Not everybody is thankful at

Thanksgiving, happy at Christmas, or hopeful as the New Year unfolds.

Recently I asked a friend about

his favorite holiday memory. His response: I'll have to think about that

one. There were not a lot of happy holidays when I was growing up. Daddy

drank all the time but gave himself permission to drink even more during

the holidays. Any holiday, but especially Christmas.

I turned to his wife, who recounted

several fond holiday experiences but closed with concern for a good friend

whose husband died on Christmas morning just a couple of years ago.

Then we talked about the death

of my father-in-law on Christmas Day in 1976. It took nearly a decade

for Daniel and me to let ourselves really enjoy the holiday season again.

At first, we felt guilty that we were still alive. Then it became more

than being painfully aware that something/someone was missing we really

felt kinda lost.

Whatever it is about holidays

that make them so special and offers such potential for joy and happiness,

that same thing makes it a time for sadness to be more keenly felt as

well.

Nobody can expect to be happy

all the time. Life does not give us that option. Into all lives the rains

must indeed fall. But when does the unhappiness or sadness turn into real

depression for which we would be wise to seek help?

When depression persists and

interferes with our daily lives, it can be an indication of what psychologists

call a depressive or mood disorder. Normal sadness is distinguished from

a depressive disorder by severity, duration and the presence of other

symptoms.

There are many categories into

which clinical depression may be divided: major depression, chronic depression,

mild depression (dysthymia), and atypical depression. Other important

forms of depression are premenstrual dysphoric disorder (PDD) and seasonal

affective disorder (SAD).

And of course there is bipolar

disorder, or manic-depressive illness, which is characterized by periods

of depression alternating with episodes of excessive energy and activity.

In major, or acute, depression, depressed mood or loss of interest will

almost always be present.

At least five of the following

symptoms are usually present and they will most often represent a change

from previous behavior or mood:

- Depressed mood on most

days for most of each day. (Irritability may be prominent in children

and adolescents.)

- Total or very noticeable

loss of pleasure most of the time.

- Significant increase

or decrease in appetite, weight or both.

- Sleep disorders, either

insomnia or excessive sleepiness, nearly every day.

- Feelings of agitation

or a sense of intense slowness.

- Loss of energy and a

daily sense of tiredness.

- Sense of guilt and worthlessness

nearly all the time.

- Inability to concentrate

occurring nearly every day.

- Recurrent thoughts

of death or suicide.

During depression the symptoms

listed here will frequently impair important normal functions at work

or in one's personal life. Major depression can last 20 weeks or longer

and is not usually brought on by drugs, alcohol or other substances. It

is also not caused by normal grief, though these things can set the stage

for depression.

Symptoms vary in children and

adults. In children, watch for persistent sadness, an inability to enjoy

favorite activities, increased irritability, headaches and stomach aches,

poor school performance, persistent boredom, low energy, poor concentration,

or changes in eating and/or sleeping patterns. Depressed children may

even tend to bully others.

Chronic but mild depression,

or dysthymia, is characterized by many of the same symptoms that occur

in major depression, but they are less intense and can last for years.

Those with atypical depression frequently overeat, oversleep, and are

aware of a general sense of heaviness; they may also have strong feelings

of rejection.

Seasonal affective disorder

(SAD) occurs in the fall and winter and appears to be related to light.

Symptoms may include fatigue, a tendency to overeat and oversleep in winter.

(Under-eating may also occur in this case.) The syndrome of severe depression,

irritability and tension before menstruation is known as premenstrual

dysphoric disorder (PDD) and it affects an estimated 3 - 8 percent of

women in their reproductive years. A diagnosis of PDD depends on having

five symptoms of depression (see above) that occur during most menstrual

cycles, with symptoms worsening a week or so before the menstrual period

and resolving afterward.

And then there's grief. Grief,

or bereavement, and depression have much in common. It may even be difficult

to differentiate between the two. Grief is a healthy and important emotional

response for dealing with loss. In people without any other emotional

disorder, bereavement usually lasts between three and six months. Grief

usually incorporates a series of emotions that include shock and denial,

loneliness, despair, social alienation and anger.

The recovery period following

bereavement, during which the individual again becomes involved with life,

takes about the same amount of time. If the grief is still severe after

this period, however, it may affect a person's health or increase the

risk for on-going depression. Some experts suggest that this severe persistent

grieving state be categorized as a separate psychologic diagnosis termed

complicated grief disorder, which would be related to post-traumatic stress

syndrome and require special treatment.

Depression can afflict anyone,

regardless of age, race, class or gender. No one is exempt. During the

holidays, and every day, tune in to those you love. Learn to listen to

what they say and don't say. The unspoken word can tell us much.

I much prefer to recommend

good friends and/or a good therapist to those who are depressed. I have

never been an advocate of drug therapy, but the truth is there are some

remarkable medications on the market now that can make a miraculous difference

in the life of a depressed individual.

If you or someone you love

is depressed, get help. Life is far too precious to waste.