Depression in Mature Gay Men

After I wrote “Why Older Gay Men Are Attempting Suicide at a Higher Rate,” I received a couple of poignant responses. One was from a sixty-six-year-old man who was struggling with the question of whether to come out to his parents and friends, the loss of his business, and several health challenges, including serious side effects from his medications. He said that he had “not ruled out” suicide but that he didn’t want to hurt his family or close friends. Another was from a sixty-one-year-old gay man from Australia who wrote about feeling invisible—even among close gay friends who were younger—and suggested that depression in mature gay men could be linked to rejection and ageism in the gay community. He is struggling with physical changes, including erectile dysfunction. Here is how I responded to them.

Neither of you is unique in what you have experienced. When I turned sixty years old, I also went through a difficult time for some of the same reasons you’ve mentioned. I had lost my mother, my stepfather, and a brother within six months, and some friends had died. I needed a knee and a shoulder replacement. My career had plateaued, and I thought it was on the decline. I had some difficulty with erectile dysfunction. All I could see for the future was a series of continued losses.

Then after I gave a speech in Houston, a man raised his hands in the air and said, “I’m eighty-two and this is the best time in my life.” I thought, “What does he know that I need to know?” His comment forced me to refocus my thinking on aging as an adventure with opportunities I had never had and may not have again. One of my favorite sayings (sometimes attributed to Buddha) is “Pain is inevitable; suffering is optional.” In other words, I couldn’t change the fact that I was sixty and that I had experienced many losses, but I was suffering because that was all I could think about.

One of the “opportunities” we have as we age is the power to reshape our thinking. We can deconstruct an old, outdated value system and develop a new one consistent with the person we believe that we are, not one based on others’ expectations of us. I wrote about this in an essay for Psychology Today titled “The Opportunities of Aging.”

Coming out is not an event but a process. Not everyone needs to come out to every person in every circumstance. Being honest about our sexual orientation is liberating for us personally, but it can damage relationships that are important. Since one of you is sixty-six, your parents must be in their eighties. They lived in an era when gay men and women were sent to prison and considered deviant and predatory. Coming out to them may have unintended consequences for them and for you. I appreciate your wish to be honest with them. They may even suspect that you’re gay. But once it is out in the open, it demands a response, and you have no control over what that response might be. Although you have been considering this for years, they will only now just begin to think about it.

In considering a decision like this, where risks and outcomes are uncertain, we tend to magnify the negative and minimize the positive. It is certainly possible that your parents might respond, “We love you anyway you are.” But there is no guarantee. No optimal decision exists, but each of us must decide for himself what is a satisfactory resolution, as well as how far and to whom to come out. You have already experienced a lot of losses. Do you wish to risk the loss of your parents’ support at a time when you really need some?

Financial and medical problems are one of the major sources of difficulty for us as we grow older. I’ve been both poor and financially secure, and I can tell you that financial security does not guarantee happiness. I am absolutely convinced that happiness during our later years depends primarily (after our basic needs are met) on having something that gives life meaning and having friends (gay or straight) who accept us as we are.

Men talk about their depression less than women do, but a good doctor is one place to start. (Be sure that the provider you select is both well trained and is someone you feel you can connect with.) All medications have risks, and the more meds you take, the higher the risks. A doctor cannot possibly remember all the drug interactions and less-frequent side effects. Patients must advocate for themselves. Having a companion go to your medical appointments with you will also result in better medical care.

Struggling with prostate problems and erectile dysfunction (ED) is indeed a potential curse or pain, but don’t suffer needlessly. See your doctor about the prostate problems. While medical problems and medications can cause some of the problems related to ED, often the problems are psychological. At the first sign of some difficulty with erections, men often begin to worry that they are losing their ability to function sexually, and then the worrying about the problem becomes an even bigger problem. I address these issues in my Finally Out Tips. But important research shows that while sex drive, erections, and ejaculation may diminish as we age, sexual satisfaction can remain constant. The important message is that good sex does not demand that we have a world-class erection!

Suicide sometimes begins to seem rational when we’re faced with a serious predicament, but it is a permanent solution to what in most cases is a temporary problem. I can’t tell you what the solutions are, but I can tell you that I believe there are solutions, although sometimes finding them can be painfully slow.

Having the right persons to talk to is critical. Your primary care physician can be a good one, but it is important that your doctor accept your sexual orientation. If your doctor doesn’t know or doesn’t accept your sexuality, he or she will give you bad advice. Younger physicians may be more open and affirming about sexual orientation, but not necessarily. If you need to find a supportive healthcare provider, try the Gay and Lesbian Medical Association referral list or ask a gay friend who is open with his or her doctor. The same advice holds true for finding a supportive counselor. The Association of LGBTQ Psychiatrists also has a referral directory.

Most of us who are older have had the experience of either feeling we were sitting on the sidelines in the LGBTQ community or have been invisible to them. For many of us, dancing the night away and drinking excessively has lost its charm. We need gay spaces where we can talk together and hear each other. Many larger communities offer these options. One international organization that provides these opportunities for older adults is Prime Timers Worldwide; another is SAGE. Both have local chapters. Social media can be helpful in connecting with others but must not become a substitute for face-to-face relationships.

It’s true, we do have a bias in our culture and a focus on youth, but part of that is because those of us who are older have not raised our voices and said, “Hey, I’m queer, too. Notice me!” Gay, straight, or other, ageism is a factor because of stereotypes. Stereotypes exist in a world of “those other people.” They exist when one outside group attempts to define another. But we are also the victims of these stereotypes because we have internalized them, too. If we believe that as older gay men we’re in a period of decline to nothingness, we are our own victims of the stereotype.

I am seventy-four now. When I was young, seventy-four was considered very old. But now I am considered a survivor, and I have a life expectancy of another twelve years. I feel an urgency of time, but it allows me to choose to do things I really want to and not do other things that I once thought I had to do. I have moved to-dos from my bucket list to an un-bucket list. I no longer feel pressured to climb the ladder to the top. I don’t go to cocktail parties unless I know I’m going to like the people who are there. I don’t sit through boring lectures. I don’t read lengthy essays unless they really have something important to say. I hope you’re still reading this one. Make this the best time in your life.