In order to understand the thoughts and actions of elderly patients with mental disorders, we interviewed 13 elders (> 60 years of age) treated at a public hospital in Belo Horizonte, Minas Gerais State, Brazil. Data analysis was based on the signs, meanings, and actions model. The majority of the elderly patients denied the presence of any mental disorder, but identified signs of mental distress, grouped into three main categories: "nerves", "head problems", and "craziness". All patients identified the symptom that justified their treatment and highlighted the following causes of mental disorders: family, living, physical, eating, and sleep problems, moral weakness, and aging-related frailty. Although they contended that someone else had taken the initiative to seek treatment for them, they accepted their treatment and rated it positively, despite some complaints related to their conceptions of the causes and consequences of their conditions. They mentioned medication as the main therapeutic measure, despite its adverse effects and low efficacy and the way it was prescribed by physicians.