Depression in the older woman

Abstract Depression is a common illness in elderly women. Most commonly it is reactive in nature, but many suffer from major depression. This can be more difficult to diagnose in older patients as they focus less on mood symptoms and more on somatic and behavioral symptoms, and a high index of suspicion is warranted. Most patients will benefit from psychotherapy, and those with more severe symptoms will benefit from the addition of antidepressant medication. The newer antidepressants have been shown to be very effective and relatively safe in older patients, but there is still a place for heterocyclic drugs and monoamine oxidase inhibitors in certain patients. Referral for electroconvulsive therapy should be considered in patients with debilitating depression and those who do not respond to drug treatment.