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Martha, a 71 year-old retired clinical social worker living in Maryland, has struggled with depression for more than 40 years. Twenty-four years passed before she received a diagnosis. Her mood disorder was treated as a chemical imbalance, and she was given medications to alleviate her symptoms.

What was your first sign that something was wrong? What symptoms did you experience?

When I experienced my first episode in 1960, far less was known about depression. I had all the symptoms of clinical depression, but the doctors never called it that. I was sad, crying a lot. I didn’t enjoy anything anymore, not reading a book in front of the fire or going out to dinner. I lost my appetite and weight. I had no energy. Ordinary tasks seemed monumental. I felt guilty because I thought I should be doing better. I thought about suicide. I had difficulty concentrating. When I had trouble adding up simple figures, I knew something was wrong, but I didn’t know what.

What was the diagnosis experience like?

I saw a physician to determine if something was medically wrong. A blood test indicated I was anemic, and he started treating me for that. While in the doctor’s office, I had difficulty remembering things, like how long I had been married and my address. The doctor referred me to a psychiatrist, who recommended psychoanalysis but never mentioned depression.

The thought that someone was treating me gave me hope to stay alive. I began to feel better. I thought the sky was the limit and that the sad feelings would never happen again. I obtained a doctorate degree and was a medical school faculty member. I held office in professional organizations.

But a few years later, the black beast of depression began to return. Despite my accomplishments, I felt inadequate and incompetent. Depression can wreak havoc with self-esteem. I contacted a research psychiatrist at the National Institutes of Health. At the end of the first interview, he said I had depression and medication would help. I was hesitant to take medication, wanting to control things myself. But I tried it. The medication helped, and I continued to see the psychiatrist for psychotherapy and support. It took nine more years to find a medication that worked really well for me.

What was your initial and then longer-term reaction to the diagnosis?

It was a relief. Now I knew what it was, and the doctor offered a treatment plan, which gave me hope. The combination of medication and psychotherapy worked best for me. Clinical depression is different from feeling blue once in a while. It affects the whole body. It usually affects brain chemistry, which is why medication can work on the symptoms. I persevered. It’s a family trait to never give up, and it helped to keep me alive.

How is your disease treated?

I take an antidepressant, which I have been told I will need to take for the rest of my life. In addition, I see my psychiatrist periodically.

Did you have to make any lifestyle or dietary changes in response to your illness?

While we cannot prevent everything, I believe we have more control over our health than people realize. I developed a healthful lifestyle, which includes having an annual physical, watching my diet, exercising 30 minutes a day, getting adequate rest and sleep, and avoiding alcohol, nicotine, and caffeine.

Did you seek any type of emotional support?

I joined a National Depressive and Manic Depressive Association support group, which was very beneficial. In a group with others with similar problems, I didn’t feel so alone.

Did/does your condition have any impact on your family?

My husband was supportive. I didn’t mention it to my sister or brother.

What advice would you give to anyone living with this disease?

Learn as much as you can about the illness. The National Depressive and Manic Depressive Association has materials to help people deal with depression. Seek care from a doctor and mental health professional. Don’t stop or change the dose of medication without discussing it with the doctor. If the medication causes side effects or is ineffective, talk to the doctor. What works for one person may not work for another.

There are many options. Researchers continue to learn more, so additional treatments become available. Make a list of what helps you feel better and what makes you feel worse. Avoid the things that bring you down. Try to function as near normal as possible. Don’t give up or give in. Keep going to work, even if you are not functioning at top capacity. Get up and go somewhere. Do something. Avoid isolation. Be kind and gentle with yourself. Help is available, and with help, there is hope.

Interviews were conducted in the past and may not reflect current standards and practices in medicine. Talk to your doctor to learn more about how this condition is diagnosed and managed today and what treatment approaches are right for you.