Q: I’m thinking I might benefit from seeing a therapist. I haven’t felt like myself lately and I don’t know what’s wrong — but something is. How do I find a therapist who is a right fit for me and good at their job? — Rachel T., Urbana, Illinois
A: First, bravo for recognizing your distress and knowing that therapy can help you manage it. Mental Health America reports that in 2019-2020, 20.8% of adults were experiencing a mental illness. That adds up to more than 50 million Americans. And the percentage of adults reporting serious thoughts of suicide is slightly less than 5% or more than 12.1 million. For adolescents it is also a pressing issue: A new Centers for Disease Control and Prevention report says in 2021, more than 42% of students felt persistently sad or hopeless and 29% experienced poor mental health.
Fortunately, we’re beginning to be more open as a society to discussing, accepting and providing treatment for emotional distress and mental illness. But it still can be a challenge to find a therapist who you can work with effectively. Referrals from friends and our doctors is a good place to start. Then, ask your potential therapist some pretty hard-hitting questions. (Remember, you’re hiring the therapist and you have the right to evaluate what you may spend your money, time and hopes on.)
• What’s your training (i.e., what certification or degrees do you hold)? Note: Psychiatrists are either medical doctors or lay analysts; psychologists have master’s degrees or Ph.D.s — more training is always better.
• How long have you worked in this field?
• What kinds of treatment or therapy do you practice? Why do you think it would benefit me?
• What are the advantages and disadvantages of the different approaches, including medication?
• How does the treatment work? How will we assess my progress?
• What should I do if I don’t feel better?
• How much will treatment cost?
Let me know how your search turns out. You’re definitely headed in the right direction!
Q: My elderly parents are experiencing hearing loss. I understand it’s associated with dementia — but I hope it’s something that can be corrected, somehow. What causes hearing loss and what can be done about it? — Greg H., Atlanta
A: Nearly 25% of adults ages 65 to 74 and 50% of folks 75 and older have disabling hearing loss. Most people think it’s all about aging and/or listening to loud music — and a hearing aid is the quick fix. But there are various types of hearing loss, each with a different cause and a different solution.
• Conductive hearing loss is a problem with the outer or middle ear and can be caused by wax buildup, a perforated eardrum, a middle ear infection or fluid accumulation that keeps the eardrum from moving properly. Generally, these are not hard to treat and hearing can be restored.
• Sensorineural hearing loss happens when there’s damage to the sensory hair cells in the inner ear or to the auditory nerve. Sound messages can’t make it to the brain. It’s caused by loud noises, some meds, aging, certain diseases and genetic predispositions. Hearing aids often help enormously, and they’ve become much higher quality and much lower cost, but sometimes a cochlear implant is needed.
• Central hearing loss happens when there’s damage to the brain or auditory processing centers caused by a stroke, brain trauma or a neurological disease.
• Mixed hearing loss is often experienced as a result of having both conductive and sensorineural hearing loss.
You should have your folks evaluated by an audiologist to rule out any over the counter or Rx medications as the cause. Common culprits are drugs used to treat heart problems, pain and infections. Then have them examined to identify structural problems, obstructions, nerve damage and more. Quality of life and cognition are very negatively affected by loss of hearing. You will be helping your parents enjoy a longer, happier life when you help them improve their hearing.
Health pioneer Michael Roizen, M.D., is chief wellness officer emeritus at the Cleveland Clinic and author of four No. 1 New York Times bestsellers. His next book is “The Great Age Reboot: Cracking the Longevity Code for a Younger Tomorrow.” Do you have a topic Dr. Mike should cover in a future column? If so, please email questions@GreatAgeReboot.com.
