Two fundamental aspects of intuitive cultural conceptions of the passage of time - cyclical and continuous - are related here to medical therapy and psychopathology, from a critical perspective of the condition of depression in old age as a modern construct. Although inspired by anthropological perspectives, this article is based on daily clinical experience and takes a phenomenological attitude. in predominantly cyclical cultural perceptions of time the ageing process is part of an eternal movement, and families perpetuate themselves in their descendants, their traditions, ties with the land, or in the practice of family crafts and skills. Cultural transformations that give rise to more directional approaches to the passage of time tend toward growing emphasis on individual roles in social history. the more difficult the change from fatalist, repetitive, traditional and eternally cycling Weltanschauungen, on the one hand, to others, based on individualizing, bureaucratizing, planning-based and successive concepts, the greater are the chances of unsuccessful old age and the medicalisation of this failure.