With many aging men and women, you won’t hear any self-identification of depressive feelings. Maybe it’s the perceived stigma about mental health issues or the sense that feeling depressed might be seen as a character flaw. The older adults I know are a stoic bunch, and they’ve handled a lot in their lives. If they’re feeling blue, they usually decide to "buck up" and cope.

And as we age into our 80s and beyond, we have a lot to cope with — loss of friends and loved ones, loss of a preferred living situation, loss of independence. As one 88-year-old man said to me, "It’s enough to make anyone depressed."

Let’s try to talk about depression — just a little. First of all, it’s a disease of the brain. The World Health Organization finds it’s second only to heart disease as a cause of disability worldwide. This next part is important — it’s a disease all its own, not a normal part of aging. It may come as a companion to other chronic conditions but it needs to be treated as its own illness. And it’s hard to treat because it’s often hard to see.

What causes it? Loads of things. There’s a genetic vulnerability, often exacerbated by stress. Medications taken for another disease can create depressive symptoms. Hormonal changes may come into play (women are twice as likely as men to become seriously depressed). A psychiatrist at the University of Washington once described it in a way that still makes sense to me: "It’s a biological disease that manifests itself psychologically."

One of the most comprehensive summaries of older adult depression is in a report from the surgeon general that points out how very difficult it is to discuss depression and poses the "startling reality" that a substantial proportion of depressed older adults receive "no or inadequate treatment." The report says the prevalence can be 20 percent of older adults who are living in the community and 37 percent living in nursing care environments.

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In older adults, the symptoms are deceptive. It can show up as fatigue, loss of appetite or sleeping difficulties. Irritability is often (especially in men) a signal of depression. Excessive concerns about bodily aches and pains can be an indicator.

I know it’s difficult, but let’s try to keep talking about this. I can say that because, as a companion to my Healthy Aging column, I’m now doing a monthly television program on community cable television (Southern Oregon University Channel 9). The next program, at 6 p.m. Monday, Oct. 25, is about depression in the older adult. I will have experts and expertise available — and you can call in with comments and queries.

I think it’s time — we should talk.

Sharon Johnson is an assistant professor in family and community development at OSU Extension and a member of the Senior Advisory Council. Reach her at s.johnson@oregonstate.edu.