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Illustration by Maya Chastain

Aging changes you. It changes the way your body looks and the way it functions. It can change your role at work and in your family. It can even radically change your self-esteem.

Midlife and later life bring both loss and liberation, but you don’t have to cope with these seismic shifts on your own. A good therapist can help you adjust in healthy ways.

Reluctant? Take a look at the data: In 2019, nearly 15 percent of adults older than 45 said they had visited a therapist in the previous year — and that was before the pandemic dramatically increased isolation across the nation.

As more and more people recognize the important connections between physical health and mental well-being, the stigma around therapy is dwindling. And studies show that therapy is as effective for older adults as it is for those in middle age.

This article discusses the benefits of therapy in midlife and later life — because therapy can be powerful and transformative at any age. Here’s how.

Hormones fluctuate across life stages. When estrogen, testosterone, and other hormones wane, it affects everything from your sleep habits to your muscle tone and your sex life. In addition to changing hormone levels, injuries and illness can sometimes keep you from participating in some of the activities you love.

And those are just the physical changes.

Relationships can also undergo big changes in midlife to later life. You may become a caregiver for a spouse or older parents. Research shows around a quarter of those aged 45 to 64 are taking care of an older relative.

Among adults over 50, divorce rates have doubled in recent decades. Fewer women than men re-partner after a “gray divorce,” (a divorce between spouses older than 50) which may mean adjusting to life on your own after many years as part of a couple.

Therapist Jill Meehan, LCSW, helps individuals and families navigate transitions like these. She says meaningful change is possible at any age.

“Resistance to change is not about age,” Meehan points out. “It’s about desire. Yes, change is difficult, but anybody can adapt if they really want to and are committed to the process.”

In a period of change, Meehan says, working with a therapist can help you:

  • tune in to what you want and need
  • clarify your options
  • learn to trust your own judgment, even in unfamiliar territory

In midlife to later life, major transitions, such as retirement, can destabilize your sense of who you are.

Researchers have found, for example, that elite athletes often feel depressed and confused after retiring from competitive sports.

When you are no longer doing something — or being something — that was once the focus of your life, a vacuum can open up. Feelings of disorientation are not uncommon.

“Some people lose the feeling of being relevant,” Meehan notes.

Even when the loss of identity is part of a natural process, such as menopause, living in the “in-between” phase between identities can be uncomfortable.

Therapy can give you a sense of direction as you redefine yourself. It can create a safe space for the trial, error, and reflection process of identity re-formation.

“What I see, working with women, is that the focus of their lives has often been on taking care of others,” she says. “When that shifts, people can start asking, ‘What do I want for the rest of my life?’ A therapist can give you permission to re-evaluate your life and get clear about your options.”

That kind of re-evaluation can lead to new opportunities. Today, workers over 50 make up around one-fifth of the workforce, a much larger percentage than in decades past.

Loss can happen at any stage of life. But the longer you live, the greater the odds that you will face a significant loss of some type. Children grow up and move out of the house. Friends and family members pass away. Important and meaningful phases of your life draw to a natural close.

“As horrible as grief is, it’s unavoidable,” Meehan says. “A good therapist can be present as a support, to help you process sorrow and regret — to validate those normal feelings and support you.”

The desire to “process regret” is a natural one. In later life, many people review their life experiences, wanting to recall and talk about times that stood out among the everyday events. Some therapeutic approaches focus intentionally on helping people look back in productive ways.

Life review or reminiscence therapy creates space for you to share important memories — whether they are of big events or moments that mattered.

Studies show that this type of therapy, which lends structure to the natural process of looking back, improves the quality of the life you’re living now.

Whether therapy takes place in a one-on-one or group setting, in-person or online, its success is based on human connection and bonding. Research has shown that a strong alliance between the therapist and the client makes therapy more effective.

Focused connection is important as you get older, when many people begin to experience a creeping sense of isolation.

Researchers have long said isolation isn’t just about loneliness. It can also lead to health problems, raising your risk of developing dementia, heart problems, and mental health conditions. The COVID-19 pandemic reinforced those findings.

“Therapy can keep you engaged,” Meehan explains. “Your therapist can be an unbiased source of validation, support, and compassion.”

Developing sources of connection may be especially important if you have been subjected to a lifetime of systemic racism.

Researchers have found that social and spiritual support, along with psychological resources, can help protect people of color from the stress of long-term exposure to discrimination.

Maintaining social relationships is so important to your well-being that experts recommend you create a “connection plan” with concrete ways to stay connected and prevent isolation.

Your results are likely to be better if you find a therapist that feels like a good “fit.” Here are some things to keep in mind:

  • Think about your age preferences in a therapist. At least one study found that women preferred an older therapist when they wanted to process universal life issues but opted for a therapist nearer their own age when experiencing an issue related to “living in today’s world.” Either way, it’s important to pay attention to your own preferences, since they may affect your ability to trust and bond with your therapist.
  • Look for a therapist trained in problem-solving therapy (PST) or cognitive behavioral therapy (CBT). Research from 2018 showed PST and CBT are effective in treating depression among older adults — especially those who are also coping with chronic illness.
  • Keep the practicalities in mind. Finding a therapist covered by Medicare, Medicaid, or your insurance provider will probably mean lower costs for you.
  • Consider online therapy. Some people worry online therapy will feel less personal than an in-person session. Others may be put off by the hassles of technology. Though it may take some time to adjust to the idea of forming a virtual connection, studies show that many older adults would rather share their concerns with an online therapist than with a family member. Many also found that online therapy helped them feel less alone.

If you’re in midlife to later life, there are strong, evidence-based reasons to consider therapy. A culturally sensitive, well-trained therapist can help you adapt to a changing body, divorce, an empty nest, retirement, painful loss, or any other life transitions you’re facing.

Therapy can also be a useful way to update your sense of who you are and what you can contribute to the world around you. It can reconnect you with other people, protecting you from the damaging effects of isolation. And it can help you look back at how far you’ve come, what you’ve experienced, and what you want for the years ahead.