I looked upon my fiftieth birthday as a turning point in my life, as a fresh start. My emotional health was the best it had ever been, I was solidly planted in a good job, I had close relationship with friends and family and I had launched a writing career.

My generous brother threw a lovely party for me at a beautiful restaurant with floor-to-ceiling windows facing in all directions, overlooking two majestic bridges. There were twenty people there; close family and friends. Five years ago, I could not have counted more than five people in my small circle. I was celebrating not only my fiftieth birthday, but a secret anniversary that only a few people knew of; it was four years that I had stayed out of the hospital — the longest I had managed since my first hospitalization 22 years prior. It was truly a joyful time.

I was happy to be putting those many tumultuous years behind me; the years of revolving door hospitalizations, the roller coaster rides of depression and recovery and the feelings of chaos and emptiness of BPD. I had finally found the right combination of medications that had worked and was managing to tolerate the few side effects. The only issue I continued to struggle with was my eating disorder and body image, especially since I had entered perimenopause, but that was very slowly improving with a dance of two steps forward and one step back, three steps forward and one step back.

It’s been almost two years since that wonderful party and my life has only improved. My relationships have grown and strengthened, I’ve flourished at my job, and my writing is going well. I had a relapse of my anorexia, but have gotten it under control again. There is something new in my life; I have a friendship with a man. We had a couple of dates and decided we’d be better off as friends and we have stayed that way. He’s kind, funny and has a good heart and I consider myself lucky to count him among my friends.

By design or coincidence, about half of my patients on my small caseload at work are close to 50. All but one of them view their upcoming fiftieth birthday, or viewed their fiftieth birthday as a big red mark signaling the start of the end of their life. All these patients see nothing but bleak, empty years ahead of them. Not coincidentally, the one patient that doesn’t view her birthday that way is the only one that is currently working.

I have learned from experience that it is a mistake to make one’s illness one’s identity so without disclosing I try to impart that message to my patients. “You are suffering from depression; the disease of depression doesn’t have to define your life.” I tell them It doesn’t mean I don’t understand how much they are hurting and suffering — that there are days when they feel like they can’t even brush their teeth — but I also push them to get out of their comfort zone.

“You are fifty, not seventy,” I remind them. “Chances are you will live a good twenty or thirty more years. And whether you do something productive with those years or not, twenty years will pass, and you’ll still be seventy.”

Typically they’ve never heard that discourse before and it makes them stop and think. “Yeah, that’s true.” Then I will take the opportunity to explore with my patients what their passions are and we identify what activity might be a good match for them. Love animals? — volunteer at an animal shelter. Curious about computers? ─ take an introductory class at the local library.

More often than not, I receive a reluctant maybe in response and then when they come back the next week, I ask my patient if he or she has looked into the activity and they say they haven’t.

The mindset of tuning fifty seems to be for my patients that of their parents’ generation ─ that it truly is “old” and time to start winding down, not gearing up. I have disclosed that I didn’t get my MSW degree and begin my career in social work until I was forty, and that appears to make an impression, but it is a fleeting one. I believe that the media’s obsession with youth in this country has a great deal to do with the feeling that once we begin to show signs of ageing and feel in our bodies some aches and pains, that is the end for us.

It’s unfortunate ─ my patients are delightful people with a variety of combined talents among them. In the end, it is we who decide if the years are kind to us, not the other way around. I wish everyone could grasp that and absorb it, like reaching for a snowflake and having it melt in our hand. There’s plenty to go around.

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