Midlife crisis: helping patients cope with stress, anxiety, and depression.

Midlife may be associated with changes and losses, including declining health status, retirement, caregiving for aging parents, and unexpected responsibility for adult children or grandchildren. Suicide rates increase with age. Depression and substance abuse are common but often under-recognized and undertreated. The primary care physician can promote healthy aging by appropriately diagnosing and treating midlife depression and substance abuse, making appropriate referrals for psychotherapy, and utilizing the support and educational resources of community and national organizations.