According to the World Health Organization, about 15 percent of adults over the age of 60 suffer from some form of mental illness. All too often, however, their changes in mood and behavior are dismissed out of hand or chalked up to the aging process.

As we care for elderly parents and deal with growing older ourselves, we need to be aware of the early red flags. Here are 4 mental health warning signs in seniors to watch out for.

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Withdrawal and Self-Isolation

It can be challenging for seniors to stay connected. But if you or a loved one gives up on social activities all together, there may be a deeper problem. Social withdrawal and isolation is often a consequence of mental illness. Loss of interest in activities that were once enjoyable is another red flag.

Depression and anxiety both make it more difficult to get out and enjoy life. Depression causes you to feel less interested in socializing. Anxiety makes it seem overwhelming to even try leaving the house or interacting with others. Both are real issues that should be taken seriously. A counselor, therapist, or other mental health professional can help.

Memory Lapses and Difficulty Concentrating

We tend to think of memory problems as a natural part of the aging process, but that’s not necessarily true. While a certain amount of forgetfulness is expected, when those memory lapses start affecting a person’s quality of life, that’s an issue. Difficulty remembering names of loved ones, forgetting birthdays or appointments, and habitually losing belongings—those are all potential signs that a mental illness is to blame.

Difficulty concentrating is another sign that things are not as they should be. If you or someone you care about is having trouble engaging with conversations or needs to have information repeated multiple times, there’s cause for concern. It’s important to get screened for Alzheimer’s and dementia, as well as talking to a doctor about other mental illnesses that can cause memory problems.

Declining Hygiene or Abandonment of Personal Care Routines

Mental illness doesn’t always show visible signs, but a major disruption to personal care routines is an indicator that all is not well. Red flags include showering or bathing less frequently, wears dirty or stained clothing, or no longer bothering to take care of appearances in other ways.

Consider a woman who spent her whole life wearing makeup and jewelry, for example, who suddenly stops caring about her appearance. She might be depressed or suffering from a memory disorder that makes it too difficult to remember her personal care routine.

Mood Swings or Changes in Personality

We all have our ups and downs. Dramatic and long-lasting changes to mood or outlook, however, are cause for concern. Irritability and a shorter temper are often early signs of a mental illness—particularly dementia.

If you notice major changes in your own mood or that of someone you care about—feeling sad more often than not, for example, or constantly worried—then it may be time to seek help.