I have been diagnosed as having dysthymia. Before I was married, my depression was real up and down, and I was a bit obsessive. Now it's just one big blah. Since I had my tubes tied (after my third child) I don't feel up to doing anything. I feel hopeless and worthless, like I have no direction. Sometimes I forget major things, like going places I go regularly, or somebody's name that I should know. One time I momentarily forgot how to drive my stickshift car. I also notice that since my tubes were tied, I have no sexual desire. This is obviously noticed by my new husband of two years. I generally have low sex desire after having a child, but this is ridiculous. I can go for months and not even think about sex. Do you know what my problem could be and if things will get better?

Jessie

I can't say for sure what might be going on with you without assessing your situation personally. But some ideas come to mind that might be helpful for you check out.

You don't mention how old you are, but if you are in or near menopause, some of your symptoms could be caused by changing hormone levels. Some women in menopause experience temporary memory problems, depression, etc. Discuss this possibility with your gynecologist, and see what he or she recommends.

Another possibility, of course, is that your symptoms are related to your chronic mild depression (dysthymia), or that you are experiencing a more severe depression superimposed on your dysthymia. In the latter case, it may be as if the mild depression has become more intense and wider-ranging. As you may know, hopelessness, lack of direction, memory and concentration problems, and low sexual desire are associated with depression.

You don't mention whether you are in psychotherapy or any treatment for depression. If not, in addition to getting a physical exam and consultation from your gynecologist, you might benefit from consulting with a psychologist or other therapist.

Antidepressant medication might be worth trying, but I'd definitely accompany any such pharmacological treatment with therapy. Cognitive-behavioral and interpersonal therapy has been found very effective for depression, and their effects can be longer-lasting than medication. Good luck.