Aging and Depression: Some Unanswered Questions

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Abstract
The subject of aging and depression leaves many unanswered questions, and the lack of precise and universally accepted definitions (not to mention an inadequate nosology) further complicates the issue. Little is known regarding the differentiation of depressive illness from a melancholic response to the stressful aging process, and equally little regarding the natural history of depressions with onset in the teens, 20s, or 30s. Studies are focusing on biochemical and physiological aspects of depression, but at present biochemists suffer from the uncertainties of the clinicians, and the clinicians and geneticists from the limitations of the biochemists. However, despite our uncertainties about the condition, several effective forms of therapy have been developed, ranging from a focus on the therapeutic milieu to the use of pharmacologic antidepressants (particularly lithium). Ultimately, the quesion remains: why are not all elderly persons suffering from depression? The answer may lie in the interaction of environment, life stresses, and the internal adaptive capacities of the individual.

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