Someone You Know Has It

Approximately one adult in six will be affected by some form of depression in his or her lifetime—a rate that varies only slightly among various ethnic groups and cultures. Low-grade depression is less common, affecting 3 to 6 percent of the adult population. Even so, the two-to-one gender disparity means that between four million and eight million American women will suffer from an insidious, low-grade mental illness, most of them receiving no help.

Fewer than half the people with clinical depression ever seek medical advice, fewer than that get appropriate help, and people with low-grade depression fare worst of all. They think, "Hey, nobody said life is a party. If I'm still showing up at work, I must be okay."

Yet the damage chronic low-grade depression inflicts can be even more devastating than a single episode of severe clinical depression. "Being 80 percent of yourself for two years is worse than being 20 percent of yourself for two months," says Frederick K. Goodwin, M.D., former director of the National Institute of Mental Health and now a professor of psychiatry at George Washington University.

Susan G. Kornstein, M.D., associate professor of psychiatry at Virginia Commonwealth University, notes, "Someone with an acute major depressive episode is much more likely to get help because there's an obvious change. But low-grade depression causes greater impairment to patients' overall functioning in their work and social lives because it goes on for so long. These people go unrecognized, even by health care professionals."

That is, they do unless somehow something gives them a glimmer that life can be much better—or unless they sink into clinical depression, says Jane Ferber, M.D., an assistant clinical professor of psychiatry at Columbia University. In that sense, a major life crisis can turn out to be a blessing: It forces people to acknowledge that they have been existing in a gray zone of subhealth.

What follows are the stories of four different women who finally got help


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