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Aging: A Universal but Personal Experience

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Despite what the advertisers and surgeons may tell us, no one has figured out how to stop the clock. And as our clocks tick longer and longer -- nowadays, 80 or more years -- we all face physical and emotional challenges.

But, are these challenges experienced differently depending on certain psychological and social factors? For example, is it different for single men and women than those who are married? How about people with or without children? Heterosexual or same-sex couples? Agnostics or theists? Rural or city dwellers? If identifiable differences do exist, wouldn't it be useful to clarify them so we can learn from each other?

In theory, 'Father Time' doesn't discriminate -- we all age. Regardless of gender, ethnicity, race, religion, class or status, at some point in our lives we all have to let go, mourn losses and move on. In the recently released "10 Lessons for Living," advice about aging is among the many pearls of wisdom collected by gerontologist, Dr. Karl Pillemer. "Don't waste your time worrying about getting old. Embrace it. Don't fight it. Growing older is both an attitude and a process," says one 80-year-old expert, using the benefit of hindsight. But as much as aging is a democratic process and how we deal with it has a lot to do with attitude, some of us are more equipped, prepared and supported to embrace it than others.

Take a look at some of the universal challenges we all face and how they may be experienced differently depending on individual circumstances. While this list includes just a few challenges and a limited number of groups that face them, hopefully it will lead to a wider conversation on the topic.

Mortality: As we age, we confront the end of life. Some experience it as an existential moment. Others face mortality with a deep and prolonged sense of anxiety. While this may be a gross generalization (there are always exceptions, a fact that applies to every category described below), I find two groups in my practice that have an easier time with existential anxiety; parents and deeply religious people.
  • Being a Parent: Couples and single people with children take comfort -- unconsciously and consciously -- in the fact that their biological progeny carry on. Non-biological children can serve the same purpose, as they embody the notion that life will continue in the next generation. Children and grandchildren can also provide a welcome distraction from the losses that are an inherent part of aging. Childless couples and single non-parents struggle as they get older with the painful awareness that they are the end of the line, even if they have chosen not to have kids.
  • Religious Affiliation: Actively religious and spiritual people seem to rely on their beliefs as they age to help ease fears of mortality and existential pain. My patients who have strong convictions about the existence of God, a higher being or believe in an afterlife are soothed by the idea that life has meaning beyond their mortal existence. They also find solace in the spiritual connection they feel toward others with similar beliefs.
Dependency: Having a support system becomes increasingly important as we age. We may have been fiercely independent for most of our youth, but inevitably we come to a stage in life when we are required to lean on others. Individuals who maintain close relationships to their families or who have created a nest of friends fare better as they age.
  • Tight Family Ties: We may have moved long distances from our place of birth, live far away from our siblings, cousins and our children, but those who remain emotionally close to family find comfort in the knowledge that they can depend on them if they need to. When extended family members live in the same city or town, staying connected is easier, especially as traveling can becomes onerous with age. People who have alienated their families -- or whose families have alienated them -- have a more difficult time. Yearnings to reconnect with estranged family members can surface during these later years, but if efforts toward reconciliation fail, it can create long lasting regret and emotional pain.
  • Nest of Friends: Men and women fare better as they age if they have created a wide group of friends around them -- whether they have solid family ties or not. For example, the empty nest syndrome is less painful for single people and childless couples who have filled their lives with friends all along. Without children, some people develop strong bonds with others based on common interests that continue throughout their lifetime. Loneliness as we age is not based on whether you are married, in a relationship or single, but on whether or not you have created a support group around yourself. People in rural, single-family homes often feel more isolated than those residing in cities and multi-family dwellings -- which is one reason assisted-living facilities have become popular.
Midlife Crisis: Reaching midlife doesn't always result in the clichéd crisis so often anticipated at this stage. Certain groups seem to have an easier time of it; people who endure previous losses and those who survive emotional upheaval.
  • Survivors of Loss: Those who have faced serious illness or losses earlier in life are often more prepared for the changes that come when they reach middle age. If these earlier challenges result in thoughtful self-reflection, midlife can be experienced as just another turning point. For example, people who have had a childhood illness, survive cancer or cope with a chronic medical problem, say by the time they hit midlife they have already come to grips with vulnerability and loss, so that aging is just a continuation of accepting that fact of life.
  • Survivors of Emotional Drama: I've heard similar sentiments from people who have dealt with major life dramas. Patients I've worked with who have had their lives upturned due to political unrest, natural disasters and bankruptcy say they feel confident that they can face almost anything. Some tell me that the emotional drama of coming out as gay, lesbian or transsexual prepares them for other difficult identity challenges, including aging. Others who struggle to emerge from unhappy marriages or who leave dead-end relationships, sometimes view midlife and beyond as an opportunity to start anew.
Ageism: The prejudice against aging is omnipresent. Although life expectancy is continually rising, our youth and beauty obsessed culture makes most anyone over 50 feel invisible. For some, this experience seems less acute; those who have dealt with discrimination before and people who rely less on their youth for their self-esteem.
  • Double Discrimination: People who have been stigmatized in other ways -- e.g. race, religious choice or sexual preference -- tell me they feel better equipped to deal with ageism. They say that age discrimination comes as no surprise. Having gained fortitude to fend off criticism, and carry on without needing approval from others, makes continuing in the face of ageism easier. They rely on the inner strength gained over years of experience to deal with prejudices later in life.
  • Leveling the Playing Field: People who have based their self-esteem on youth or good looks -- e.g. the prom queens, jocks or members of the 'in crowd' -- tend to suffer ageism earlier and more painfully. They fight the natural process of decreased stamina, sagging skin, loss of fertility and virility, sometimes taking dramatic measures to avoid it, relying on cosmetic procedures, plastic surgery and steroids in order to 'anti-age.' They struggle as they try to hold onto an image that once brought them status and success, fearing the unknown as the playing field is leveled.
Health Care: At some point, as we get older, we are forced to rely more on health care. Two groups struggle more as they deal with the increasing medical care they need; those that are both physically and financially unprepared and people with particular needs that medical professionals sometimes fail to recognize.
  • Being Prepared: It's obvious that those who plan for their future fare better as they age. Preparation involves not only staying as flexible, strong and active as possible, but preparing for the time when, regardless of our condition, we will have health needs that require our attention. For those who have routinely worked out, kept up regular medical care, good hygiene, eating and drinking habits, aging takes less of a toll. People who combine these ongoing healthy routines with saving for retirement and maintaining proper health insurance are most prepared for the special needs that occur during the last stage of life.
  • Medical Care Providers: There is a strong desire to be surrounded by loved ones when illness occurs, yet when it comes to medical decisions, hospital visits and even funerals, sometimes only immediate family members are recognized. This is particularly troublesome for unmarried mates or same-sex couples who may have lived together for years, but are forced to be separated during this last stage of life. Likewise, close relationships with ex-stepchildren or ex-in-laws are also sometimes dismissed by the medical profession. Doctors and health care facilities that are insensitive to the particular needs of aging patients sometimes add to their feelings of loss. For example, there are some assisted-living facilities that don't welcome same-sex couples and hospitals that make it uncomfortable for them to talk openly about their medical conditions. Unless medical professionals embrace the special circumstances of each individual aging patient, it will interfere with providing the best treatment possible.

In "Get a Midlife," the NY Times reports that most people 65 and older chose their middle years over any other stage of life when asked, "what age would they most like to return to?" If this accurately represents the sentiment of our aging population, I believe that there identifiable groups that make up this majority. Sure, in the end, no matter how we experienced our youth, to some extent the playing field levels. And while we all come together as we confront that one thing we share -- aging -- there clearly are psychological and social factors that contribute to how we each experience it.

Do you think the aging process is different for certain individuals or groups?

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Vivian Diller, Ph.D. is a psychologist in private practice in New York City. She serves as a media expert on various psychological topics and as a consultant to companies promoting health, beauty and cosmetic products. Her book, "Face It: What Women Really Feel As Their Looks Change" (2010), edited by Michele Willens, is a psychological guide to help women deal with the emotions brought on by their changing appearances.

For more information, please visit my website at www.VivianDiller.com. Friend me on Facebook (at http://www.facebook.com/Readfaceit) or continue the conversation on Twitter.