It has power and strength, an entity unto itself, a presence lurking in the corner of the room. It reaches up and pulls you down into sadness, listlessness, confusion, and fatigue. Each day the weight drags you farther below the surface until the easiest task is overwhelming and you no longer care about yourself or the world around you. You move in slow motion, trying to keep up with those around you. You can’t find the energy. You try to concentrate, but the ability has faded away into the fog it has created. You lie in bed staring at the wall, into nothingness. The tears are endless; the intensity of the sadness threatens to destroy you. Some thoughts are confusing, some decisions too difficult to comprehend. It steals days, weeks, months, years you can never reclaim. It takes away who you are and leaves behind a person you do not recognize, whose words and actions you cannot understand.
Maybe you recognize a patient, your husband, your daughter, your best friend. Me? I recognize myself.
In 2004 I was diagnosed with an acute episode of major depression. It affected my mood, sleep, energy, cognitive function, motor skills, and ability to manage self-care. I couldn’t work; at first, I couldn’t even remain at home. There were no flowers from coworkers, no cards from friends, no endless offers of assistance. My family and closest friends stood patiently by while I, with the help of my care team, journeyed back to who I was before it arrived in my life. I felt like a shell of my former self. Getting out of bed, showering, eating, or walking sucked up what little energy I had. It spread out and permeated every part of my physical, emotional, and cognitive self.
My journey began at home, with care from my family doctor and a psychologist. As I became more and more ill, their care increased exponentially. I continued to deteriorate. I was moved to my sister’s, and my care was taken over by a psychiatrist. I learned first-hand about treatment-resistant depression. Countless additions, subtractions, and adjustments to my medications took place over weeks, months, and years. Small gains, setbacks, complications, and successes became an endless roller-coaster ride. Yet—slowly—I was getting better. I was lucky. My psychiatrist’s goal was remission and recovery, not merely improvement or stability. Not once did she say to me “There’s nothing more I can do. This is as good as it gets.” When my confidence faltered, her response was clear and confident. “I still have a few tricks up my sleeve.”
Six weeks into my journey, I was able to return home. My family doctor and psychologist rejoined the team, along with my pharmacist and an exercise therapist; I saw my psychiatrist each week. Together we traveled the road to remission and weathered the speed bumps and potholes along the way. It was an extremely difficult journey. There is no ribbon to wear, no run to inspire you, no party to celebrate your return to health. Even those in the public eye who come forward, quickly fade from memory.
After 4 months I returned to work part-time. It was not a smooth transition. I had been honest about my illness, and I am discouraged to say what a mistake that was. Support, present at first, waned when my recovery did not progress “on schedule.” Coworkers had been asked to “keep an eye” on me. As a social worker, I was disappointed when I learned this. Would that have happened if I had returned from a battle with breast cancer?
Gradually I was able to take on more work. I was also slowly able to complete my Master’s of Social Work, which I had enthusiastically begun just 3 months before becoming ill. In the early stages, it had been hard to concentrate and keep up, and one professor suggested that I seriously consider postponing my studies. A senior professor reassured me that was not the consensus, and that if I had raised the idea myself, they would have worked hard to talk me out of it. Little did she know how much strength she lent me. It was those words and her confidence in my abilities that helped when I was particularly unwell, struggling with school and the trials of returning to work. With the incredible support I received, I finished the program 6 months behind my classmates.
It took nearly 2 years to reach remission, a term used in the literature to describe 3 consecutive months symptom-free. The public reserves the term for illnesses like cancer. I was lucky. I had a care team that addressed my depression from many directions. I had a psychiatrist who continued to look for alternative treatments when one failed to produce results, who patiently attempted different combinations of medications and creatively put together one idea after another until she found the one that worked, who, most important, always aimed for recovery and never said “This is as good as it gets.”
Without the care I received, I would not be where I am today. I have met those whose lives have been derailed for years by their depression, and I wonder if I could have been one of them. I know how ill I was. I know how hard it was to find my way back. But my care team never gave up. My illness has affected who I am. How could it not? But I am not a better person because of it. I have no greater insight; I don’t feel like I have triumphed over life’s great obstacles. I am just thankful to be me again.
I don’t know what the future holds. Depression does not define me, even though I must now be conscious of it. From time to time it grabs hold momentarily and I experience an echo of what once was. It passes quickly and I recognize it is not the forecast of something more sinister. Nevertheless, I know that I am at high risk of future episodes and that I will likely be on medication for a long time. I don’t know the consequences of that, but it is a price I am willing to pay for health and well-being. What I know at this moment, as I zip down the highway on this sunny day, is that I am feeling happy, healthy, and content. The radio is on and The Temptations spill loudly from the speakers.
Now that I think of it, this is as good as it gets.
Footnotes
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The author has chosen regretfully, and somewhat ironically, to remain anonymous, owing to ramifications in the workplace already experienced.
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