Outside the air smelled of springtime and promises. Inside the homemaker could hardly get out of bed.
"The weather's been getting better, but my mood's been getting worse," the gray-haired woman told about 50 people jammed into a meeting room at the Woodburn Center for Community Mental Health in Annandle, Va.
"It was a big effort just to get here.I have no energy, I feel anxious and I can't sleep or eat.I used to be such a happy person, and I don't know what's wrong."
These feelings are all common symptoms of depression, social worker Jenny Craig and gerontologist Margo Harvey told participants in their workshop on "The Blues, The Blahs and Depression."
And an increased incidence of depression, to mental-health professionals, is one of the first signs of spring. While some people attribute this to tax time, Harvey has another reason.
"During the spring expectations are high. Everything is renewed and fresh and people are supposed to feel good. If, in reality, someone doesn't feel good, they get disappointed and depressed.
"If nature is changing all around them, but they seem to be stuck in the same old grind, they may feel alienated and lose self-esteem.It's the same during holiday time when expectations run high. If reality can't match the dream, people get depressed."
Suicide rates and hospital admissions for depression reach a peak during the spring and fall, according to Dr. Frederick Goodwin, who heads the National Institute of Mental Health's depression research studies and is studying biological reasons for this phenomenon.
"These are the times of the year when the ratio of daylight to dark is changing most rapidly," says Goodwin. "There is indication that the amount of light and dark is very important in synchronizing biological rhythms."
The body's attempt to adjust to this major light-dark change, he says, may account for its increased vulnerability to depression. "Plus, many people have sleep difficulties during the changeover from winter to spring. They may get overly concerned about this and that may affect their mood."
Depression appears to be cyclic, says Dr. Goodwin. "Some patients get depressed like clockwork every six months, eight months, two years."
Just as women's "blue feelings" are linked to menstrual cycles, "men have biological rhythms, too. Their cycles seem to last an average of 40 to 50 days."
The word depression is used to describe everything from "a simple sad feeling" to an incapacitating illness, notes social worker Criag. "In its mild form depression is a universal phenomenon that goes along with life.
"Even dogs and monkeys get depressed. Getting 'the blahs' may be a signal to yourself and your loved ones that something is not quite right and needs examination."
A simple "down" feeling, however, "doesn't necessarily mean that something is wrong," says Dr. Goodwin. "Some people expect too much of their moods. They try desperately to fulfill the notion that they must be happy all of the time.
"They assume that if they're not feeling good every minute there's something wrong and immediately try to change their life, get a new job or new wife. They wind up getting depressed about being depressed."
But the capacity to become depressed is part of being mentally healthy, he says. "It means you're significantly in touch with your feelings to become saddened by a loss. It's a part of life."
When these normal blue moods get out of control, however, professional help is advised. Dr. Goodwin lists three factors to help tell the difference between the blues and major depressions:
Complexity of symptoms.
Impairment of the person's ability to function.
"Common symptoms are changes in sleeping or eating habits, loss of energy and sex drive, the inability to concentrate and the inability to enjoy the things you usually enjoy.
"If a person feels the symptoms more than a week or 10 days . . . or if they are chronically unhappy in a way that is interfering with their relationships or making them perform substantially below their potential in a job, they may want to seek someone's help in sorting out their feelings."
Depression is the most treatable of any of the major psychiatric disorders, says Dr. Goodwin. Most people first seek help from their family physician or a community mental-health facility.
He cautions against constant use of alcohol or drugs as self-medication. "A lot of people get into taking a few drinks or pills every night to counter anxiety feelings.
"Someone doing this should ask himself if he could get along without it. Are they using drugs in order to deal with a bad feeling? If so, they should stop and see if they are trying to swallow a lot of their feelings instead of dealing with them."
Depression is more common among women than among men, says NIMH research psychologist Lenore Radloff. "Speculations as to why this happens cover everything from hormones to difficult social roles."
Social worker Ginny Frederick, who teaches courses on Women and Stress, has another answer:
"Today's woman expects herself to do superhuman feats. They assume they've go to be supermom, have a super career and a super marriage. When they can't meet these unrealistic goals they get depressed."