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.
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Therese, I am a huge fan. I follow your writing in your various forums. I have lifelong depression and your writings have helped. I am a big fan of mindfulness to help depression aand would like to see more on that.
This was wonderfully written and inspires me to lead a practice with these aspects in mind.
Bravo! Another excellent article dearest Therese! I agree with nearly everything you had to share save for “I would have been a more difficult patient”. Being both a registered nurse who has major depressive disorder along with the much loved PTSD from a violent childhood I have to say that when one is labeled “difficult patient” during medical care you actually will be treated with sub-optimal care. It will be all over your chart and everyone who reads this forms a negative opinion about you. They will rush you out, not give you complete information or all options. Difficult patients are not liked. If you are treated by providers who themselves are not fully developed adults it can get downright ugly. I have worked with these types of people and have a witnessed quite horrific care of very vulnerable patients in particular I recall an elderly woman who had pseudo seizures from childhood sexual abuse and was labeled difficult. Some staff labeled her crazy and treated her very inhumanely, she was laughed about. I of course was horrified when this happened as I shared her history of abuse.
I have nearly all of the other physical “disorders” you list and now as I approach the age of 60 next year I realize the huge toll on my physical health from PTSD as well as the stress of all my depressive episodes. agh! And yet I wonder what came first the auto immunities or the mental health issues?
Yes, I have to say I have rec’d superb teaching facility care at UWHC, Madison, WI and yet…. why oh why are these “world-class” institutions not on board with alternative medicine for psych? They have absolutely no knowledge of all the necessary supplements we need! Thank God for you! I am providing my provider with your list and I really think taking these has helped as I am feeling that the medications just are not the complete picture and are best as a deterrent to suicide and perhaps necessary as maintenance but absolutely coupled with alternative therapies, with medication being important but not the end all because the meds all seem to shit out on you after awhile if you aren’t doing your program of alternative care ie exercise, supplements, diet, living like a nun, in bed early, etc, etc all the fun things we get to do that others don’t have to!
And yes looking back…oh my! But riding this storm through menopause on top of it nearly did me in!
Thank you, thank you, thank you.
I have tinkered with writing an article called “unsolicited advice for my psychiatrist”–and my first draft hits your first two points as well!!! NO ONE could have said it better than you, though–and I appreciate the rest of your insights as well. Always a reader of yours, I will continue to find insight into our shared MH struggle. Thank you!!!
I share my experiences of depression/anxiety over the last 50 years when I can- if it prevents only one person from making the same mistakes I did, it is worth sharing.
I just came across your site and read a few of your posts. It is really nice to see someone who is open to sharing their story so that you can educate and give others hope. I like that you explain things in a way that people can understand a why and how in layman’s terms!
My story is somewhat similar to yours and my eyes have just recently been opened to the reality of how complex your bodies and minds are and that there is not just one way to deal with mental and health issues. I have always been a strong believer in diet, lifestyle, and more holistic approachs to healing. As a RN working in a hospital, I am surrounded with western medicine and many doctors (not all, but most) who do not have enough time to go beyond simply writing prescriptions. I have a solid medical background, and really want to help people help themselves. I try to take it upon myself to take as much time as I can to listen and talk to people with various mental and physical ailments in the hospital to help them find their own answers to achieving a balance in their lifestyle. I would like to do more and spread more education about disease understanding and holistic approach to people before they get so bad I see them in PCU. Any recommendations on how to do this?
This is the first time I have written, so first I need to thank you for being such an amazing advocate. Whenever I read your articles and or posts, I feel like you have a secret window into my brain, soul and heart. And the fact that you are able to do all that you do while simultaneously dealing your own battles is nothing short of mind-blowing to me. Which brings me to my specific comment: My doctor once told me that one of the particularly cruel symptoms of depression is that it becomes a million times harder to do the very things that might actually make you feel better, like exercise. What’s worse, the things you actually want to do are often self-defeating, like staying in bed all day. It’s totally counterintuitive, and for me at least, is in sharp contrast to how I react when I have a physical illness or ailment. In other words, it requires no physical or mental effort for me to take a few aspirin when I have a headache. When I had a bad sinus infection last year, it was not difficult for me to take the medication— in fact, I WANTED TO. Because 1) I knew it would make me feel better, and 2) I wanted to feel better. However, even though both of those things are true in the case of my depression, I find it so difficult and overwhelming to do the things I KNOW will make me feel better (apart from taking my meds). So how do I find the motivation to go running or to practice meditation, deep breathing, etc., when every fiber of my being is fighting me?
Thanks for your comment. It depends on the severity of my symptoms. Sometimes I have to baby myself and other times I have to challenge myself. It’s a difficult balance. I usually try to do SOMETHING, even if it’s small — like get out of bed. I start there. Then I get dressed. Often times, momentum builds and I can fake it through the days. But there are times I just can’t stop crying either. So I try not to beat myself up. The hardest part, I think, is battling the voices. If you can distract yourself as best you can, sometimes you find that you are capable of more than you think — if you can get out your head through distraction or loving kindness to yourself. Hope that helps.