Around 14% of people over 70 live with some mental health disorder, but the elderly are referred to psychological treatments less frequently.
Maurizio is 70 years old. Recently, he started going to therapy to try to better understand the migraines who have been with him since he was seven years old. I wanted to understand what could be behind them.
Over the years, he consulted several doctors and sought different opinions. Therapy was more of an attempt to trace the origins of the problem. But he continued treatment even after realizing he might never find a single cause.
“The process itself became something meaningful, a space for introspection that helped me understand my life more clearly,” says Maurizio.
Antonio, 73, and his wife, Gigliola, 68, turned to therapy in hopes of save the relationshipafter years marked by disappointments and unspoken tensions.
“After a while, I realized that I felt lighter, more open,” says Antonio. “Looking inside ourselves and bringing out things that we had never been able to say may have helped us,” adds Gigliola.
Their stories challenge a common idea: that therapy is only for young people. And a growing number of studies suggest that many older people could benefit from the same kind of help.
Therapy in old age
The potential for therapy to treat mental disorders and improve overall well-being is well established. Still, it remains relatively rare for older people to have access to these services.
According to the World Health Organization (WHO), approximately 14% of people over 70 live with some mental health disorder, especially anxiety and depressionand 17% of all suicides occur in this age group.
A study published in 2024 concluded that only about 4% of adults in the United States aged 65 and over received psychotherapeutic support, compared to 12% of young people aged 18 to 24 and 8% of adults aged 35 to 64.
This is despite there being no evidence that therapy is less effective or less useful as we age, according to Pim Cuijpers, professor of clinical psychology at Vrije Universiteit Amsterdam in the Netherlands.
“Therapies work throughout adulthood”, argues Cuijpers, who recently published a review on psychotherapy for depression in different age groups.
“What surprised me was that there has been a considerable amount of research on people over 75 and we have found no indication that psychotherapies work differently in this age group,” he says.
Older people may find that therapy helps address concerns specific to aging, such as social isolation and chronic illnessesbringing several benefits. Many report an improvement in general well-being, a renewal of motivation and greater participation in social life.
In this sense, therapy can act as a bridge, helping elderly people to reconnect with themselves and the world around them. According to a review published in 2025, more expressive results can occur in interventions carried out in groupswhich makes sense, as they offer a structured way of socializing and sharing with other people.
And, although they seek therapy less frequently, older people tend to remain in treatment. Completion rates among older participants can be as high as 54%, often higher than those seen among younger adults. This suggests that elderly patients often demonstrate a strong commitment to therapy and are able to maintain the work necessary to bring about significant change.
“We don’t know exactly why, but we can imagine that when older people decide to seek help, they are also more motivated to get involved in that process,” says Cuijpers.
Barriers to treatment
Financial difficulties help explain part of the difference in access to therapy among older people. In some cases, health insurance does not cover psychological treatment, and many elderly people are unable to cover the costs on their own.
But another barrier may arise within the healthcare system itself. The path to therapy often depends on referral by a primary care physician. However, some investigations suggest that older people are referred to psychological treatments less frequentlyeven when they present symptoms of anxiety or depression. Their suffering may be wrongly interpreted as a natural consequence of aging or worsening physical health, rather than as a mental health condition that deserves treatment.
Freud was wrong
Part of this prejudice goes back to Sigmund Freudfounder of psychoanalysis, who argued that therapy stopped working after the age of 40 or 50, says Rossana De Beni, professor and senior researcher in experimental psychology at the University of Padua, in Italy.
In 1905’s On Psychotherapy, a brief technical text on the practice of psychoanalysis, Freud wrote that, above a certain age, “the elasticity of mental processes, on which treatment depends, is generally absent.” But this is “absolutely false”says De Beni. In fact, “studies show exactly the opposite.”
According to De Beni, health professionals need to see the elderly person as they really are: not just as “an elderly person”, but as a complex individual, with multiple dimensions. The problem is that age-related prejudices are often “deeply rooted”.
Part of this ageism can be internalized by the patients themselves. The idea that mental health problems are just a normal consequence of aging is among the most frequently cited obstacles to seeking treatment.
This is especially worrying because ageism itself can increase a person’s predisposition to anxiety and depression.
The truth is that positive changes can happen throughout your life.
“Aging, until the very end, is a process of change”, says De Beni. “People become more fully who they are, in a continuous movement of transformation, learning and flexibility that never really comes to an end.”
Maurizio clearly identifies with this idea.
“Therapy helped me in three moments: when I went through the separation of my marriage, when I needed to deal with some conflicts with my children and during the transition from active work to the phase before retirement, when I had to find new ways of relating and living with other people”, he says. “I never thought it could be too late for anything.”
And he hopes to have served as an example for other people.
“I think this may have planted a small seed. Maybe not today or tomorrow, but who knows, maybe the day after tomorrow someone will make it germinate and water it,” he says.
A world of therapeutic options
There are different types of therapy, which can be adapted to each person’s needs. Some options that may be worth considering are:
- Cognitive behavioral therapy (CBT): focuses on identifying and changing thought patterns considered harmful or dysfunctional.
- Psychodynamic therapylike psychoanalysis, for example: it pays special attention to the way past experiences influence emotions and behaviors in the present.
- Family therapy: recommended for those who want to work on issues that go beyond the individual, as in the case of Antonio and Gigliola, analyzing relationships and dynamics within the family as a whole.
- Group therapy: creates opportunities to share experiences with people facing similar situations, helping participants feel more understood and less alone.
