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OPTIMIZE YOUR HEALTH Generativity vs. Stagnation! Integrity vs.
Despair! I am staring 50 in the eye this month and I have made a sobering realization: It’s really not a very big deal. Today’s 50 is not the same as yesterday’s age 50. I remember how my grandmother looked and acted when she was in her 50’s. She used a henna rinse (hair dye had not yet been invented), had varicose veins that affected her gait (surgery was expensive and not readily available), and made comments about how she was going to die soon (she lived to be 92). Still, this birthday prompted me to ask our Center providers to write about aging and health, and mental health needs due consideration. There are many stereotypes and myths about aging adults, but many hidden facts as well. Some facts are very dark, indeed—the fact that the most likely individual to commit suicide, after teenage boys, is an aging male with a chronic or terminal illness, an unfortunate fact that has been borne out in my clinical experience. Or the fact that the incidence of alcoholism increases with age. Recently a colleague shared with me that gambling among retirees was becoming an epidemic; there are more casinos and more buses taking seniors to them. Many aging adults share concerns with Dr. Huang regarding their memory. There is a bit of a myth that if you are cogent enough to worry about your memory, then you have nothing to worry about! However, early onset Alzheimer’s is rare and has more of a genetic basis than does late onset Alzheimer’s. Memory does deteriorate slowly with age. If a person becomes more forgetful than seems “normal” or is troubled by problems with memory or concentration, it is more likely to be caused by stress, anxiety, or depression. A recent Dutch study of over 3100 elderly citizens demonstrated that mild anxiety might be beneficial for cognition, while too much anxiety was sometimes detrimental; depression, however, always had a negative effect on cognition. The only way to know for certain whether it is memory loss, anxiety, or depression causing forgetfulness is through an appropriate screening. The worries associated with aging are best dealt with by being busy. This advice is not meant to be glib. Erikson gave us his stages of psychosocial development as a model for organizing observations, but also to guide us. In middle age, he described the stage of “generativity vs. stagnation”. Generativity is accomplished by engaging in meaningful activities, whether through paid or volunteer work or by helping one’s family members in an appropriate role. Generativity can also mean creating works of art, writing, photography, cooking, gardening, and so forth. Often people in my office complain of feeling stuck or stale at the late middle stage of life. Those who follow this simply recommendation do find renewed pleasure and purpose. As for me, I’m turning 50 and life has never looked better! As co-owner of the Center with Dr. Huang, I am so pleased with how the Center is evolving, and I have you, my patients, to thank for helping to make the Center a place of healing and positive change. Here is a truth: We are all growing old together, which means we are also all learning together as well. The more fully evolved we become, the better off we are. In my mind successful aging has to do not just with accepting that one ages, but with embracing this inescapable fact. —August 2006
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