Contrary to the fundamental ageism of our society, it is possible to live well in old age. Yes, there are financial, physical, and emotional challenges, but there are also great opportunities to be a productive worker -- paid or volunteer -- who takes pleasure in being effective and in spending time with coworkers, to be a good parent, spouse, lover or friend; to contribute to your community, nation or even the developing world; to enjoy sports, the arts or travel; to discover new interests and cultivate new skills. Time may be comparatively short; but many older people finally have time for more than the daily grind.
There is a remarkable array of opportunities for those of us who are old, but not without our mental health. To say that depression, anxiety and cognitive decline are enemies of achieving the potential of old age is too abstract. Imagine instead what these conditions mean.
- Imagine that almost nothing interests you or gives you pleasure. You could not care less whether your grandchildren come to visit, or whether Barack Obama or Sarah Palin will be the next president or whether your favorite sports team wins the championship game.
- Imagine that you live with unrelenting sadness, regretting the errors and lost opportunities of your past, hopeless about your future and thinking that death would be a relief.
- Imagine that you frequently miss family and friends who have died, that you see their "ghosts" when you pass a place where you used to spend time together, and that you feel there's no one left who cares about you or who you care about.
- Imagine that you are constantly irritated, that you overreact to insults and that you have only harsh words for your family, friends or caregivers.
- Imagine that you worry all the time. Did you lock the door? Did you insult your friend? Did you tell your daughter to get married once too often? Are the new people in the neighborhood dangerous?
- Imagine that you believe that someone who comes to your home to help you is robbing you, or that a neighbor is spying on you.
- Imagine that you cannot bring yourself to get rid of old newspapers, broken bric-a-brac, and clothing you will never wear because they are your connection with a lost life.
- Imagine that you feel you have no more to contribute to your family or your community and that your life has become meaningless.
- Imagine that you rely on alcohol to sleep or to ease your fears or that you become addicted to painkillers that dull your mind.
- Imagine that you are responsible for an older family member, who needs help to dress, to eat, to bathe, or to go to the toilet. For years you have had to be there morning and night and too often have had to manage life-threatening crises when you should have been at work, with your own children, or asleep. Has the stress worn you down? Have you burned out yet?
- Imagine that one day you cannot remember the way home and that over time you cannot remember enough to have a conversation with old friends or to use skills that have defined you but that have slipped away.
These are all symptoms of mental illness, and isn't it obvious that they are enormous barriers to living well as you age?
What can you do if you or a person you care about experiences such symptoms and is finding life difficult?
There is no easy answer. Nothing beats being active and involved, and some people with mental or substance use disorders are lucky enough to be able to recognize the need for changes in their lives and act accordingly -- with or without friendly persuasion.
But depression and anxiety tend to create a vicious cycle. The more depressed and frightened you are, the less likely you are to be active and involved; and the less active and involved you are, the more likely you are to be depressed or frightened. Then it's time to get help. Does that have to be some form of therapy? Not necessarily. Some people can get what they need through spiritual experience or meditation. Some get it from peers who are there for them or from aging services providers. But many older adults can benefit from medication and/or psychotherapy from their physician, a local clinic or a mental health professional in private practice. (Call 1-800-273-TALK for information about local mental health services.)
Sadly, some people just refuse to acknowledge that they need help and, as a result, lose out on rich opportunities to live well in old age, which -- to say it again -- is possible, but not without your mental health.
(This article is coauthored by Kimberly Williams, co-founder and Director of the Geriatric Mental Health Alliance of New York.)
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