Maybe You Should Talk to Someon - Lori Gottlieb Page 0,69

whenever you’re ready to date again. I’d texted back, Whenever isn’t here yet.

I glance from the phone to Rita.

“Well?” she says expectantly as we enter my office.

“Well what?” I ask, handing her back the phone. I’m not sure what she’s getting at.

“Well what?” she replies incredulously. “He’s eighty-two! I’m no spring chicken, but please! I know what eighty looks like naked, and that gave me nightmares for a week. I’m sorry, but seventy-five is as far as I’ll go. And don’t try to talk me out of it!”

Rita, I should mention, is sixty-nine.

A few weeks ago, after months of encouragement, Rita had decided to try a dating app. After all, in her daily life, she wasn’t encountering any single older men, much less those who met her requirements: intelligent, kind, financially stable (“I don’t want anyone looking for a nurse and a purse”), and physically fit (“Somebody who can still get an erection in a timely manner”). Hair was optional, but teeth, she insisted, were not.

Before the eighty-year-old, there had been a same-age gentleman who was not so gentle. They had gone out to dinner, and the night before what was supposed to be their second date, Rita had texted him the recipe and photo of a dish he said he wanted to try. Mmmm, he texted back. Sounds delicious. Rita was about to respond, but then another Mmmm popped up, followed by You’re killing me here . . . , followed by If you don’t stop, I won’t be able to stand up, followed a minute later by Sorry, I was texting my daughter about my bad back.

“Bad back, my eye, the pervert!” Rita exclaimed. “He was doing who knows what with who knows who, and he certainly wasn’t talking about my salmon dish!” There was no second date, and no dates at all until she met the eighty-year-old.

Rita had come to me at the beginning of spring. At our very first session, she was so depressed that when she gave me an account of her situation, it seemed as if she were reading an obituary. The final line had been written, and her life, she believed, was a tragedy. Thrice-divorced and the mother of four troubled adults (due to her own bad mothering, she explained), grandchildless and living alone, retired from a job she disliked, Rita saw no reason to get up in the morning.

Her list of mistakes was long: choosing the wrong husbands, failing to put her children’s needs above her own (including not protecting them from their alcoholic father), not using her skills in a professionally fulfilling way, not making an effort when she was younger to form a community. She had numbed herself with denial for as long as that worked. Recently, it had lost its efficacy. Even painting—the one activity she enjoyed and excelled at—barely held her interest.

Now her seventieth birthday was coming up and she had struck a deal with herself to make her life better by then or stop living it.

“I think I’m beyond help,” she concluded. “But I want to give it one last try, just to be certain.”

No pressure, I thought. While suicidal thoughts—known as suicidal ideation—are commonplace with depression, most people respond to treatment and never act on those hopeless impulses. In fact, it’s as patients begin to get better that the risk for suicide increases. During this short window, they’re no longer so depressed that eating or dressing seem like monumental efforts but they’re still in enough pain to want to end it all—a dangerous mix of residual distress and newfound energy. But once the depression lifts and suicidal thoughts subside, a new window opens. That’s when the person can make changes that improve life significantly over the long term.

Whenever suicide comes up—either because the patient or the therapist broaches the topic (bringing it up does not, as some worry, “plant” the idea in a person’s head), the therapist has to assess the situation. Does the patient have a concrete plan? Is there a means to carry out the plan (a gun in the house, a spouse out of town)? Have there been previous attempts? Are there particular risk factors (lack of social support or being male; men commit suicide three times more often than women)? Often people talk about suicide not because they want to be dead but because they want to end their pain. If they can just find a way to do that, they very much want to be alive. We make the best assessment