This state, described medically as involutional depression, is a serious disorder.

It develops when the functions of the endocrine glands may be reduced in activity. These glands secrete hormones, chemical substances which travel via the blood stream to other organs which they stimulate into action. Women have a much higher incidence of this type of depression than men and they tend to experience difficulty earlier, when they are about 50.

Some think that this type is caused more by the emotions than by any lack of hormonal activity but, whatever cause, women suffering from it frequently need in patient treatment in hospital and indeed are responsible for one of the highest admission rates. It is a painful and distressing fact that the most upright and conscientious of women can be tormented by greadful feelings of guilt and unworthiness, with thoughts of self-destruction.

In men, involutional depression is more common when they are nearer 60. At this time of life, many men often experience a phase of self-questioning. They think their early dreams are unfulfilled, they wonder about the significance of life or lack of purpose and they often feel a sad realization that they have not got very far. In this illness, these ideas are more common among successful, rather than unsuccessful, people. Yet again, they may be oppressed by being promoted, and now are faced with responsibility beyond their capacity - a demonstration of the 'Peter Principle' that 'every man' rises to the level of his own incompetence. At this time friends begin to have heart attacks or die, other friends move away, and early retirement or redundancy may leave the individual feeling useless and unwanted.

The illness is often brought to light by the developing of hypochondria - when a person is overly concerned about his or her health. Irritability is common, with great pessimism and thoughts of death. Sufferers are usually quite agitated - restless and overactive as well as despondent and confused, often pacing up and down and wringing their hands. Sleep and appetite are poor, concentration is lost and there is marked indecisiveness. Hopelessness is often distressingly present, misery is very apparent and the sufferer looks wretched. The disorder is slow in developing and, when fully developed, thinking is often distorted and deluded.

This illness can have a devastating effect upon the family. Medical help should be sought promptly and happily the condition is quite treatable, although, once again, self-help is not practicable. If the illness is not diagnosed and treated at the early stage, hospital care is often the best course, especially so it agitation and when there is a state of feeling persecuted. The primary need then is the control of the agitation, the securing of sleep and, at the same time, anti-depressant treatment.