The Age of Diagnoses and Prognoses

It’s hard to do, but keep your sights not on what you have lost but on what you have left.

It’s true. Things change. And not always for the better.

It was a shocking realization in a way. I have reached the age at which my friends no longer call me to tell me about a new man in their lives or a big promotion or fantastic trip. I have reached the age of diagnoses and prognoses. Now my friends call to tell me of illnesses, injuries, death of other friends, and instead of discussing whether they should really sleep with a new love, they discuss whether they should take the early retirement package being offered.

This could be so depressing. I am not in denial of aging, but I want to believe that things won’t change so dramatically. I want to believe that we can all have wonderful new opportunities forever. If I believe that from today forward that life is only a downward slope on which I will pick up speed, then I would likely become very depressed.

This is in fact, brain-based reality. You are in many ways what you believe. And your brain regards as important those things on which you focus your attention and about which you repeatedly think. Then it helps you out. The more you think about something, the more support your physical brain gives you to keep on thinking it: more blood supply to neurons, more white matter to support the process. And, if what you are focused on is negative and pessimistic, not only does your mood affect motivation but it affects behavior and your body too: you can lose energy and stop participating in things that have given you pleasure, making your quality of life that much less.

When I was 30 or 40 and said to myself, “Today is the first day of the rest of my life,” I could muster enthusiasm and excitement and motivation. How can I do that today, when I am at the age of diagnoses? I have started to think hard about this depressing possibility in aging, as I notice that my cohort of acquaintances are all in this quandary of learning to really live until we die. I realize that to avoid the depression that could really sink a person, we may need to work harder than ever at staying involved in life but how we are involved may look different with each passing year. I think about those I know who have achieved great old age. They demonstrate ways of behaving that help them stay actively involved in living:

  1. Oscar at 90 was walking on the treadmill to improve balance and strength. He was previously vigorous, but after an illness, he had lost a lot of strength and energy, so this walking required him to put work into it. I asked him how he could put so much effort into that boring routine and he replied it gave him time every day to think about and pray for everyone in his family – about 40 people in all! He was emotionally involved in the lives of people he loved.
  2. Dolores at 93 gave up traveling some years ago, but she gardens and swims at levels that accommodate lower energy. She acknowledges sitting to watch the birds for much longer stretches than ever before, staying involved in the natural world that has always been her source of peace.
  3. In his 80’s, Paul reads important works of philosophy that have been on his shelf for some time, and he stays involved mentally in the world that interests him and finds people to discuss his interests with him.
  4. Chuck, in his 90’s coordinates a volunteer organization. While he no longer does the physical work, he stays involved in the community he cares about doing what he can: scheduling, creating notices and announcements and generally making sure everyone is informed.

They all say they have time now for things that seemed too time-consuming before.

Was it aging that gave them time? Not really. We all have the same amount of time in each day, but aging gives us new ways to use our time. No longer being as mobile gave Dolores time to take in the beauty and charm of the birds. I am coming to believe that to weather the relentless beating that aging gives us, we have to think about what we can still do that gives us joy or meaning or a way of connecting to others.

I do not intend to be come off as a Pollyanna. I am stricken that a dear friend is fighting a deadly cancer, and many others are now in contests with chronic diseases. One acquaintance recently opened a conversation with, “So what drugs are you taking?” and she did not mean recreational choices! I know that if you are in constant pain it is exhausting and if you cannot breathe freely you cannot do many simple things. No one chooses those conditions that severely limit life. But it is also a choice how we think about our limits as we age.

Our thought processes are in our control, and we can plan for the perspective we want to take even before hitting older ages. I want to start nurturing in myself right now, the kind of mental, spiritual and emotional resources that will help me face the future with anticipation that I can still have joy, still be connected to other people, and still have value even as I age. We do not live in a culture that can see value in aged persons, and I don’t think I am going to change that culture, but we can change our own beliefs about ourselves.

  1. Remind yourself that you have contributed and still do, as Oscar did in praying for those he loved.
  2. Nurture patience toward others so that you may be more patient with yourself as you lose the physical strength or mobility to do as much, as Dolores has in her patience with sitting to enjoy the natural beauty around her.
  3. Nurture pleasantness even when you do not feel like being pleasant, so that when you must rely more on others you can turn to them a cheerful face and spirit that will acknowledge your gratitude for their help without burdening them with your own unhappiness.
  4. Nurture interest in the world of ideas and community, like Paul and Chuck, so that you can keep your mind and your sense of belonging active regardless of the physical strength you keep.

One of my favorite poems is the Desiderata by Max Ehrmann, and I intend to reflect on his words, remembering that I have a right to be on the earth even though I am not young, and accepting his idea to “take kindly the counsel of years, gracefully surrendering the things of youth,” because regardless of age, health, beauty or energy “you are a child of the universe no less than the trees and the stars and you have a right to be here.”

If we can remember those words of wisdom, it will take us a long way to avoiding depression as we age.