Depression comes in many forms. At one extreme is severe clinical depression characterized by profound despair, hopelessness, and the inability to take pleasure in anything (anhedonia). At the other end of the spectrum are those who are “mildly” depressed, or “dysthymic”. Outwardly they may do well in life but still feel uninspired and lack fulfillment. They feel like they are not living up to their potential and are missing out in life. Like severely depressed patients, those with dysthymia typically have persistent negative thinking and ongoing recrimination. Antidepressants are reported to be only partially effective for 30-60% of clients. While clients may develop insight with talk therapy, even “insight” doesn’t prevent negative or anxious thinking.