cognitive changes and comorbid conditions

What about memory loss and dementia?

This is where things can get complicated. Some cognitive decline is expected with age—but it’s not always dementia. Sometimes, memory and thinking problems are caused by depression, anxiety, or even temporary medical issues like infections.

I’ve seen people who seem deeply confused or forgetful, and it turns out they had a UTI or were dehydrated. Once treated, they bounce back. It’s not always dementia. Sometimes it’s treatable, and therapy can still help.

How do mood and memory issues overlap?

People in the early stages of Alzheimer’s or dementia often know something’s wrong—and that awareness can be devastating. A lot of times we’re dealing with more than one thing at once. Depression, anxiety, and cognitive decline often go together.

When we see these issues in tandem, it takes a thoughtful approach. It might mean shorter sessions, simple language, or incorporating techniques like reminiscence therapy. But that doesn’t mean more traditional therapy isn’t an option—it absolutely can be.

What therapy looks like

What treatment approaches are most effective?

I use cognitive-behavioral therapy (CBT) with a lot of my older clients. It helps them unpack their feelings, challenge long-held beliefs, and reframe how they view themselves and their stage of life.

I also use behavioral activation—helping someone re-engage with things they enjoy, even in small ways. Sometimes it’s just helping someone get out of bed or out of the house again.

Therapy gives them space to talk about things they may not feel safe sharing elsewhere—especially if they’ve lost close friends or don’t want to burden their children.

What about patients with dementia?

For those experiencing cognitive decline, therapy might look a little different. We might shorten the sessions or slow down the pace. I also do reminiscence work—asking about positive memories and having clients tell stories from their life. That can be incredibly grounding and calming.

We’ll talk about something like making breakfast with their grandmother—the smells, the sounds, the feel of that memory. It brings comfort and connection, and it’s a powerful tool when words or logic start to feel harder to access.

Supporting a reluctant parent

What if my parent doesn’t want therapy?

That’s really common. A lot of my older clients didn’t grow up talking about their feelings. They were taught to push through, to not burden others. So when they first come in, it’s often because a family member or doctor pushed them to do so.

That first appointment is often, “I don’t want to be here. My daughter said I had to come.” But that changes.

Once they realize this is just a conversation—that I’m not here to lecture or fix or pity them—they begin to open up. They start to see the value of being truly heard.

The number one indicator of whether treatment will work? The clinical relationship. Can you meet the person where they are? That’s my job. And when I do, people of any age can benefit from therapy.

Why geriatric mental health matters

What do you wish more people understood?

Older adults are not burdens. They’re not done. They’re people with full lives, rich histories, and more to give.

We’re not just talking about helping people live longer. We’re talking about helping them live well longer.

And mental health is a huge part of that. The people who age best are the ones with resiliency—the ones who can adapt, pivot, and keep showing up for life even when it looks different than it used to.

At Columbia, our job is to help make that possible. We help older adults stay connected, feel supported, and reclaim a sense of purpose in their later years.

They still have things to offer. They still want to connect. They still want to feel well.

That’s why investing in mental health isn’t just about care—it’s about dignity, purpose, and helping older adults continue to live meaningful lives.

Columbia Mental Health is here to help

If you’re concerned about an aging parent or loved one, Columbia Mental Health offers compassionate, individualized care for older adults. Whether it’s therapy for depression, support through life transitions, or help navigating cognitive decline, our providers are here to listen—and help.