What I Would Do Differently If I Were Diagnosed With Depression Today


I’m republishing this piece from my archives.

girl dancing

Someone in recovery circles once told me that if you have one foot in the past and another in the future, you are essentially peeing on the present. I try to remember that when I’m engulfed in regret—obsessing about all the things I did wrong in the past and wishing to God I had made different decisions. However, writing about my mistakes has always been healing for me because I’d like to think this small action could possibly prevent someone else from making the same ones. If I can help a young person or anyone who has recently been diagnosed with depression take a more direct route to healing, it seems irresponsible on my part not to share my detours and missed cues, to keep to myself the information that I now have.

Each mental health journey is so very unique. Therefore, I can’t tell you what’s right for you. My wish is that my story might give some person out there an ounce of hope that if she never stops thinking for herself, and is involved in the decisions of her health, it is possible to live a full life with depression.

What would I have done differently?

I Would Have Made Sure I Was Under the Right Care

When I was first diagnosed with depression, I settled with the first doctor I met, a man who saw me for about ten minutes every month, with whom I felt very uncomfortable. I put my health into his hands because, at 18 years old, I thought all doctors were the same, and I didn’t have an option for better care.

I spent 10 years going through seven doctors who all misdiagnosed me. Needless to say, I missed out on a lot of life during that time.

I’d advise people to go to a teaching hospital for the best psychiatric care, where you will find physicians conducting research on new therapies and medications to treat depression, tackling complex conditions by drawing from their own collection of data. It is there, in those classrooms and labs, that evidence-based information is produced – the gold that leads to miracles.

At a teaching hospital, you’re more apt to find a psychiatrist who will spend a few hours at your initial consultation and prescribe medications they know work, like Lithium, which has been around for a long time but isn’t going to make anyone rich.

I Would Have Been a Difficult Patient

As I said in another post, it’s only in the last three years that I have become a “difficult” patient—a woman who isn’t afraid to ask questions and probe her physician for more information. A good psychiatrist can handle it. She wants you to get well and will welcome additional research, inquiries, doubts, etc. If a doctor is threatened by queries, which I have experienced, I think this is a red flag that ego issues could impede optimal care.

If I were sitting in my first psychiatrist’s office today, 25 years later, I would be my own health advocate. Only I know my body—the way I suffer after eating sugar and white flour, the systemic weaknesses that surface when managing too much stress, the gut problems that go back to when I was a baby, my adverse responses to certain medications. Physicians can access useful medical data and pull information from their years of training and practice, but they need a patient’s input to customize treatment plans for difficult depression cases. If I could go back, I would have been invested 100 percent in my own health and been a difficult patient.

I Would Have Treated Any Underlying Causes

It took me more than two decades to consider some underlying causes of my mood disorder, health conditions that worsen my depression. I am growing more convinced that persons who suffer from chronic depression and anxiety usually have other ailments contributing to their symptoms that they are unaware of: hypothyroidism, gastrointestinal disorders, Lyme disease, hormonal imbalances, adrenal fatigue, sleep apnea, alcoholism or substance abuse, anemia, autoimmune conditions, and nutritional deficiencies.

Because of the current healthcare system, psychiatrists and primary-care physicians don’t have the time (and many simply don’t have the insight) to ask about a person’s digestive history or any other general health questions that would provide clues to an underlying condition feeding the symptoms of depression and anxiety. For me, cleaning up my gut issues, addressing my pituitary tumor, taking some key supplements like Vitamin D and Vitamin B12, and changing my diet made a substantial impact on my mood.

I Would Have Been More Educated About Medications

There is a place for medication. I absolutely believe that. Having recently gone through hell trying to taper off my meds, I am now more convinced than ever that drugs can be life-saving. I just wish I would have been more knowledgeable about their side-effects so that I could have better assessed the benefit-risk ratio, especially during those periods of my life in which I might have been okay with less, and definitely during the time when I was with a psychiatrist who overmedicated me.

I Would Have Learned Ways to Calm Myself Down

So many of my depressive symptoms are tied to my stress reaction. As I’ve said in other posts, I believe that my mood disorder is essentially a stress disorder—the tension generates static in my central nervous system and other biological systems that promote “dis-ease” in every sense.

Looking back, I wish I would have invested some time in the activities I do now—like deep breathing and yoga and mindfulness and Epsom-salt baths and massage and aromatherapy–to prime my parasympathetic system and reverse the detrimental stress reaction that can cause depressive symptoms. I wish I would have attended the Mindfulness-Based Stress Reduction (MBSR) course back then. I would have felt more in control of my emotional health.

I Would Have Focused on Epigenetics Along With Genetics

We all have genes that predispose us to certain illnesses—in my case, most of what’s inside the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)–but the key word here is “predispose.” When I was first diagnosed with depression, I was stuck on my aunt’s severe bipolar disorder and suicide and felt certain that, because I shared some of her genes, I would end up hospitalized on and off for the rest of my life, as well. Looking back, there were too many conversations between my therapist and me about family history and what I should be careful about, and not enough about the freedom I had to take my health in a direction vastly different from my aunt’s.

I know that I need always remember my family history; it serves as a reminder of what can happen if I don’t take my mood disorder seriously. However, alongside genetics, I am also concentrating on the new science called epigenetics (meaning “above” or “outside” of genetics), the study of cellular variations that are not caused by changes in the DNA sequence. Epigenetics is closely related to the concept of neuroplasticity that says that we aren’t stuck with the brain that we were born with. We have more room than we think we do to direct our health toward healing and wholeness.

Join Project Hope & Beyond, the new depression community.

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Therese Borchard
I am a writer and chaplain trying to live a simple life in Annapolis, Maryland.

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4 Responses
  1. Lizzie

    So interesting Therese. I agree with you. I feel the same . Twenty two years to get the right diagnosi of anxiety and major depressive disorder after a breakdown. I have always had anxiety and tendacy to depressive thoughts from being a child.
    Dr’s have thought I was maybe suffering from bipolar but in facts it was antidepressants that made me manic. Even though I repeatedly said I felt too high and couldn’t sleep. Sleeping tablets made things worse.
    But it’s hard to be assertive when you are feeling so bad. I have finally got the right diagnosis but treating it is not easy.
    Again the medication was too high and I felt I could fly after two doses. After an a hours sleep I woke up feeling I wanted to fly out of the bedroom window.
    That was 5 mugs of escitralopram. I am now on liquid form and taking only two drops. Even at three drops I felt like dancing in the street if I heard music.
    All the things you had just said I agree with.
    But when you are poorly and suffer from anxiety Dr’s presume you are ” over anxious” ” over sensitive” ” being difficult ” as you stop another medication as the side effects are terrifying and making things worse.
    Some of us need tiny doses. Doses that are not thought to be at a therapeutic level. So they higher the dose!!
    Even the psychiatrist who finally diagnose me started with a high doses of a combination of drugs.
    Suicidal thoughts can sometimes be a side effect.
    You don’t always need a sledge hammer to crack a nut.
    Sometimes less is more for us sensitive souls. A homeopathic dose. Gentle loving care. A softly softly gentle approach.
    I have read so many book along this journey. The charity shops which I help to fill with as yet another has been discarded.
    I agree with you one hundred percent. But without this journey you have gone on would you be here to give advice to others?
    Without your journey of twists and turns and highs and lows would you be writing these articles??
    Your suffering has helped others.
    But what we all long for is a good nights sleep. To find peace. To wake up in the morning feeling refreshed and find some joy.
    To be rid of suicidal thoughts and anxiety. To live for the moment and not focus on the past or being scared of the future. Thank you for sharing this
    We deserve the best treatment for our broken brains just as a broken leg retires a plaster case.

  2. Such an interesting read and definitely something not everyone thinks about daily! I think it is so important for everyone to place themselves into someones shoes with depression. Mental health is not something to be taken lightly and it is something many many people suffer from daily. Thank you for sharing

  3. Layne

    My wife is fighting two devils: 1. Stage 4 Metastatic Breast Cancer and 2. Severe Anxiety and Depression. #1 let to #2. She saw 3 Psychiatrists and 2 Oncologists. He is on 2 meds for the Cancer and 4 meds for the Depression. She is anti-depressive resistance. Tried guided imagery, Lightbox therapy, meditation, etc. Say a clinical hypnotist who said she can only address the anxiety. She is on her 3rd round of TMS (Transcranial Magnetic Stimulation). Nothing seems to work. My extensive research indicates only Ketamine Infusion Therapy and ECT is left. Any ideas?

  4. marty

    this brought me calm as you present truths/ownership of your recovery process. lizzie’s points provide a perfect balance “would you be…” kudos to both of you