Two fundamental aspects of cultural intuititive conceptions of time's passage - cyclic and continuous temporality - are here related to medical therapy and psychopathology, in a critical view of depression in old age as a modern construct. Although inspired by anthropological perspectives this paper is based on daily clinical experience and on a phenomenological attitude. In predominantly cyclical cultural perceptions of time the process of ageing is part of an eternal movement, and families perpetuate themselves in their descendants, in their traditions, in land ties or in the practice of familiar crafts or skills. Cultural transformations that give rise to more directional approaches of time's passage tend to implement individual roles more and more in social history. The more difficult the change from fatalist, repetitive, eternal cycling traditional Weltanschauungen to individualizing, bureaucratizing, planning and successive ones, the larger the chances of an unsuccessful old age and medicalisation of this failure.