Think You Are Too Old for Mental Health Therapy?

The truth about age and psychotherapy

I have always treated adults of all ages. Now that I'm older myself (I am 70), I realize that the older people I treat benefit perhaps even more than younger patients. Some examples:

Marci, 59, was diagnosed with Parkinson's disease. Her neurologist referred her to me for “mood swings.” What emerged quickly was that her mood swings were actually panic attacks, which resulted from her efforts to deny the reality of her illness. In therapy she learned to accept her condition, which translated into significant improvement in her tremors and far fewer panic attacks.

I met Bob, 65, when he and his wife started couples therapy. Bob was initially skeptical, but as he moved into individual therapy, his chronic anxiety diminished, leaving him with an enhanced feeling of personal agency, liberation and comfort in his own skin.

Gladys, 85, lost her husband to COVID-19 and was unable to attend his funeral. She felt like a “stranger” to herself, full of grief and anxiety. Therapy helped her realize that she could make it, even on her own.

In each of these cases, the patients had successful therapeutic experiences in part because of the advantages conferred by their age: Studies show that aging is associated with more openness and an improved capacity to manage difficult feelings.

Getting better with time

Finding a suitable therapist can be challenging, but don't be discouraged. Since there are relatively few therapists with actual formal training in geriatrics, it is usually more realistic to search out a general therapist who is open to working with older adults.

Start by asking your primary care doctor for a referral. (Neurologists are also a good source for referrals.) If you're taking any medication for emotional management, it's important to include talk therapy as part of your overall health plan.

The American Association for Geriatric Psychiatry lists more than 500 geriatric psychiatrists in the U.S. and some in Canada. Many psychiatrists provide medication rather than psychotherapy, but they can be a good resource for referrals.

Many medical schools have departments of geriatrics that can refer you to resources.

Psychology Today's Find a Therapist online tool, the APA's Psychologist Locator and the ZenCare therapist database are terrific resources. Type in your zip code and you'll find a list of professionals near you. Refine your search by clicking on treatment methods, specialties (such as life transitions or marital problems), age-group specialization (seniors, for example) or cost per session.

Private insurers, Medicare and Medicaid all have lists of in-network providers. Check that list against referrals you've gotten.

When you've identified a potential therapist, call and request a free consultation. (Many will continue to offer sessions over the phone or via teletherapy.) Ask, too, if he or she has experience treating people in your age group or with your particular concerns.

To be sure, there are cognitive changes that may limit therapy in some older patients. But therapy isn't a classroom — it's a journey of self-discovery, and those with mild impairment often do just fine.

Daniel Plotkin, M.D., is a clinical professor of psychiatry at the University of California, Los Angeles.