Midlife may be associated with changes and bosses, including declining
health status, retirement, caregiving for aging parents, and unexpect
ed responsibility for adult children or grandchildren. Suicide rates i
ncrease with age. Depression and substance abuse are common but often
under-recognized and undertreated. The primary care physician can prom
ote healthy aging by appropriately diagnosing and treating midlife dep
ression and substance abuse, making appropriate referrals for psychoth
erapy, and utilizing the support and educational resources of communit
y and national organizations.