Conversation

A: I’m a little reluctant to lump the whole generation together, because as they’d be quick to point out, they’re full of individuality. They understand that growing older doesn’t have to mean a decline. You see them making a conscious decision to enjoy this time in their lives, to enjoy the time to pursue hobbies and interests. To bring joy to it and make it the best that it can be.

Q: You are yourself a baby boomer. What’s an essential value that has been with your generation from birth to retirement age?

A: They’re more willing to question authority, more so than other generations. They’re willing to question their doctor, their government and even the status quo. Advances in medicine and psychiatry have happened at the same time as an explosion in information technology, so that medical knowledge is available to individuals on an almost immediate basis. And they expect to be able to discuss this information with their doctors in exploring options for their own care.

Q: How does this change their relationships with their physicians and mental health professionals? What should doctors get ready for?

A: It can create a wonderful partnership, and for the most part, medicine is embracing this patient-centered decision-making. When you are part of the treatment decision, you own that treatment, and you are more inclined to carry it out.

Q: However, you may also have people pressuring their physicians into letting them try the latest and greatest mood-disorder drug because they saw it on TV?

A: Real information about medical advances isn’t the same thing as advertising. The purpose of advertising is to create desire, in this case for the newest and most expensive drugs. Glossy, alluring images are used to overemphasize the positive while downplaying the risks. That isn’t a balanced, informative discussion. When a medication is indicated, the doctor and patient should collaborate to consider the benefits and risks, including possible side effects.

Q: But there have been some amazing advances in psychiatric medications?

A: We have a generation of new pharmaceuticals with a high efficacy for treating anxiety, depression and other disorders. But psychiatry isn’t limited to advances in medication, and drug treatment isn’t always the best solution. Some studies on the treatment of resistant depression have shown that adding certain kinds of psychotherapy is as effective as adding certain medications. One of these, cognitive therapy, focuses on how your thoughts about situations and relationships affect and reinforce your feelings and your behavior, and how you can address certain disorders, including depression and anxiety, by changing those distorted patterns of thinking.

Q: Geriatric medicine and geriatric psychiatry are growing specialties here. Most people worry about the possibility of dementia, or impaired thinking, as they age. Is it inevitable?

A: Not everyone will experience cognitive decline as they grow older. For those who do, advances in screening will allow doctors to diagnose it much earlier than before.

Q: And treat it?

A: The advantage of knowing early is that doctors can often slow the process down or even stop the process if there is a reversible cause at work. The disadvantage is that it creates the anxiety and the burden of knowing. But every large drug maker and several biotech companies are working hard to develop effective treatments, and there is a lot of ongoing scientific research into ways to stop cognitive decline.

Q: There are also worries about the decline in sexual functioning. And, given the abundance of advertising for drugs that address sexual dysfunction, it seems that they’re willing to be frank about it?

A: The boomers are a bit bolder than previous generations and more willing to talk about things, which means they’re more likely than previous generations to address problems with sexual functioning. They know that aging does not have to be the end of sexual vitality, and that growing older does not mean your sexuality is going to wane and dissipate.

It’s important to note, though, that sexual dysfunction can have physical causes—side effects to medications, poor circulation, low testosterone levels—but psychological causes can also interfere dramatically with sexual functioning and enjoyment. This might be depression, performance anxiety or difficulties in the relationship, which couples can address together with therapy.

Q: Where does their willingness to shake up assumptions about aging—to question everything—come from?

A: Some of the answer comes from growing up during the time of the Vietnam War. The late 1960s and early 1970s were a dark time in the relationship between our government and our people. People found out that their government was lying to them about the war. This was during a time when the boomer generation was undergoing its own adolescent rebellion, which is one of the tasks of individual development. That rebelliousness spilled over into attitudes about authority. Antiwar feelings, coupled with horrible images of human suffering, increased an awareness of the importance of social justice. The women’s movement was developing, the civil rights movement was developing. They came to value harmony and community. There was a rise in the desire for kindness and caring, for the principles of absolute equality and the sanctity of human rights. All of these values are still very important to boomers.

Q: Some of our most prominent local philanthropists are from this age group, and we’ve seen the real enthusiasm they have for giving back. What does the "me generation" gain by helping others?

A: Some remarkable research is being done on positive psych-ology, a psychotherapy that focuses on enhancing joy and happiness. Studies done by Dr. Martin Seligman, one of the pioneers in this field, show that the acts of kindness that people do have a longer-lasting boost to their happiness than things they do for themselves. You can feel good by doing good, a concept that appeals to the boomer philosophy.

Q: With so many more people willing to seek mental health treatment, will we finally see the stereotypes and stigmas disappear?

A: The more you talk about something, the more you de-stigmatize it, and you can see that in new attitudes about mental health. Boomers are more likely than previous generations to know someone who is benefiting from psychiatric treatment, and to see that treatment is worth pursuing.