When Older Women Speak: Aging, Emotional Distress, and the Self

Studying the interaction of gender, class, race/ethnicity, and aging in the depression experience of older women provides a unique opportunity to understand how aging plays a significant role in shaping conceptions of self and emotional health trajectories for women. Based on author interviews with mostly working-class, depressed, elderly women, this book contributes to the theoretical understanding of femininity and aging and the practical implications for policy and effective health care treatment. Cultivating an "alternative self" can reduce older women's suffering and provide the emotional resources to change their inner worlds, even if the outer world stretches beyond their control. Depression affects women twice as often as men. Up to 40 percent of older adults respond poorly to depression treatment, and depression is linked to higher morbidity and mortality rates and cognitive decline. Older adults with depression have 50 percent higher health care costs, yet depression is accurately recognized in less than one half of older adults in primary care. While older men are more likely to die by suicide, older women are two to three times more likely to attempt suicide, and depression is the best predictor of suicide in older adults. Latina and African American women have lower rates of depression treatment compared to non-minority women. From issues of health care access to the stigma of depression, older Latinas and African American women are at an increased risk for untreated depression. This book seeks to address some of the significant gaps in our knowledge of late-life depression in women, especially in ethnic minorities, ranging from detection and efficacy of depression treatment to informal influences (e.g., family) on formal depression care seeking.