### Patient: Doctor, I have been feeling down and depressed for a long time. I wake up every morning feeling sad and anxious. I feel like I am always in a low mood and can't seem to shake it off. 
### Doctor: I understand, it sounds like you may be experiencing dysthymic disorder. I recommend that you undergo a depression screen to confirm the diagnosis. Additionally, you should undergo psychological and psychiatric evaluation to determine the best course of treatment, which may include psychotherapy and mental health counseling. As for the other tests you mentioned, a lipid panel and toxicology screen would not be necessary for this particular condition. Finally, varicose vein stripping is not related to this issue and is not required.