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A Hole In Her Heart
Veronica Aguirre's hard-drinking father left the family home in Chicago when she was 5. "That was a crushing blow for me," she says. "I used to make up stories about how my dad was going to come back and get me. They were lies and everybody knew it, but they let me lie."

Over the years—as a student at an all-girls' Catholic high school, as a young woman partying and working on a Caribbean cargo ship and later as a single mother in Chicago trying to support her daughter while going to nursing school—Aguirre harbored that suppressed grief from her childhood.

Today the 43-year-old home health care nurse looks back and sees in that grief the seeds of the low-grade depression that had dogged her for years. "When I looked at a blue sky, there was an underlying black," she says. "Literally."

Martha Hawkins, a 53-year-old Montgomery, Alabama, restaurant owner, grew up in a poor black family in 1950s Alabama. "Life was just never really right," she says. "I never felt good about myself." The message she absorbed was the one delivered to most southern girls of that era: Be sweet. Try to please. When a boyfriend asked her for sex, she said yes. When she got pregnant at the age of 16, she married the boy because both sets of parents thought it was the proper thing to do. And she dropped out of high school. "After we got married, I always did what his mother said to do," she recalls. "I never made any decisions. It's hard when you have so much to say and nobody to say it to."

The common wisdom about depression—that it's anger turned inward—is a cliché that contains some truth. But depression is a complicated illness that is usually caused by a combination of external stressors and biological triggers.

A family history of depression is a strong indicator of risk. Beth Vesel's early memories are of a mother who suffered from periodic bouts of severe depression and who spent much of Vesel's childhood in a haze of medications. Hormonal fluctuations, which disproportionately affect women in their childbearing years, are also a factor. The two-to-one ratio of depressed women to men holds true only between puberty and menopause; there is little or no disparity between the genders in children and the elderly.

Escapes That Lead Nowhere
Not everyone who suffers from low-grade depression looks back on an unhappy childhood; for some, the problem begins in adolescence or early adulthood—the result, perhaps, of the inevitable stresses that accompany such rites of passage as moving into a first apartment, graduating from college or losing a first love. Someone who is vulnerable might slip into low-grade illness without even realizing it.

That's the way it was for Meri Nana-Ama Danquah, 33, a Los Angeles writer who has written a memoir, Willow Weep for Me (Ballantine). "The depression was just part of who I was," she says of herself in her early twenties. At that time, Danquah had just moved to L.A.; she was writing and working temporary jobs, rarely taking time to enjoy the charms of the city. "I wouldn't go to the park and roller-skate," she says. "It was like, Why bother? I was functional. I'd get up and go to work. You have moments of pleasure. But the basis of your life is not contentment. It's not pleasure. It's almost like having a film over your life."

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