Cecilia Ford, who has been a psychologist in private practice in New York City since 1987, has addressed emotional issues for us in many articles over the years. This week, she counsels a woman whose life has been severely constricted by osteoporosis and a fall from a horse.
Dear Dr. Ford:
I have severe osteoporosis at 65, with a curvature of my spine that is already causing me to stoop. The curvature in my spine came from some spontaneous compression fractures in my spine. Then I fell from a horse nine months ago and actually fractured a vertebra in my upper spine, just above my bra line. I had to have surgery to stabilize this and know that I am lucky that the operation worked well so that I am not in much pain. However, I seem to have aged overnight due to the change in my posture and my inability to do the athletic things I used to do. In fact, most of my social life was with other riders, and now that is lost.
I am divorced and financially fine, but I don’t know how to rebuild my life. I have a house in horse country near a big city and an apartment in the city. I never worked outside the home, and have only a university club and a women’s club where I know people. I feel invisible and alone, honestly. I was always the life of the party, liked to drink and do outrageous things, but I look at myself in the mirror and don’t see that woman anymore. In fact I have a loss of interest in this kind of social life. I don’t sleep well anymore. I don’t have much of an appetite, and am thinner than I should be, especially with my bone loss. I see a physical therapist twice a week and work out with a trainer who understands my postural problems.
How do I move into the next stage of my life? How do I find new interests? How do I know if I need medication, since I really feel sad most of the time about this change in my life. I sometimes feel hopeless but am still able to get out and go to a lecture or communal event at the club.
I don’t have children or any close relatives, and that is causing me to think about what I need to do in order to be as independent as possible. I am sure this is weighing on me as well.
Thanks for any suggestions you might have.
Dr. Ford Responds:
Since you have recently lost an activity that was both one of your main sources of pleasure as well as the focus of your social life, it is no surprise that you are feeling an acute sense of loss. To make matters worse, your injuries have caused a physical decline; you are no longer able to exercise the way you once did, and thus are deprived of yet another source of well-being. No wonder you are feeling so sad and withdrawn.
With such a multi-determined precipitant, your sadness may well have the potential to become clinical depression, and it is worth your while to have a consultation with a psychiatrist to determine whether or not antidepressants are warranted. At the very least, however, I recommend that you consult a psychotherapist at this time—for the following reasons. It seems that you are at a crossroads in your life, and you need both support and guidance. Not only would psychotherapy aid in the treatment of your depression, but, as you yourself recognize, you need help generating new interests and new ways of developing social connections.
Having had such a strong interest in riding for so many years, you may be not be able to find one activity that is so absorbing or time-consuming to replace it. Nevertheless, it is a good idea to try to develop some new interests, since this is the way of meeting people, and it is not always easy for older adults to make new friends. (Also, some research has shown that learning new skills helps prevent Alzheimer’s.) In the meantime, it might be productive to look up old friends that you have lost touch with and renew past acquaintances. The Internet has made it much easier to do this, of course.
Finally, many experts in the science of “Positive Psychology” find that people who do volunteer work report that they are happier and more fulfilled than those that don’t. This may be even more true for those in later life: According to the work of the late psychologist Erik Erikson, the central challenge in leading a healthy emotional life as adults is centered around what he termed generativity vs. stagnation. He contrasted those who use their wisdom to teach and mentor others in what they have learned, versus those who cease to grow, develop, or contribute.