Feelings of sadness are experienced by all of us at sometime in our lives. Sadness, despair and grief are normal and are temporary in response to difficult circumstances associated with employment, divorce, or death of a loved one. However, prolonged bouts of extreme hopelessness, despair, and sadness; often unrelated to major external influences is becoming more typical. True clinical depression is experienced by 20 million Americans annually and is the leading cause of disability in children and adults worldwide according to the World Health Organization.   Depression is the most common psychiatric condition in the U. S. It is estimated that over 30 million Americans take drugs for depression or anxiety and Prozac is the most commonly prescribed drug. Depression is not only associated with several medical conditions such as premenstrual syndrome, and anxiety but is also a risk factor for life threatening conditions like cardiovascular disease. For most, it is likely that depression results from an interplay between imbalances in what are termed “biogenic amines” or neurotransmitters, compounded by patterned and habitual feelings of pessimism and hopeless. Neurotransmitters are chemical messages made from amino acids that allow the brain and the rest of the nervous system to communicate with itself and the body. Neurotransmitter testing is performed in the office in more challenging cases.