Depression Most Common in Middle Age
> 1/30/2008 11:05:04 AM

Popular images of unstable adolescents and neglected senior citizens as the most obvious victims of clinical depression have, according to new research, mistakenly reversed the equation. The disorder is most often reported among men and women who've entered the dreaded "middle age" period that, depending on which source one goes with, lasts from approximately 35 to 65 years of age. Typically, the greatest concentration of symptoms occurs during the 4th decade of the average patient's life.

In a study drawing on survey responses from 2 million subjects in more than 80 countries, researchers in the US and the UK determined that, for Britons, the peak age for depression is 44; for Americans, the same variable was 40 years for women and 50 for men. Interestingly, these trends applied on a near-universal scale regardless of variables like socioeconomic class, marital status, parenthood and career placement. From Azerbaijan to Zambia, subjects on the whole reported greater degrees of personal satisfaction in young adulthood and seniority, and the unity of these patterns was remarkable. The only abnormalities in the study occurred in developing countries, where researchers report that data was often insufficient and unreliable, opining that shorter life expectancies among economically deprived developing world populations may have compromised the application of their survey statistics.

The answer to the inevitable question - why? - remains elusive. Researchers theorize that a profound and deep-felt change of some kind begins to occur in the modern-age man and woman when approaching and passing the average human lifespan's 40-year median; the process is very gradual, and exactly how or why it occurs is up for debate. How can we characterize the movement of this mood cycle: is the healthy promise of youth followed by the often painful concessions of early adulthood and, finally, the liberating self-acceptance of age? Researchers have several theories involving personal circumstances that foreshadow the gradual influence of depression: the breakup of marriages; disappointment with one's career; growing children, aging parents, and the financial commitments they entail; the often profound realization that the many caprices of youth were merely fantastic whims to be abandoned with age and reason. Confronting one's own mortality as it draws ever nearer and witnessing the illness, death, and personal difficulties afflicting friends, family, and associates may certainly contribute to the disorder's development as well. Among the elderly, on the other hand, declines in health and fortune seem to prove less destructive; perhaps the youthful resistance to accepting the limiting parameters of one's own life begins to recede with age and a certain satisfied resignation that amounts to personal freedom rather than fatalism.

Personal health, a major determining factor, is also very closely related to depression; the disorder very often produces, or alternately stems from, such comorbid conditions as obesity and physical disability, both of which grow more common in middle age. The vast majority of chronic depression cases present by young adulthood, but living a healthy life into one's 40s or 50s does not predict subsequent fortunes. Depression may arrive slowly and unexpectedly, eventually interfering with one's social, professional, and family lives, and the fact that a given patient has not experienced depression in his or her adult life does not mean that it will not worm its way in as the individual ages. Knowledge cannot supplant experience, and informing patients of the uncertanties presented by the aging process will not necessarily make that period any easier. Still, patients should be aware that downturns in mood are common at certain points and that perseverence can be extremely rewarding as the troubles of adulthood seem almost trite when viewed through a larger lens.

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