Maybe You Should Talk to Someon - Lori Gottlieb Page 0,70
we can, and as long as there’s no imminent danger, we monitor the situation closely and work with the depression. If the person is set on suicide, though, there are a series of steps to take right away.
Rita was telling me that she would kill herself, but she was very clear that she would wait out the year and not do anything before her seventieth birthday. She wanted change, not death—as it was, she was already dead inside. For now, suicide wasn’t my concern.
What was concerning to me, though, was Rita’s age.
I’m ashamed to admit this, but at first I worried that I might secretly agree with Rita’s grim perspective. Maybe she really was beyond help—or at least beyond the kind of help she wanted. A therapist is supposed to be a container for the hope that a depressed person can’t yet hold, and I wasn’t seeing much hope here. Typically I see possibility because the people who are depressed have something to keep them going—it might be a job that gets them out of bed (even if they don’t love that particular job), a network of friends (just one or two people they can talk to), or contact with some family members (problematic but present). Having children in the house or a beloved pet or religious faith can also protect against suicide.
But most notably, the depressed people I saw were younger. More malleable. Their lives might seem bleak now, but they had time to turn things around and create something new.
Rita, however, seemed like a cautionary tale: a senior citizen, utterly alone, lacking in purpose and full of regret. By her account, she had never truly been loved by anybody. The only child of older and distant parents, she had messed up her own children so badly that none of them spoke to her, and she had no friends or relatives or social life. Her father had been dead for decades, and her mother had died at ninety after suffering for years with Alzheimer’s.
She looked me in the eye and presented me with a challenge. Realistically, she asked, what could change at this late date?
About a year earlier, I’d gotten a call from a well-respected psychiatrist in his late seventies. He asked if I would see his patient, a woman in her thirties who was considering freezing her eggs while she continued to look for a partner. He thought that this woman might benefit from consultation with me because, he said, he didn’t know enough about the dating and baby-making landscape for today’s thirty-somethings. Now I knew how he felt. I wasn’t sure that I fully understood the aging landscape for today’s senior citizens.
I’d learned in my training about the unique challenges faced by older adults, and yet this age group gets short shrift when it comes to mental-health services. For some, therapy is a foreign concept, like TiVo, and besides, their generation grew up largely believing that they could “get through it” (whatever “it” was) on their own. Others, living on retirement savings and seeking help at low-cost clinics, don’t feel comfortable seeing the twenty-something therapy interns who predominantly staff them. Before long, these patients drop out. Still other older people assume that what they’re feeling is a normal part of aging and don’t realize that treatment might help. The result is that many therapists see relatively few seniors in their practices.
At the same time, old age is a proportionately larger percentage of the average person’s life than it used to be. Unlike the sixty-year-olds of a few generations ago, the sixty-year-olds of today are often at the top of their games in terms of skill, knowledge, and experience, but they’re still pushed out professionally for younger employees. The average life expectancy in the United States now hovers around eighty, and it’s becoming common to live into one’s nineties, so what happens to these sixty-year-olds’ identities during the decades they still have left? With aging comes the potential to accrue many losses: health, family, friends, work, and purpose.
But Rita, I realized, wasn’t experiencing loss primarily as a result of aging. Instead, as she aged, she was becoming aware of the losses she had been living with her entire life. Here she was, wanting a second chance, a chance she was giving herself only a year to realize. As she saw it, she had lost so much that she had nothing left to lose.
That part I agreed with too—mostly. She could still lose her health and beauty. Tall and