That blue mood; some advice on handling depression.

Just back from an early-morning walk with a friend, a sure cure for blue moods through the years, I lay in bed overcome with tears and trembling. My marriage was ending. Guilt, failure, shame, and fear had buried my already slightly melancholy personality under a blanket of gloom I couldn't lift. At the same time I was experiencing waves of anxiety -- almost panic attacks. I couldn't focus on the routine of the day, let alone make mental pictures of a hopeful future.

I'd been praying--earnestly and regularly. I was also seeing a good counselor. Not only did the physical symptoms not go away--they didn't even decrease. Suicidal thoughts, even specific suicide plans, flooded my mind. My shrinking willpower was finding it difficult to keep self-destruction at bay.

"I think you'd better be evaluated by a physician," my counselor suggested at the next session. "You are experiencing so much pain and anxiety that we can't begin to deal with this tangled ball of problems."

The idea of medicine for my mood was distasteful. I'd always prided myself on my strength and my coping ability. Obviously, however, determination and home remedies were not making a dent in the double whammy of depression and anxiety I was experiencing.

My doctor prescribed Prozac. "But only for two months," she cautioned. "If you need medication to cope beyond that time, I want you to be thoroughly evaluated by a psychiatrist whose specialty makes him more familiar with these depression drugs." I was seeing her the same week the news stories broke about a New York woman suing Eli Lilly, claiming that Prozac had induced her to slash her wrists. "I'm not worried about your using it," said my doctor. "Prozac is a well-tested drug with fewer side effects than others in its class. A few lawsuits aren't uncommon."

With some misgivings, but not knowing what else to do, I began taking Prozac, carefully supervised by my doctor. "It may make a change in your blood sugar," she said. "We have to really watch that with diabetics." My blood sugar went up. We reduced the dosage. The panic subsided within a week and a half. My mood lifted. I could function again. The personal problems were as tangled as ever, but now I could begin to deal with them.

As I write this, it's seven months later. I am divorced and am trying to jump-start my career. I still experience pain, guilt, and great sorrow. I don't take Prozac now, but I'm glad it was there for me for those two months.

My journalist self wanted to learn as much as possible about Prozac and other antidepressant and antianxiety drugs. Let me share just a little of my research.

Depression is an inexact blanket term that covers everything from a normal case of the blues to what Winston Churchill once called "black dog" depression.

"There can be and often is also a relationship between depression and anxiety," says psychiatrist Gary Blount, medical director for Adolescent Services at Charter Sunrise Hospital in Albuquerque, New Mexico. "It's hard to imagine being depressed, deeply depressed, and anxious simultaneously, but it's not that uncommon. These are the worst conditions--the most painful. You feel down. You can't concentrate. You have no focused energy. And you have a panic attack at the same time. It's called agitated depression."

In response to the growing seriousness of depressive and anxious disorders, medical researchers and pharmaceutical manufacturers have brought out an array of neurochemical agents. More than 20 antidepressants, for example, are available by prescription, and new drugs are being tested all the time.

Doctors, both those trained in psychiatry and those with little background in this highly specialized area of pharmacology, are jumping on the bandwagon. Some estimate that antidepressants and antianxiety agents account for more than 75 percent of perscriptions in the United States. Valium, Xanax, and Prozac, among others, have become household names.

This trend worries many professionals. Even some psychiatrists fear that their peers may become internists who "manage" emotional illness the way doctors manage diabetes: by administering a drug and monitoring its progress. Yet these drugs, combined withgood psychotherapy, are returning thousands of people to normal living.

"What these drugs do, when they are used correctly, is strengthen the floor you are on," says Blount. "They make your lows not so low. If you stumble and fall, you won't go down so low. They give you rest and courage and strength to do the hard work you must do to deal with the problems. The optimal treatment for depression is a combination of medication and psychotherapy."

When you're considering whether or not to take mood-changing medicine, here are some important things to think about:

1. As effective as they may be, psychiatric drugs are far from perfect. They all have side effects. These include dry mouth, nausea or dizziness, constipation, weight gain, and problems with eye focus. "I don't think I've ever treated a person with antidepressants without some kind of side effects," says Blount. "On the other hand, I very rarely stop the treatment because the side effects are too bothersome."

2. Most of the antianxiety drugs are habituating. This class of drugs include Xanax, Valium, and Librium. That means you will likely develop a tolerance and feel you need to increase the dosage to get the same results. Your body as well as your mood come to depend on them. Withdrawal may be difficult. "The antidepressants are more benign," says Blount.

3. All drugs should be taken under careful medical supervision. Sometimes what first appears as depression may be a thyroid disorder or an early symptom of diabetes. Your doctor should be thoroughly acquainted with your general health and specific medical problems. He or she should also be aware of other medicine you are taking.

4. Follow the directions exactly. Don't play with the dosage according to how you feel. Increasing the amount of some drugs can be life-threatening. Combining these drugs with caffeine, alcohol, other medicines, or street drugs is extremely risky.

5. No mood-changing drug should be discontinued abruptly. Doing so can lead to headaches, nausea, jittery feelings, and/or other forms of mild to severe discomfort. Sudden withdrawal from antianxiety drugs can lead to convulsions, psychosis, coma, and even death, although this is not common.

6. Don't expect drugs alone to solve your problems and "cure" your depression. Effective treatment must include a combination of therapies.

Antidepressants or antianxiety medicines may be necessary in the treatment of some forms of depression. They certainly shouldn't be the first line of attack. Fortunately there are a number of natural mood elevators that offer only benefits:

1. Warm baths are simple enough, but they help.

2. Therapy with lights is considered a legitimate treatment, not only for a condition that has recently been diagnosed as Seasonal Affective Disorder, but also for general mood improvement. Patients sit for a few hours each day in front of very bright full-spectrum lights. "I don't understand entirely how it works," says Blount, "but for some people it makes a real difference."

3. Regular vigorous exercise encourages the production of endorphins, chemicals that give your body a natural "high."

4. Humor, reading a funny book, or going to see a light and lively play can sometimes break a down cycle.

5. Talking honestly and openly with a friend or with a sympathetic, understanding group of people can bring enormous relief. Remember, long before today's wonder drugs, doctors were bringing their patients relief by encouraging them to talk.

6. A simple change of pace may help. Get out of the house and go to the store. If your life is usually bombarded by noise and is full of stress, provide yourself some time and space for peace and quiet.

Don't be ashamed of depression and anxiety. They are real maladies, not signs of character weakness. Don't rush quickly to a medicine fix. No drug is completely benign; they all carry some danger. On the other hand, if after thorough will help you cope, don't be too proud or too afraid to follow his or her advice.

Betty Gibb if a free-lance writer living in Columbia, Missouri.