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Rhodes, Maura.  When you can't beat the blues.  McCall's, October 1966. p
116-120+.


If you're always down, you may be suffering from dysthmia, a little known
form of depression that plagues ll million Americans.  News that will make
you feel better fast:  There's a cure.


Rose Wagner is living the kind of life sitcoms are made of:  At 41, the
New York City resident has a devoted husband, a pampered pooch named Bosco
and a quirky, satisfying job photographing people with their pets.  Tis is
quite a change from 14 years ago when, soon after moving to Manhattan from
Wisconsin, Wagner developed a relentless case of the blues.  A clothing
store manager at the time, Wagner had never considered herself especially
moody - she enjoyed socializing and going out and had plenty of energy.
"But in New York, I was under a lot of stress, and I began to notice SI
couldn't handle the day-to-day grind.  It was hard to focus and
concentrate, and I was drained by the end of the day," she recalls.  "On
weekends I preferred sleeping to taking a walk.  It reached the point
where I wasn't even up to going to the movies with my boyfriend."

Wagner's tenacious dreary mood lingered - for l2 long years.  Despite it,
she married, switched careers and adopted Bosco, all the while  believing
her glumness to be "just the way I was."  It wasn't until two years ago,
while she was watching a televeision program about depression, that she
realized seh might need a medical boost to help her out of the doldrums.
After seeing a psychiatrist, Wagner was diagnosed with a form of chronic
mild depression called dysthmia (dis-THIGH-mee-uh), also known as dysthmic
disorder.

Dysthymia, which means, literally, "ill-humored," afects up to 5% of the
popultaion of the United States, according to the National Institute of
Mental Health.  Most people diagnosed  with dysthymia are betwen the ages
of l5 and 54, and the malady is twice as common in women as it is in men,
although this may be because women are more likely to report their
symptoms, says Kay Redfield Jamison, Ph.D., a professor of psychiatry at
the Johns Hopkins University School of Medicine in Baltimore.  Jamison is
the author of An Unquiet Mind (Alfred A. Knopf), a book about her own
battle with manic depression.

Yet, pervasive as dysthymia is, many who struggle with it spend years
being misdiagnosed and mistreated simply because they mistake their
symptoms for personal shortcomings or personality quirks.  "Dysthymia
causes you to think there's something wrong with your character," explains
John C. Markowitz, MD, and associate professor of clinical psychiatry at
Cornell University Medical College in New York City.  Your're likely to
think, "I'm just a bad person.'"

When you just don't have any zest for life

It wasn't until l980 that psychiatrists began offering medical treatment
for this disorder. That was the year dysthymia was classified as a form of
depression, thanks to a major overhaul of the Diagnostic and Statistical
Manual of Mental Disorders, or DSM (the criteria developed by the American
Psychiatric Association to define mental illnesses).  According to the
DSM, dysthymia is a depressed mood that occurs for most of the day, on
more days than not, and persists for  two years or longer.  In addition,
at least two of these symptoms are present:

- Poor appetite or overeating;
- Insomnia or sleeping too much;
- Fatigue or low energy;
- Low self-esteem;
- Poor concentration;
- Difficulty making decisions;
- Feelings of hopelessness

While dysthymia is rarely incapacitating, "it puts a glass ceiling on
life," says Michale E. Thase, M.D., a professor of psychiatry at the
University of Pittsburgh School of Medicine.  "You're unable to enjoy
yourself, have fun or experience pleasure.  You may feel shy or
embarrassed around others, and you procrastinate because you're afraid of
failing or because you have no energy."

"You might not achieve your full potential at work, believing you're not
being promoted because you don't deserve it," adds Kimberly A. Yonkers,
M.D., an assistant professor  in the department of psychiatry ad of
obstetrics and gynecology at the University of Texas Southwestern Medical
Center at Dallas.  "You may not get married, or you may not feel satisfied
with your marriage."

Given this broad and somewhat vague spectrum of symptoms, it's easy to see
how dysthymia can go undetected.  Often it takes a crisis to alert
sufferers to the fact that they have a problem:  BEcause they lack the
self-esteem, energy or optimism needed to pull through hard times, as many
as half of those who have dysthymia are driven to episodes of severe
sandess when faced with significant adversity.  This compounds the
illness, resulting in a situation called double depression.

Sandy Marincic, 33, of North Huntingdon, PA., experienced this
vulnerability when, within two years, she lost her live-in boyfriend,
relocated because she had landed a new job, then lost the position.
Rotten as her luck had been, " the worst part was I had to find another
job, make decisions.  I was paralyzed," she recalls.  While most people
would have brooded for a few weeks, then started picking up the pieces,
Marincic sank into a deep funk.  Sevrely depressed, she finally answered
an ad for a research study of antidepressants at the University of
Pittsburgh and learned she was dysthymic.

"I realized Ihad suffered from the blues all mylife," she says, "Thinking
back, I could remember only two periods during childhood when I actually
felt good.  I was lethargic and unhappy at my job.  I accepted all this as
my lot in life."

Dysthymia can have a variety of causes.  For some sufferers, early
adversity--say, growing up with an alcoholic parent--sets them up for
depression.  For others, a chronic disease, such as arthritis, may send
them into a tailspin.  But for many, THE PREDISPOSITION TO DEPRESSION MAY
BE BIOLOGOCAL. "THERE'S LIKELY TO BE A FAMILY HISTORY OF DEPRESSION," says
Thase.  

Good news:  Help is on the way

Fortunately, medication is effective for relieving the problem. It worked
for Claudia Myers, 33,of San Carlos, Calif.  With a loving marriage, two
wonderful kids and a challenging, satisfying career as an attorney, Myers
is a shining example of the fact that a woman can have it all.  Yet even
as a child, Myers was moody.  "I didn't act the way most kids did.  Things
bothered me," she recalls.  "I always felt angry and frustrated, and I
cried a lot in private. I remember when I was eight, a cousin I hardly
ever saw got married, and I developed an overwhelming sense that she was
abandoning me.  I cried for weeks after the wedding."

As an adult, Myers continued to be down on herself, down on life and angry
to boot.  "I thought I was just being crabby," she says.  Despite her
misery though, she succeeded in some areas: "I had no social life, but I
did pass the CPA exam, and I went to law school."

It wasn't until after she was married and had had her first baby that
Myeres recognized something might be seriously wrong.  Following the
baby's birth, her glumness metaorphosed into (full blown depression).
(Last page of article missing.)


Down times:  When depression is most likely to hit.

There are a number of times during a woman's life when she may be
especially prone to feeling blue.  Many of theses coincide with
reproductive events, explains Kimberly A Yonkers, MD, an assistant
professor in the department of psychiatry and of obstetrics and gynecology
at the University of Texas Southwestern Medical Center at Dallas.  Experts
believe estrogen and other female hormones influence the workings of the
neurotransmitters that control moods.  Here are the times when women (and
girls) are most likely to find themselves battling different forms of
depression.

Menstruation.  Three percent of women experience a recurring condition
known as premenstrual dysphoric disorder.  Characterized by severe tension
or irritability and/or difficulty concentrating, all of which affect the
ability to function, this condition commences one to two weeks before each
period and subsides within a few days after a woman's period has begun.

Childbirth:  About 5 to l0 percent of women will experience minor
depression while pregnant.  In additoin, the "maternity blues" -minor mood
swings - hit aproximately 80% of new mothers during the first three days
after giving birth.  A smaller number of women experience a more serious
and persistent condition called postpartum depression, which is marked by
a low mood, obsessive worrying about the baby, panic attacks, trouble
sleeping, flagging energy and feelings of guilt. 

Menopause:  It is during the five years immediately before or after a
woman stops menstruating that she is most likely to experience depression.
Estrogen treatment may help.