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Aging takes a lot out of people.
There are the physical demands
— the aches and pains, the illnesses, the cost — of
passing 70-plus birthdays.
Now comes Tamara McClintock
Greenberg to point out that our rapidly aging population has a
host of mental health problems.
Greenberg is an associate
clinical professor of psychiatry at the University of
California, San Francisco, and author of the recent book
"Psychodynamic Perspectives of Aging and Illness"
(Springer, 2009).
Among other conclusions, she
disputes Freud, who said psychoanalytic treatment is useless
for people 50-plus. "Some of my best patients are older
patients," she said. "They are more serious."
Q. Today, people are living
longer than ever imagined. To be 100 is not even unusual. Why
should this gift of age depress people?
A. For many people, there is a
shock of living this long. There are limitations — mobility,
for instance — and quality-of-life problems. So much of our
culture is around using our bodies to work and move around;
when you lose that, you also lose a major coping mechanism.
Plus, you may have to be more dependent on people. Or living
in a nursing home, for example. Loss of independence is very
depressing.
Q. You suggest family members
are in a great position to notice this depression.
A. For the current elder
generation, there is still a stigma to admitting mental health
problems. They are not likely to tell their doctor they are
feeling depressed. Often family members are in a position to
recognize something is wrong — the person is more withdrawn,
has less energy, not trying as hard to cope. Someone who needs
help walking, for example, might say they don't even want to
try; it's not worth the effort.
Q. How about an anti-anxiety
pill instead of mental health therapy?
A. Pills don't work. They can
actually make people worse.
Q. We know boomers will swell
the aging ranks. Anything different about them?
A. I just finished a blog for
Psychology Today on a study that says boomers have higher
rates of drug and alcohol abuse. They are dying from drug
abuse. This is the first generation that has spent so much
time caring for their parents. They know first-hand what is
coming and that is depressing to them. And they are afraid
they may run out of money.
Q. Is mental health therapy for
the aging often a lengthy process?
A. No. There are some people I
see just once every two weeks, for example. Part of my being
involved with elders — say someone in a nursing home who
says, "I really just wish I would die" — is to
tell them it makes sense to feel that way, but you can't
control when you will die. My goal is to help them live and be
more comfortable with the time they have left.
Q. Will giving people treatment
later in life really be productive for them, and is it,
frankly, worth the money?
A. I think mental health
treatment should be available to all people, and I think we
need to take into consideration providing psychotherapy for as
long as people need it.
Physicians need to be able to
spot depression in older adults because today's older
generation rarely admits to it.
Everyone is going to have to
become specialized in aging. The impact of mental health
problems on medical issues is real. Grief, stress, depression
— all can be factors in the physical problems associated
with aging. And just aging itself is traumatic.
We are going to have more older
people and we need to offer them mental as well as physical
health.
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