Depression is a biochemical unbalance of the brain. It may come on suddenly. It runs in some families. It tends to be recurrent (40 percent). Depression can ruin a person’s life.

Depression is essentially treatable. You don’t will yourself “mind over matter” out of a depression. Controlled studies compared to placebos show that modern antidepressive medicines work. Untreated depression may land you in a nursing home unnecessarily or may make you unloved and lonely. You can die unnecessarily of a depression. Suicide rates in the general population are 12.4 per 100,000 people and in 80- to 84-year-olds, the rate is 26.5.

Don’t wait and see. It won’t be brief, and untreated, depression will last at least six months.

A depressed person has an all pervasive feeling of sadness. There are feelings of worthlessness, inadequacy and incompetence which hound the patient daily. They don’t think normally and many don’t calculate correctly. Depressed people isolate themselves by withdrawing from friends and family.

There is no laboratory test to make this diagnosis. There are, however, score sheets that reliably differentiate reactions to sad news and grief from depression. One-third of widows and widowers say they are depressed, and half of these are still in the state a year later. About three months is a reliable estimate for normal grief. After that, consultation is recommended.

Family physicians see depression in 5 percent of their office practice and 20 percent of their nursing home patients. The first year in the nursing home is a time of high incidence of depression. Many older people may not report depression because they think it is “normal” or they have no hope for any form of treatment. Only about 10 percent of the elderly who need treatment for mental disorders get it.

Treatment given by capsules, such as Dispramine or Nortriptyline, works extremely well. There are other drugs, but these two have fewer side effects in the elderly. Sixty or 70 percent of people will improve on this medicine, but it takes up to six weeks to show its full benefits. The physician must explain the side effects of dry mouth, constipation, slight giddiness and other happenings so the patient puts up with these nuisances and continues to take the medicine until the good effects begin. A course over six months of medication will cost about $100, which is minuscule compared to the damage cause by an untreated depression.

In a small number of cases in which these medicines are not effective, electroconvulsive therapy is worthwhile. It is nowhere near as repulsive as the movies would have us believe.

If you have this problem, please let your doctor know. No one will think the less of you, but they will certainly congratulate you on your improvement on treatment.