Barry Duncan, PsyD, Scott Miller, PhD, and Jacqueline Sparks, MS
“One side will make you grow taller, and the other side will make you grow shorter.”
“One side of what? The other side of what?” thought Alice to herself.
“Of the mushroom, ” said the Caterpillar, just as if she had asked it aloud; and in another moment it was out of sight.
Lewis Carroll, Alice's Adventures in Wonderland
Shelley fights back the tears as she utters in a voice barely audible to her family physician, “Things have just gotten to be too much. At first I didn't want to get up for work, and now I don't want to get up at all.” Shelley feels hopeless, desperate, and fragile. In times gone by, she rallied during the tough times and met obstacles head on. But this time is different: no lastminute heroics or rising to the occasion, no platitudes or pep talks that have always worked for her in the past. The doctor looks at the ten-item questionnaire Shelley completed in the waiting room; it accurately reflects her poor appetite and loss of pleasure in sex or anything else for that matter. Her physician explains that such “neurovegetative symptoms” are a sign of “clinical depression, ” a medical illness resulting from a chemical imbalance in the brain. She also tells Shelley that though the problem is serious, there is no need to despair because the illness is now treatable. The doctor gives Shelley a brochure that says treating depression is just like using insulin for diabetes. By taking an antidepressant, Shelley will in-