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1 We all feel sad at times. However, clinical depression is a serious matter. Clinical depression sometimes called major depression is a biologically based brain disorder that affects ones thoughts, feelings, behavior, and physical health. When people complain that they feel terrible, they have no interest or take no pleasure in things, have trouble sleeping, lack energy, have poor appetite, or cannot concentrate, depression is a definite possibility. 2 Depression in its many forms affects more than 6.5 million of the 35 million Americans who are 65 years or older. Most older people with depression have been suffering from episodesof the illness during much of their lives. For others, depression has a first onsetin late life-even for those in their 80s and 90s. Depression in older persons is closely associated with dependency and disability and causes great suffering for the individual and the family. 3 Many older people and their families dont recognize the symptoms of depression, arent aware that it is a medical illness and dont know how it is treated. Others may mistake the symptoms of depression as signs of dementia. Also, many older people think that depression is a character flawand are worried about being stigmatized, so they blame themselves for their illness and are too ashamedto get help. Others worry that treatment would be too costly. 4 Older persons with depression rarely seek treatment for the illness. Unrecognized and untreated depression has fatal consequences in terms of both suicide and non-suicide mortality. The highest rate of suicide in the US is among older white men. Depression is the single most significant risk factor for suicide in that population. Tragically, many of those people who go on to commit suicide have reached out for help-20% see a doctor the day they die,40%the week they die and 70%in the month they die。Yet depression is frequently missed. | 
