Depression during the midlife years tends to be multi-faceted. Not only is it uniquely experienced, but there are individual differences in onset, course, previous treatment, and current contributing factors. While midlife issues differ for the sexes, there are many commonalities (e.g., career transition, loss, grief, health concerns, relational issues, divorce, among other challenges). At the same time, though, gender differences in how women and men manifest depression exist (e.g., anger versus withdrawal).
In other words, there are multiple interacting components at play with midlife depression. Seeking out a counsellor with awareness, knowledge, and skills in the areas depicted below is an important consideration when working with midlife depression.
Discussion of depression’s history is a helpful guide to understanding past and present factors contributing to the onset and course of midlife depression. It is important for counsellors to inquire about previous involvement in group, individual, and other supports accessed for depression. This information generates understanding about what was helpful, less helpful, and what could be re-incorporated into current treatment planning.
Contrary to long-held tendencies toward standardized treatment approaches for depression, given the individualized nature of multiple interacting factors that contribute to depression across the life span, my midlife depression research found that clients benefit most when their counsellors collaborate to customize treatment and target these core dimensions of midlife depression: (a) history of depression (e.g., onset and course); (b) nature of the depression being experienced (e.g., loss-based, stress-related, complex past-present interactions, health-related); (c) how the client conceptualizes depression (e.g., hereditary, situational, stress-based, and lifetime); (d) buffers available and/or needed (e.g., social supports); (e) current self-management strategies (e.g., self-help tools, support groups and resources, medication, and group therapy); and (f) mindfulness-based approaches for a focus on daily living and well-being.
A treatment plan for a client with lifetime depression that began during adolescence accompanied by conflict, abuse, and alcoholism in the parental home followed by subsequent adversity and hardship into midlife differs significantly from a treatment plan designed to help a client manage midlife depression resulting from occupational stress and strain.
In closing, it would be helpful to ask your counsellor about her/his experience working with midlife issues. Midlife is much more than the stereotypical portrayal of a ‘crisis.’ Rather, midlife is akin to resting at the fork of a road – an opportunity for new directions, self-renewal, hope for the future, positive change, and healing from past difficulties. Midlife brings with it multiple challenges, losses, and opportunities. It is not surprising that depression during this time of life can seem like an impossible hurdle. However, is it a helpful signal that change is necessary and that learning new ways to live a preferred life can shape a renewed future.
The views expressed are mine alone and do not reflect the views of the CCPA.
Dr. Debbie Grove is a therapist working in Edmonton, Alberta. To learn more about her, visit her web site at www.learningtolive.ca
*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA