What was it like before we had specific treatment for depressive disorders? What were the burdens of depression and its consequences? If treatment were not available or not utilized, how would the elderly with depressive disorders suffer? These are very cogent and necessary questions to be explored. This paper examines some historical records of the preantidepressant world and highlights the words of those who described the suffering of depressive disorders. From there this paper will address the current data relating to the burden of depressive disorders in general and the elderly in particular. The increasing emphasis on the mutual and bidirectional interaction between the physical disorders (such as basal ganglia and vascular diseases) in the elderly and depression and the negative impact of nonrecognition and nontreatment will be presented.
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