Pessimistic, grouchy, bored, blue? Chronic low-grade depression can feel so familiar you don't even know you've got it. But it's rampant among women and underdiagnosed. The good news is that with treatment, you can be better than ever. 

At some point, they were happy; they had moments of joy. And then, one molecule at a time, the happiness went away. Sometimes the loss began in childhood, and their well-being disappeared so gradually they hardly noticed. For others, sadness came on like a sudden fog after months of stress. After a while, negotiating daily life was like driving a car with a dirty windshield. It was tolerable. They coped. Pleasure? That consisted of not feeling really bad, interspersed with a few moments of genuine laughter and fun—which, over the years, grew increasingly rare or became possible only with the aid of alcohol, drugs or the temporary high of sex. If someone had asked them, "Are you happy?" they wouldn't have known what to say.

They are four women who have never met: a nurse in Chicago, a literary agent in New York City, a restaurant owner in Montgomery, Alabama, and a writer in Los Angeles. But for each of them, there came a moment when they realized: This can't be normal.

"I walked into a psychiatrist's office, and he said, 'You suffer from depression.' Nobody had ever told me that before. I thought, Oh, my God, I'm seeing the world through a different lens," says Beth Vesel, 43, a literary agent and happily married mother of a 5-year-old boy. Up until that point, Vesel had felt there was simply something wrong with her personality, some character flaw.

"It's like you're walking around with a leg that's half an inch shorter than the other, and everybody tells you, 'The problem is your back,' or 'It's your neck.' And then somebody says, 'Your leg is half an inch shorter, but we can construct a special shoe,'" she says.

Low-grade depression (dysthymia) is one of the most common ailments on the planet and one of the least likely to be diagnosed. Like its cousin, clinical depression, low-grade depression hits women roughly twice as often as men (though some researchers believe mood disorders in men are underreported because of social stigmas). Clinical depression is a kind of mental hurricane: Symptoms include debilitating insomnia, weight loss, anxiety or a mental fog so dense that people forget what they've read as soon as they've read it. The pain is so awful that suicide can seem an acceptable solution.

Low-grade depression is more like a year of drizzly weather. It is, by definition, chronic. A diagnosis requires the presence of symptoms on more days than not for a period of at least two years, which is what makes it so hard to pin down. Any given day might be okay, even happy. Yet in the general run of days, there are more gray ones than not, more unhappiness than joy. Most people afflicted with this kind of chronic malaise instinctively blame themselves: They would rather believe they can solve the problem—if they could just find the right job or the right man or lose weight—than admit they have a psychiatric disorder.

That's not to say that the problems a depressed person fixates on don't exist. But a healthy person might take action, or simply look around for a fun distraction. A person with low-grade depression broods and gets stuck. Caught in that drizzly mental weather, she doesn't seek shelter or buy an umbrella; she goes on slogging through puddles.


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