Depression among older Americans is a "major public health problem" according to medical experts. About half of older adults who see their doctors for physical ailments have significant depressive symptoms and 15% of these patients have severe clinical depression. Unfortunately, many doctors do not recognize depression or believe it is inevitable in the elderly.

Americans 65 and older account for about 20% of the nation's suicides, but only about 13% of the population. Suicide rates for Americans ages 80 to 84 is almost twice that of the general population. Older women are at the greatest risk of serious depression. Although more women attempt suicide, more men succeed in killing themselves and use more lethal methods (usually guns).

Unfortunately, the population which most under-utilizes the mental health system are older adults and the elderly. Many older people still believe there is a stigma to seeking help for emotional problems, or that sharing personal things with stranger would be embarrassing. Family members may also think that depression is normal in older people and thus do not encourage their relative to get help.

There are many reasons for depression in the elderly in addition to the factors that cause it in younger adults. Within the geriatric population the older a person gets the more likely they are to have had multiple losses: their health, their mobility, their home, financial security. Certain medical conditons and medications are also associated with depression. Older adults have frequently lost a spouse or other relatives and friends as well.

Of course depression is not the only mental health issue for older adults. They suffer from many of the same problems as younger adults (e.g. anxiety, divorce, stress, substance abuse, even ADHD).

At one time I worked exclusively with seniors who had mental health and/or substance abuse problems. This invaluable experience enables me to be especially sensitive to the needs and concerns of older adults who come for counseling. My experience has helped me to understand what strategies are more likely to be helpful with the older person and which are not likely to help.