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Jeff Skolnick, M.D., Ph.D.
Jeff Skolnick M.D., P.h.D.

Depression As We Get Older

Is it an inevitable fact or transformative opening?

“In a spiritually sensitive culture, it might well be that age is something to be admired or envied.” - Rowan D. Williams

Major Depression (aka: clinical depression) is a brain disorder. A terrible condition that can strike at any age; yet, it is estimated that there are seven million older adults with depression in the U.S. An added five million have what’s known as a “subsyndromal” depression—meaning they have depression symptoms but don’t meet enough official criteria to get the diagnosis. What that means is that there are an awful lot of people in what ought to be the golden years of life dealing with dreadful sad and nervous moods and/or having sleep and energy difficulties, losing desire or pleasure in even basic things such as eating and being with others, dealing with increased aches and pains, and having awful thoughts about life and themselves.

In the midst of all the symptoms of this insidious illness, there lies something that may be equally disturbing. It may or may not surprise you to hear that at the core of all depressions are psychological issues that are common to practically everyone as we get older. I’ll explain.

Children can totally immerse themselves in a fantasy world. Even as they grow up and into young adulthood, they can still live in a form of fantasy—that their lives will last forever. Even the first inklings of “Oh my gosh, I’m turning 30,” can be easily distracted from at that age.

Eventually, the distractions and denial collide with reality—the reality that everyone and everything we love and cherish including our own existence will be gone. Reaching retirement, the death of friends and family, the loss of looks and abilities with increasing medical conditions, these are all intrusions into that youthful fantasy which can lead to what the poet Thoreau called “lives of quiet desperation.”

Add the increasing vulnerability to brain chemistry imbalances and the twelve million older adults with known and reported symptoms of depression may just be the tip of the iceberg.

So is this the inevitable outcome of leading a human life—that our older years are bound to be fraught with grief and the stress of aging, which also raises our odds of having a clinical depression? The answer is not only “no,” the outcome can be the opposite…if it’s played right.

Examples abound in both religious and nonreligious circles of individuals who, in their older years, are endowed with such wisdom and heightened maturity that they find peace and contentment they had never known before.

Then, looking to the East, there’s the classic story of Siddhartha Gautama, known as the Buddha who, having grown up insulated, was exposed to old age, sickness and death in a way that shocked and depressed him. (Remind you of the more gradual anguish that comes from getting older?) Using that heightened awareness, he Awakened himself to a reality that has been described as Nirvana, an ecstatic realization that brought him to a higher level of living than he had ever imagined possible.

So what does this myth—if it is actually all a myth—have to do with clinical depression in older adults? Plenty. Because there was a Siddhartha and he did realize something that has been passed down faithfully over thousands of years to modern times: that suffering can spur great Awakening. And that great Awakening reveals the mystery and amazement of life every second we are alive.

Now granted Major Depression is a brain disease. However, as much as we know about the biological causes of depression, we are learning more and more about the potential of the brain (called neuroplasticity) to undergo radical change at any time of life. Any time of life!

Let’s put two and two together: The brain can get sick and cause depression. The brain can also be trained to radically evolve into a great Awakening—a stage of extraordinary maturity known to a small segment of the population for thousands of years. It means a blissful excitement and appreciation for life and pleasant tranquility all the remaining days of your life.

Ergo, get the sick brain well with:

  • Complementary healthcare (blending alternative healthcare with conventional medicine)
  • Modern life and wellness practices (all the things you’d learn in the self-help section of a bookstore, from diet advice to how to organize clutter to ways to manage stress)
  • Meditation or contemporary brain exercises used for the same purpose as meditation (the subject of my book and workshops)

Of course, you need a clear and concise game plan, based on brain sciences, complementary psychiatry and modern life-wellness. And all of it has to be geared specifically for the purpose of promoting the highest stages of brain development known (that is, “Awakened” levels).

So, that’s how it is technically done. The inevitable suffering and shock of advancing age—even clinical depression—can be used for transformation into unimaginable appreciation, meaning and life-satisfaction.

Yet, to be able to implement this rigorous game plan there must be structures in place for community support, professional guidance and education in a variety of areas. However, regardless of the difficulty and need for a clear plan and support structures, the larger point is that nothing can take away from the heartening fact that negativity around aging can be transformed into a better, brighter and more amazing experience of being alive.

Sound like pie in the sky? Many major discoveries, like human flight, were based on what was possible. Just as flight revolutionized human society, heightened brain development has the potential to significantly transform how we look at aging.

Jeff Skolnick, MD, PhD is author of the book Awaken Your Brain and can be found online at

About the Author
Jeff Skolnick, M.D., Ph.D.

Jeff Skolnick, M.D., Ph.D., is a psychiatrist. He is a Clinical Assistant Professor of Psychiatry at the University of Washington.

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