We live in a time of enormous technological progress and economic prosperity. Opportunities abound — life is hectic. But in our frenetic activity we may end up feeling lost, incomplete, and left out. Often, having a sense of being alone and alienated, we long for something... somthing is missing, perhaps we know not what. We may experience a deep sadness, even melancholy, and we may know not why.

But sadness and melancholy do not equate with pathology. Such feelings can be a natural reaction to a world that is out of joint, to a life that has lost its meaning. That is not to say that they are not significant, that we need not deal with them. In fact, they should serve as a wake-up call to do something, and do it forthwith.

First and foremost: take counsel with yourself. Take along a guide: a trusted friend, a therapist, a spiritual advisor —someone who knows the territory, who has been there before. Also, it might not hurt to take a vacation, to renew old friendships, to reconnect with family. And it is probably time to cut back on externally directed activities and commitments, to re-evaluate your work, your relationships, and the very fabric of your life.

The Nordstrum family lived the American Dream. Forty years ago, Siegurd had left his native Norway as a cabin boy on a freighter. After a long ocean voyage and several misadventures, he wound up as a ranch hand in Southern California. He worked his way up the chain of command, saved his money, and prospered. Eventually he bought his own ranch, married, and had children. He became a a multimillionaire and a pillar of the community. He now looks forward to becoming a grandfather for the first time.

But there is a problem, one that will not yield to hard work, or love of family, or willingness to endure. At 17, his youngest daughter, the “baby” of the family, is deeply depressed.

Julie is morose, apathetic, irritable. She has no appetite, eats mostly sweets, and has lost weight. She has insomnia, but at times she sleeps all day. Her movements are slow and listless. She is always tired, even though she does practically nothing at all. She is restless and anxious and cannot concentrate on anything. She is not interested in anything, does not want anything. She has feelings of guilt and has thoughts of suicide.

Julie has not used psychoactive drugs: she has not experienced a major trauma or the death of a loved one; and her life circumstances do not suggest severe physical or emotional stress or deprivation. There is nothing “out there” to account for her moods and her behavior. Yet Julie, like millions of other adults and adolescents, is suffering from depression.