Depression in Older Adults: Discovering Our Innate Potential to Meet Any Challenge

Welcome to the Living to 100 Club Podcast.

Here's our host, Dr. Joseph Casciani. Greetings to everyone joining us today for our podcast. You're listening to the Living to 100 Club, and I'm your host, Joseph Casciani. You can find this conversation and all past conversations on our website, livingto100.club. In addition to my podcasting, I'm a public speaker, and I present to community organizations and senior groups on topics related to aging well and managing setbacks. And on my website, you'll see options to sign up for one-on-one resilience coaching for anyone wanting more personal time To Talk. I also provide consulting and training on clinical topics like depression and dementia. Now on to our podcast where we discuss successful aging, staying positive, and making more informed decisions. Dr. Alan Weisser is our guest for today's podcast as we discuss the topic of depression in older adults. We examine the symptoms of depression and contrast it with symptoms seen in middle-aged adults How can we help the person who's in denial? Can we learn different approaches to surviving the physical and personal setbacks and even thrive once we get beyond them? Can we rely more on our innate ability to manage stresses? First, a little background. Dr. Alan Weisser is a clinical psychologist who has worked in public sector mental health institutions for many years. Becoming expert at bringing people together and solving problems. He founded New Options, Inc. in 2002 to help people with chronic pain learn to fully engage in recovery. He is the author of the book New Possibilities: Unraveling the Mystery and Mastering Chronic Pain. Alan, welcome to our podcast.

Thank you.

Glad to have you with us today. I always like to open by asking our guests to tell us a little bit about the journey that brought you to where you are today.

Actually, it's a question that's led me to understand some things in the process of doing this. The journey probably began when I was 12 and a half, when I broke my neck doing a backflip on a diving board. And found out that when you're doing a backflip, you're supposed to dive out from the board, not straight up. Yeah, that doesn't work out well. So not to be flip about it, literally, because when they brought me to the hospital, and remember, I'm 12 and a half, before this happens, I am a fearless child and sort of self-starter and risk-taker. The doctor comes in, I'm in a cast in my neck, I know I've broken my neck. And he says, if you don't die and you're not paralyzed, you will be crippled for the rest of your life. And I actually called friends to say goodbye. Wow. So they kept me in the hospital over a month. I really couldn't stand being there, so I made a fuss. But the bottom line is I ended up being at home on my back in a brace for a year. I wasn't allowed to get out of bed or even sit up. When I did start walking again, I wasn't paralyzed, but I was atrophied. So it took me close to a year to regain normal walking. So my total recovery physically was almost 3 years.

Wow.

Right. So that's a big deal. And ultimately, working with chronic pain patients, I can certainly make a connection to having something major happen. And also being told what many of my patients are told, that it can have a huge impact on your ability to function. But the part I want to really emphasize, which relates to our conversation, is the thing I did not do. No one knew how frightened I was. Nobody knew how I felt about this. I just put on a happy face. I can be very funny. No one knew. What they didn't know, and I came to understand was that not only had my neck been broken, but so had my identity and my confidence in myself. That took years to work my way through. I almost flunked out of high school, which is really interesting considering I have two PhDs.

Wow.

So along the way in high school, and this is important, part of why I do the work I do, the person who started turning me around on this and helping me to understand how I'd really been impacted as a total person, not just physically, was my high school chemistry teacher who noticed I was failing his course and came to me and said, like, why are you failing my course? And I go, like, why would you think I wouldn't? I'm not that smart. He goes, yes, you are. I go, no, I'm not. I wish I had a recording. It was a funny conversation. Bottom line is he insisted on tutoring me personally. I got a C in the course. That was the beginning of me understanding that what I thought I knew about myself or my limits wasn't necessarily true. That experience of other people knowing me and recognizing this and getting past my defenses has been something that's happened over and over again through my life. I've been very fortunate. And those— that began the journey to healing in a total sense as a total person. So being who I am, by the time I got to college, I was really tired of this idea that I couldn't do any high impact or anything that could be physically impactful. I didn't do any sports in high school, but I decided I was going to find out regardless of the risk. So what did I do? I signed up for judo and trampoline.

Of course you did.

Yeah, I know. I still remember that first throw. If you know much about judo, you get slammed to the ground a lot. And I remember that first throw thinking, I'm either going to do something god-awful to myself or make a point. I have not had a problem with my neck, and there's some interesting reasons why that happened. But point being, not that doctors are wrong, but too often doctors will pass sentence on a patient and say, learn to live with it, you're sort of stuck with it for the rest of your life. And that may be true, and it may be good counsel, but more often than not, it's not, for a lot of reasons, especially if you're only speaking to physical recovery.

Yeah, that kind of prognosis can really shut us down, right? I mean, it takes away all of our belief in recovery and, you know, striving and perseverance. So yeah, that was an important, pivotal conversation with your chemistry teacher, that's for sure.

Yeah, and then other people in college and beyond that, when I went into the world, I started as a tribal attorney. The whole idea of really being there for people, representing people who didn't feel powerful in any sense, weren't empowered, This has been something I've been working at since I was a kid. I've always been oriented towards helping people who can't help themselves. While I really enjoyed being that attorney and representing people who didn't have power, it ultimately turned out to be not what was really soul satisfying, which eventually led years later to me becoming a clinical psychologist. Along the way, I had I got involved very deeply in the martial arts. I'm still involved in the martial arts many years later. I intend to practice easily to 100, maybe past that. So for me, living to 100 already has that particular goal in mind, which I've been able to honor. Good. So when I got involved in clinical psychology, I think I'm very fortunate. Things happen in ways that are really interesting. I had to work in a state hospital in New York to do my internship. And in New York, where I come from, you can't practice as a psychologist until you have gotten your PhD. Well, I'd done my coursework, but I still had to finish the dissertation, which, as you know, can take a long time. So I did an internship in Bronx Psychiatric Center, which is part of Einstein Medical Center teaching hospital, and didn't think I could work with people that were chronically mentally ill. I'd never been exposed to that before. It seemed overwhelming. But I spent that year on the training unit learning just exactly how to do I could do that. So I stayed on, and I ended up staying in the hospital for 10 years and discovered all kinds of different ways that I could actually help people who are chronically mentally ill and institutionalized to recover. But I also learned that that would be a combination of every modality. In the training unit, we all worked with the same theory about how to help the patient. We were all trained in a similar fashion. Didn't matter if you were a social worker, psychologist, psychiatrist, medical doctor, housekeeper. Everyone understood the basic approach. Everyone had their own part of it, and we all collectively put it together. With aging, just as with chronic pain, these are a team effort.

All right?

This idea of it taking a community, well, those are two really good examples. Uh, not that I think that anything that's difficult in life is something people can handle all by themselves. I used to believe that. I've kind of gotten over being, you know, I don't really need anybody else's help. I'm in recovery. So I did that kind of work close to 17 years and then decided to come out to Seattle. And when I came out here, I went from working in a hospital where I created a lot of programs. This is important because it set the foundation for what I do with chronic pain patients. Just almost by accident. I had reasons for leaving community mental health. It was just the system. It was so broken that it really didn't make a difference how innovative I could be or dynamic in the approach. It was very hard, as it was in the hospital, to get enough people to go along with major changes. Just almost by coincidence, I was trying to figure out what I wanted to do next. Saw an opening for a part-time job as a pain management therapist. I didn't know anything about physical pain management. Took the job, learned their model very quickly, which was cognitive behavioral, which is okay. But also recognized because of my work in the hospital, I learned that in a hospital you do not treat the disease, you treat the person. If you can work to restore a person's life, that helps to balance the impact of the condition. And I started thinking about, okay, as I did with the chronic mentally ill, What do these things mean to a person? What does it mean to be chronically mentally ill, locked in a state hospital, pretty much all of your life taken away? I, I started exploring with my chronic pain patients, what does it mean if you lost a job or if you were physically incapacitated or your relationships are on the rocks? We began to assess what later became called collateral damages. And the basic notion that evolved from that was it's not just a physical problem. It's a physical problem plus collateral damages, which at this point in time can number up to 200.

Yeah. Hard to tease out a single event from the overall effect on the person.

Well, the point being, a good example is sleep disruption. Sleep disruption all by itself can increase your pain by 50%. The problem is the medical community, and I work with the best doctors here, do not look at this, right? They'll sit with you and ask for a pain rating, but they don't talk about the 200 things that could be contributing. So you have these collateral damages that are adding to your physical pain, undermining recovery, right? Undermining your immune system. Mm-hmm. So the beginning, and that's why the book is called Unraveling the Mystery, the mystery was what's really going on here? It's not just about what happens, it's about what does it mean to the person, the unique person, right? And that led to something we'll talk about, I guess, in a few minutes about what we came up with to really deal with that.

Yeah, it's so important to understand how we interpret these events that happen to us and how we label or explain them to ourselves. That, that can really influence how well we manage them. So you've worked with a lot of different age groups, um, you've worked with severe mentally ill. Tell us what your thoughts are on the difference between depression in middle-aged adults versus depression in older adults. Any thoughts about that?

Yeah, my experience has been that it, it doesn't show up the same way symptomatically. It may have some of the traditional symptoms that most people are familiar with, but often people who are older will experience a sense of numbness, loss of interest in things, they shut down emotionally more and more, they tend to want to handle it themselves. People that are younger may be more inclined to seek treatment. Older people not. So it's, it's harder to recognize. And from my point of view, the more interesting question, which I want to talk about in a few minutes, is so you have symptoms in reaction to a condition that's considered medical, but the really interesting question, since these are psychological impacts, is how do you explain that, why those things are happening?

Yeah. Yeah.

You have a constellation of symptoms. Why those?

That's a very important point. I mean, when we were in the— when I did all my work in nursing homes, we— I would continually help the nursing staff understand that, you know, the patients are not going to come and say, "I feel depressed today." They're very unlikely to report symptoms of depression or sadness or remorse. Instead, we're going to get complaints of physical pain or discomfort, somatic complaints. And again, they're the kinds of complaints that are not easily treated. They tend to be more of the vague somatic complaints. But yeah, that's an important point that it does— the picture is very different from younger adults. And we used to talk about the increased interiority for the patients who would kind of withhold a lot of this as opposed to middle-aged adults who might really reach out and say, look, could you help me with these struggles? And we don't see that so much in seniors. Yeah. Yeah. So what other symptoms do you think we have with depression in older adults? I mean, we get— you mentioned sleep problems and appetite and, you know, physical activity. Are there other symptoms that we can see in depression with This age group?

Well, I wouldn't claim to be expert on this particular population for that condition, but I think we've covered some of them. But I would expect it to be relevant to the challenges they have. So if you understand the existential problem with getting older, and then you think, okay, so how would that be likely to show up symptomatically? And there is a correlation between a particular symptom and the person, and everybody's unique, right? As you and I both know, you can do a depression inventory on 10 people, but I look for patterns. There's no one way for a person to be depressed, even if they have the same symptoms. How much of it do they have? What level is it at? How do they interact? What is the pattern that's presenting? For example, as you know, if it's an older adult or anybody else, some people will show you lots of impact on self-esteem. Right, self-criticism, those, those things that have to do with self-love. But not everyone does. Then you have other patients who have a lot of the other symptoms, but they don't have those. Well, if they have those relating to how a person sees themselves, that is a totally different treatment. That is a totally different orientation towards the person. And I think as to older adults, and you're probably aware of this, I don't know if this is true, I would imagine that older adults have a shrinking sense of identity. Of value, of purpose, and importance. Not always, but often. It's hard for that not to happen when you begin to have things start to be less than they were. That would, that would be what I did. So I'd expect— I don't know if you can tell me this part, I don't know— I would expect that with a lot of older adults who are depressed, that you can see more of that pattern of them feeling less about themselves.

Yeah, I think you're right. And I think the problem is that we tie our worth and value to our, you know, our health status or our physical performance. And, you know, even to other factors like whatever, wealth, or— I mean, we make these incorrect links between how worthy and how valuable we are to what our body is, how well our body is still performing. So that person is going to be in trouble when he sees that physical decline, that means my worth is also declining. Of course, that's not the case. That's an important point to make, Alan. Yeah.

I have a suggestion to make at this point. There's a number of concepts that we've developed that are helpful and they apply. The model of this book is for chronic pain patients, but actually most of it is relevant to any kind of pain, whether it's emotional or otherwise. What I say to patients is, from an existential point of view, from an evolutionary point of view, right, self-esteem is not dependent on who you are. If you think about it, right, a person that loves themselves, that feels good about themselves, is much more capable of addressing the challenges in life, right?

Right.

So why would evolution design a creature whose self-esteem is dependent on something as transitory as who you are and what you can do?

Good question.

As Mr. Spock would say, it's illogical. What I do say to people is your self-worth is based on what you are. As a human being, you are infinite potential. We know this, we love it, we applaud it, we seek out people that are inspiring to us, right? Who you are is a creation, and there's any number of ways that you can be you. So if you attach your identity to these things that are transitory, good luck with that. All right, I refer to it as patients with the one-trick pony syndrome.

Yeah.

But if you cut through this and say, look, let's define you based on what's meaningful to you, your sense of purpose in the world, and how many different ways can you achieve that? Look at a guy like Stephen Hawking. I can't imagine having that happen and becoming who he was.

Sure, sure.

People do, and I think that has a lot to do with people not being encumbered by attaching their worth to who they are.

Well, it is intrinsic, I say, you know, that again, it's irrespective of what we look like or how wealthy we are or what our, you know, physical status is. It's intrinsic. It's always there regardless of the external. So it's similar to what you're saying. Tell me though, what's your— what you think? We see a lot of denial in older adults. I mean, we just You know, it's like, how do you differentiate between denial and positive thinking? Sometimes I think it's really the same thing. But how do you— how would you approach somebody who's in, you know, just denial about their limitations and losses and, you know, loss of interest and all of that? What's your—

for starters, with compassion and respect. Yeah, right. It's a way of defending themselves against things they can't handle. Right? They try and lessen the sense of threat to their needs by making it smaller. Right? That's, that's an understandable human reaction. The problem is that you can't fully address a problem if you're not willing to fully acknowledge the extent of it. Right? When I refer to that as acknowledging negative realities is the first step towards empowerment. If you can own the full extent, you know, for example, how many people reacted to the COVID virus? With denial, right?

Sure.

We don't need masks, it's not really happening, not those people aren't dying, go to the extremes into what you and I would probably refer to as delusional thinking. So I say to people, I understand, I get it, and I get why you don't want to know and don't want to have to deal with it, but if you don't, you're actually disempowering yourself. As frightening as it may be to acknowledge the truth, The truth will set you free. So that's one aspect of it, but I have respect for this. But what I think that I need to mention at this point is the way I consider what depression actually is.

Okay.

I don't relate to depression as a medical condition. Yeah, it's got a biological substrate, but with neuroplasticity, chicken or the egg? Genetic components? Maybe so. And medications help, but you and I both know that medication without therapy is not going to be nearly as beneficial.

Why?

Because the therapy changes the neurochemistry. Chemistry. But more importantly, from an existential point of view, I started looking at depression and going like, what's being accomplished here? You know, if you don't judge all of the problems it creates and you're like, what is this person trying to accomplish by getting into this state? You know, the central feature of depression is that you shut down emotionally. You get flat, anhedonia, right? You just don't care, right? What I think depression is, is a coping mechanism. I think every mental health disorder is a coping mechanism that comes with terrible side effects. So what are they trying to shut down? It turns out they're trying to shut down what I would suggest are the two most important human emotions: anxiety and anger. Why anxiety and anger? Because you may be familiar with this, most people are not, anxiety and anger are evolutionary designed to help you address threats to your needs. But if you have too much of that going on, don't know how to handle it, shut it down. The problem is it's the equivalent of turning the light out in the house by shutting the power down in the city. You're trapped now. You made your condition worse. And worse than anything, you cut yourself off from what nature provided you with to get you out of this. So I approach that with people existentially. I say, if you could learn how to understand and properly use these emotions, You wouldn't need to be depressed. That's a bold claim considering all the different treatments for depression, which I have a lot of respect for. I'm trained in doing, I've done. This approach to depression is a coping mechanism and showing people how you don't need that, right? That most things in life are not going to shut you down unless you choose to be shut down, but that's because your coping system needs to evolve.

Yeah, there are other ways to cope with our anxiety and anger. Right.

See, with denial, if you say to a person, okay, for now you may need to do that, but what if I showed you a way to embrace this and actually make use of this instead of trying to avoid it? What I say to people is a little bit different than FDR. He said, the only thing to fear is fear itself. I say, the only thing to fear is fear of fear.

Hmm. Okay. Yeah, because it's that unknown and Yeah, the anxiety, I always attributed to really a fear of, you know, being alone. A lot of our neuroses are ways to avoid that notion that we're basically alone, you know. It's the unknown that we're not sure of, right? It's the—

well, it's the presumption of unknown, right? If you look at human needs, right, you can categorize all human needs under love of self, love of others. With a lot of subheadings, right? So with my patients, I say, OK, you're getting older. You have physical problems. You've lost a loved one. All of the different things, all right? Remember, from my point of view, life is full of major stressors, things that affect your entire life. Chronic pain is only one of them. Getting older is another. These are big-ticket items, like COVID, all right? Chronic pain is a 9/11 event.— it is not an ordinary event and people don't get that. So I'm saying to people, look, there is a system designed by evolution for millions of years, an existential immune system, which doesn't just help you physically, but addresses you emotionally, psychologically, and existentially. You learn how to use these tools, you evolve your immune system, you can take on the challenges. And I understand this, I'm at a certain age where I'm in that zone myself. So I get it. All right? You get to a certain age, you know, where you go like, I don't know if that happened next day. I don't know who's— it's like being on a battlefield. I don't know who's going to get blown up next. Right? And the challenge is, how in the world do you maintain equanimity? How in the world do you maintain a love for life? Right? My favorite example of this is my mother, who lived to be 100, who was the kind of person who was dedicated to making other people happy in whatever way she could. So over the years between 80 and 100, she couldn't see, she couldn't hear, she couldn't hardly walk. Fortunately, she was well off, so she was living in a palatial, you know, home in Florida, more like a hotel. And I remember that she was 99 and I was with her and she said, "I have to go downstairs, right? I need to make somebody feel good today." And I, "How in the world are you going to do that? I mean, you can hardly function." Right? She said, "It's okay, just take me downstairs." Right? So we're walking around and she goes to people and tries to get them to smile. She says, "Show me your teeth." All right? It took about 7 people before they did. As soon as that person smiled, she said, "I'm good. My life still has meaning." That was her goal. She taught me a lesson about this, that there's always ways to demonstrate that what's meaningful to you in your life can happen if you're willing to adapt, if you're willing to change, if you don't get caught up in— you don't discriminate between the negative and the positive. Everything's an opportunity.

Yeah, yeah. So really being able to tell the difference between what we can control and what we can't control, and also I think having this mission as your mother, you know, so capably fulfilled, just having a goal, a purpose to help others, to reach out to others.

Yeah, yeah, those are the story of my life, and it's why I love martial arts, because martial arts is about you don't know your limits. Yeah, yeah, right. If you buy into the idea that you cannot, you already finished.

So a lot of other cultures— when you and I talk on the phone, we discuss this— but a lot of other cultures really don't experience depression like we do in Western society. What's your thinking there? Why, why are we, why are we maybe more vulnerable to this condition?

I, you know, there's so many different cultures, and I've worked with people from many other cultures. I was actually unofficially adopted by a Bedouin tribe, and that was really interesting years ago to kind of learn how people like that think about mental health issues. I spent time in Japan, so I sort of know the Japanese mentality. I've worked with a lot of Chinese patients, people from South America, Central America. A lot of it's culture. A lot of it is how people in those cultures learn to express or not express emotion. A lot of it depends on how they apply their thinking process. Everyone, no matter where they come from, is given the same basic tools— your feelings, your thoughts. All human experience ends in feelings and thoughts. But for all kinds of reasons, cultures are going to be different. In some cultures, you're likely to see this show up in physical symptomology— headaches, stomach upset, more of a somatic presentation. Because when I work with— I can't stereotype or generalize, but the Chinese patients I work with do not want to talk about this. It's supposed to be dealt with in the family. You don't talk about this. You don't share those emotions, vulnerability. Japanese, I can tell you from working in Japanese systems for years in the martial arts, not expressing your feelings is considered a sign of honor. Right? So you have these different attitudes about vulnerability. You have these different orientations towards your feelings and the way you think about things. So I would expect it to, as I said earlier, show up with a different pattern. But what were they really talking about? If everything that— no matter how it shows up symptomatically, if it's all an attempt to shut down certain emotions, there's any number of ways you can do that. You focus on somatic stuff, then you're not thinking about what you're really frightened about, right? So I think that I would explain the difference by different ways to approach dealing with the same problem, something that people do not know how to handle, and it's culturally specific to how they would relate to dealing with it.

Yeah, all right. So I like this topic of existential suffering as you, as you describe it, and you've, you've pictured, or you've put this picture together of another way to define or describe this condition. So tell me more about this existential suffering. What do you mean by this?

It's a really wonderful question because my orientation— I, I was classically trained. I, I went through 15 years of psychoanalysis, and my work in the hospital that department was psychodynamic. So I've been trained in all these different approaches, but the parts that resonated most for me were systems orientation and an existential approach. And so if you want to look at what person— what people are suffering with from an existential point of view, what that literally means is that everything that happens to you is not just happening to one part of you. It's happening to all of you, right? We don't walk around with only one zone of our life being activated. We are totally activated. So existential suffering is saying, yeah, you are having physical pain. That's one level of suffering, right? And you're having some emotional pain in reaction to that. It's another level, psychological pain. But ultimately, the big question is, is my life still meaningful? Do I still have any purpose? Do I still have any value? What I mean by existential suffering is simply a better definition of what it really means to suffer. And so if you don't address all of those aspects of a person, if you don't take a holistic approach, you're not likely to have the same outcomes.

A lot of it is our self-talk though, right? I mean, what goes on in our head and how we, again, how we explain these events, how we interpret them, and how well we think, you know, we're going to recover from them. That's going to really color our ability to move forward.

Right?

It's what, what goes on in your head.

True, but if you're familiar with— I'm sure you are familiar with reality testing.

Sure.

You can think whatever you want to think, but thinking is not nearly the cool tool people think it is, right? Because your thinking can be distorted by judgmental thinking, assumptions, rationalizations, magical thinking, right? Belief-based thinking. You understand that your thinking process is not nearly as reliable as your feelings. Nobody ever tells you to trust your head. They tell you to trust your gut. What people don't know is that means trust your anxiety. One of the functions of anxiety is actually to identify appropriate solutions to a problem. You can come up with what you think is a great idea for dealing with a problem and somehow it doesn't help. So I respect what people think about their condition, but mostly if they're thinking in terms of what they cannot do, they're already in trouble. They're putting their power into all the reasons why something cannot happen instead of all the reasons why something could. If you're infinite potential, think of the power that you can tap into, but you have to own the pain. And denial is a great example because one of the most difficult things for my patients to do is to embrace the pain of their loss. To go, okay, and not accept it. I will never use that word. Acknowledge the fact that things have changed. Acknowledge you woke up this morning and your body doesn't work the way it used to. Your life is different than it was. Own that first. Own the pain of that. Grieve the loss for that. Because if you don't do that, you're not going to want to then move on. When somebody dies, if you don't grieve the loss, you can't move on, right?

But so many people stay there, right? And they'll move on. It does offer a little bit of a protection too, to hold on to that loss, to hold on to that pain. That means they're not needing to move on and get beyond it.

I've seen that. From my point of view, that's kind of like trying to meditate when you're about to be hit by a truck.

Well, I don't know, it's, uh, I think it's very— look, I respect, I respect that people do that, but if you're not addressing the power that you have, if you're not making use of that I, I think it's a tendency to rely so much on the emotion and to hold on to that rather than to be willing to work through it and move beyond it, because I think that emotion is very protective for people. It allows us to— we don't grow, but it's, it's safe and it's predictable. It's like a comfort zone.

I agree, but the problem is, like I said, it's a way of coping, but there's a lot of side effects. If you're willing to understand the side effects from that Yeah, yeah, yeah, look at the balance, right? People don't consider the cost, right?

There's a lot of cost to that, of course, there's a lot of cost.

But yeah, I'm with you on the human condition. There's a lot of things I would rather not think about at all.

Yeah, so what are the upsides to, uh, you know, putting depression behind us? You've talked a lot about how our condition can limit us, handicap us, but how do we, how do we experience the positives of moving beyond depression? How can we envision that? How can we kind of get a taste of it by putting depression behind us?

I think the core idea behind the work that I do is a search for meaning. You know, depression does not allow you to reconnect, and often what I'm working with patients on— and many people don't know, right? It's really interesting. If you ask a person, what are you here for? They go like, what do you mean? I mean, why are you alive? What are you here for? All right, ultimately, I've never known anyone that doesn't have something they're here for, they just don't know. So if I say, look, I understand why you might get depressed, I understand why you might be overwhelmed by anxiety, I understand why all kinds of things can happen because you're up against something you don't know what to deal with. All right, but if you understand that if you upgrade your system, if you optimize the way you can operate as a human being, that you may find your way through this. Or maybe not, but you're investing your power in where you want to be in your life. Beyond depression is living in the reality of what's happened and finding a way to say, I'm still in the world, I'm still here for a purpose, I'm still here to be meaningful. Uh, like my mother's example, I mean, getting one person to smile, most people wouldn't think of that as a great accomplishment, but for her it was completely meaningful. So we get to decide that, we get to decide what matters and what doesn't. You're depressed, you're not deciding anything. Other than I don't want to deal with it.

So we get in touch with more, more of our purpose, more of our— what is my meaning in life? What is my, what is my reason for existing? And this is, this is way beyond wallowing in, you know, sadness and helplessness. This is what— this is way beyond that. Yeah, yeah.

I've worked with over 2,000 patients in the last 20 years, and frankly, I wouldn't be saying anything I'm saying if my patients didn't inspire me, because taking this approach actually makes a difference. I've seen people go through major personal transformations using— because there's a toolkit here, right? So we make use of that. We make use of the same things that you might make use of in your own work in terms of insight and other approaches. If medication helps, right? If other forms of therapy— that's all great.

Sure.

This is a powerful approach because it cuts to the heart of the matter. It cuts to All right, your life has begun to feel less meaningful. Is that the end of the story? Or is your meaning not defined by what you can and cannot do? Once people get that, then they go like, okay, well, what can I do? How can I express who I am and what I am? I can't pick my grandchild up to play with. And a lot of chronic pain physicians, they throw the baby out with the bathwater, right? If I can't do that, I don't react. I say, well, why don't you sit and hold hands, right? Why don't you go for a walk? There's always a way. Yeah. And that's a message that most people need to hear. And think about it, right? Did evolution design us to give it up once we start getting older and we start having things in decline? Does that make any sense at all? Makes no sense to me at all. What makes sense to me is that we learn throughout our entire lifespan, that we never stop learning. We just reach a certain point in time where we don't like the lessons.

Yeah, to learn the new ways, more effective ways to handle these struggles, these stresses, the anxieties. And as you mentioned with medication, we always know that there are symptomatic relief from, from the antidepressant, but we don't learn those new skills. We don't learn those new ways to cope and deal and and managed. That's the limitation. I mean, it serves its purpose, I agree, but it is— it's only a partial solution.

Well, in physical treatment, this is often the case. You'll get an injection which will relieve your pain long enough to benefit from physical therapy. I think of medications as buying you time, right? Denial buys you time. These other ways of operating, fine, but do the work. So that you don't need to be dependent on those things.

And the work is so important and it's valuable and it's effective, right? I mean, it works. It works. That's the beauty here. That's the beauty. Yeah.

Trust me, I would have given up on this a long time ago if not for the fact that my patients actually seem to be able to benefit from this. Uh, and this is not a traditional approach to chronic pain management at all. I don't know of anybody else in the state that approaches this way. I'm not trying to promote myself on this, it's just a different way of thinking about it.

Yeah, and there is hope, there is an upside, there is, uh, the real, real superior benefits to letting go of this extra baggage. It's very possible— it's not just possible, but it's, uh, it's expected, especially when We get out of our own way. Yeah.

Or actually get into ourselves. Look, everybody's different. Everybody develops a way of coping and dealing with stress. Uh, there's no wrong way, but if we're designed for an optimal level of performance, I would want to find my way to that because that's where the power is.

Yeah.

One of the biggest barriers I see with my patients is that they find out the hard way that they don't actually love themselves and they never did.

Hmm.

Love's conditional. And I work with a lot of very successful people, but it doesn't really matter. Ultimately, they can't figure out why, despite them having whatever they think they wanted, they still don't feel good about themselves. They run into something like chronic pain and they crash and burn, right? Because the system's not designed for it.

Yeah, not much to build on there. Great conversation, Alan. A lot of interesting topics. We could spend hours on so many of these different directions. But, um, what's your— what you're thinking about takeaway from our conversation? What would you like our audience to remember from this conversation today?

That I think the most powerful coping technique of all to deal with, whether it's aging or some other major something, is inspiration. Being inspired. Personal example, I've always been inspired to learn. I've always been curious. That still drives me. I could use another 100 or 200 or 300 years. In terms of where I want to continue to go. Be curious, know that there's things in your life that are meaningful to you, tap into your inspiration, right? Anybody we ever see that overcomes things, they are inspired for some reason, right? So I would like people— and not that people don't know this, but I don't know that they understand two things: inspiration and connectivity, right? Being able to connect to other people emotionally, being able to be part of other people, and inspiration will take you through almost anything life's got to challenge you with. Great. And understand that there are technologies that can take you to that, not just the one I use, but there are others. But if you think about the end goal, my end goal is to enjoy my life. And not everybody getting older gets depressed. It's not a natural thing to necessarily happen with aging. But I think that if you sample the people who get depressed and the ones that don't, I think you'll find a great deal of difference in how they define their importance in life and their meaning.

Sure.

So consider that.

Yeah, yeah. So that's great. That's the, the inspiration. I mean, staying inspired about our future is so key, but the connectivity element also.

One last, one last point about my mother. So there she is, 90 years old. She's been married twice. My father died and then she married again. He died. She's 90 years old and she says, "I need another boyfriend." I go like, "You know, you're 90 years old. You can hardly function." She says, "I like having a partner." And sure enough, 6 months after she told me that, she has another partner.

Yeah. Right?

And yet you and I know how devastating it is. You have a lifelong partner, somebody you've lived with so many years, Frankly, I think it's one of the scariest things that can happen to a person, and, and as you know, can be totally devastating, kill you. So know that you don't have to, that there is no one way to be you, no one way to enjoy your life.

Those are tough hits. How do you face the future alone? But people do. People recover and they reconnect and establish new relationships when we never thought we would. Be able to do that. I mean, that's, that's the beauty of this. It's unknown. It's a blank screen in front of us, right? We can write whatever script we want. Yeah. Well, it looks like we're out of time for today, Alan, but before we wrap up, I just want to remind our listeners about a co-sponsor for this program, A Mighty Good Time. Are you looking for ways to engage and stay active? Check out amightygoodtime.com. It's a one-stop shop for events and activities for those 50 and over. It's free to search and it's free to post. TheMightyGoodTime.com. And be sure to visit the Living to 100 Club website to sign up for our weekly podcast announcements and monthly newsletters. And while you're there, be sure to download a free copy of my 9 Tips for Living Longer. Lastly, pick up a copy of my book, Living Longer Is New Normal. All About Maintaining a Positive Mindset in All We Do. It's on Amazon as an ebook or hard copy. We've been talking today with Dr. Alan Weisser. Alan, uh, for those who might want to contact you, what's the best way to do that?

Yeah, easiest way is to go to our website, which is newoptionsinc.com. That has connectivity to accessing the book on Amazon. We're going to be putting out some classes on this model in about a month. And, uh, I'll probably be starting a radio show in about 2 months. So anything that's happening in reference to this, you can find on that website.

Great, great resources there. They can contact you, our listeners can contact you, as well as get more information and purchase your book too. So good luck with the radio program.

Thank you.

Thanks very much for being a guest.

I look forward to inviting you on as a guest.

Great, I'd love to be there. I'd love to be there. Yeah. Thanks to all of our listeners for tuning in today. Hope to see you next time.

Hi, I'm Laurie LeBay, and I wanted to tell you about Alzheimer Speaks. Which is another great podcast. You see, my own mother lived with dementia for 30 years, and I felt lost. Did you know every 3 seconds someone in the world is being diagnosed with dementia? Odds are it's going to hit your families too. We want to help you connect to services, products, tools, research, and stories so you can be prepared. Please subscribe to Alzheimer Speaks on your favorite podcast platform.