Observations, Learning, and Activities for the New "Over 21s"

Sneaky Depression

Depression must have been following me around for a long time. I’m not sure when it caught up with me–I didn’t even know it had. It’s not like one day I woke up with Depression snoring next to me. There was no lightning bolt marking its sudden appearance. I wasn’t feeling particularly sad or seeing everything in black. I’m not sure if I was feeling hopeless or particularly morose. Days didn’t drag or fly by; they just blended into one another. I hadn’t been feeling particularly energetic, but I blamed the fatigue in part on the hot and humid tropical weather. When the pets napped during the mid-day heat, I often found myself joining them, even though the air conditioner kept me comfortable so I wasn’t being directly impacted by the weather. Arthritic back pain has been my steady companion, and I blamed most of the fatigue on the constant struggle with Pain. I miss being able to take my Naproxen to keep Pain at bay. It had worked really well for me, but it also was complicit in a near-fatal bleeding ulcer incident nearly a year ago, and I’ve had to stay away from it ever since. So I blamed my lack of awareness of Depression on Pain. Pain kept me distracted while Depression slowly permeated my body and my soul.

That I became aware of Depression’s presence was sudden. It was about two weeks after my last visit to my psychotherapist. I was thinking about how I don’t really like her, and that I don’t know why she insists on continuing to see me. The session wasn’t terribly productive, and I realized that her voice had taken on tones of dislike and condescension. She was telling me that I am a selfish bitch (not in those words) who turns away from any group or individual who doesn’t agree with me–that it’s my way or the highway. This took me by surprise. It had taken me most of my 65 years to work up the nerve to simply be able to say to myself, “This is not how I think or feel or see things. I can walk away from this.” I wasn’t feeling bad about this type of thinking and subsequent actions, and I didn’t understand what brought on this tirade from her. For the year or so that I’ve been seeing her–generally once a month, with a three or four month lag recently–we’ve discussed my issues with family and my husband. I rarely talked to her about my social life or activities. Yet she was talking as though we have known each other well for years and shared a circle of friends. The thought going through my mind was, “Is this professional behavior in a therapist?” In the US, I had never experienced this type of reaction from a professional therapist–some insurance plans won’t pay for antidepressants without a prescription from a psychiatrist. I started wondering whether she had been trained in The Netherlands or elsewhere, and if this was professional behavior there. Granted, the country of Sint Maarten is more like a mid-sized US town, with its population of roughly 45,000. Adding the 40,000 or so residents of the French side of the island, the whole island takes on the proportions of a small city, with each side having its own culture within the greater culture of the Caribbean. My next question to myself was, “Has she been talking to other people about me? If so, whom would we know in common?” And again, thoughts of professional behavior went through my mind. I had pretty much made up my mind that I would be cancelling my next appointment (coming up next week), but decided to let it stand and re-assess during or after.

As I continued to ponder the strange session, I started thinking about my activities as symptoms and how likely it might be that Depression had caught up with me again. I started thinking about my life over the past year. I had taken a vacation from my husband and ended up overstaying my welcome with my children. I came home to discuss separation with my husband, but then bleeding ulcers almost killed me in the middle of the night–twice within two weeks–and how instrumental he had been in getting an ambulance here quickly. He visited me more in the hospital during my two five-day stays than he ever visited me during major surgeries back home when he worked a block or less away. Since he doesn’t drive, and since the hospital is almost on the other side of the island, that took a major effort on his part. Life on a small Caribbean island is vastly different than the conveniences associated with large urban areas in the US. He had to rely either on friends or on taxi services to visit me, since buses don’t run near enough to the hospital for easy access in the tropical heat, and visiting hours are extremely limited.

The night I returned from the hospital after my second stay, I noticed that one of our two cats was acting strangely listless. Over the next three and a half months, she spent more time at the veterinary clinic than at home, first for a pancreatic infection, and later for feline diabetes. The male cat missed her, and started to jump into the car whenever I had the tailgate open, possibly hoping she was in the car. He did that late one night when my husband was unloading the car from my earlier grocery trip. My husband doesn’t always notice things at the best of times, and I had forgotten to tell him of this cat’s new habit. I didn’t go anywhere the next day, and the car was sitting in the tropical winter sun all day, with me wondering why the cat hadn’t yeowled to come in. My hunt for the cat ended when I found him the following day, when I needed to run to the pharmacy. I would never have to hunt for him again.

A few weeks later, I began to notice that I was losing stamina instead of gaining it during my exercise sessions in the community pool. At first, I thought it was emotional stress from losing one cat and having an ill one. I drove to the doctor’s office to discuss the condition and was sent for a blood draw because the doctor thought I looked somewhat anemic. Because of local holidays, it would take longer to get results than usual, and we had been scheduled to visit a neighboring island for a conference my husband needed to attend. I was feeling weaker and weaker and tried to beg off, but my husband seemed more concerned about the fact that we had already paid for my fare and a rental car, and insisted that I would feel better from a change of scenery. By the time we returned, I was feeling much weaker and took the first opportunity possible to visit the doctor for bloodwork results. My blood count was so low that the doctor could not believe I drove to the office. I was not even allowed to drive the half kilometer home to pick up pajamas and other hospital stay essentials (locally, you provide your own pajamas, toothbrush, soap, towels, etc.) before I was whisked away to the hospital.

During the five days I spent at the local hospital, the staff doctors managed to scare me to death about the condition of my colon (since the ulcers had healed quite well, it had to be my colon, they reasoned), saying that I would need to have half of it removed and that I was taking a chance that I would bleed out from a burst sac in my colon at any time. I was not about to have surgery on the island, so we scheduled a visit to the Mayo Clinic in Florida for a consult and possible surgery. It turned out that my colon was fine and that my problem with anemia was because–after a total of eight units of blood transfused into me during my three island hospital stays–the hospital doctors had never thought about prescribing high dosage iron supplements. In essence, my body had shut down blood cell production after the two bleeding ulcer episodes, and that was the cause of the anemia, not internal bleeding from my colon. Much relieved, we returned to our island condo on Christmas Eve, with no pets to greet us and several days of no pet distractions. When I was finally able to bring home the dog and ailing cat, it was like celebrating Christmas a few days late.

Shortly after the New Year–on my birthday, in fact–I had to take the ailing cat back to the clinic, as she was refusing food and water, even from hand-feeding and forced hydration from an eyedropper. For the next nine days, the clinic tried to order various insulin types for her, trying anything to get her to come around. On the tenth day, I received a call from the veterinarian asking us to consider her suffering, as nothing was working on her. Before we were able to get there, and much to staff’s surprise, the cat had chosen her own time to die, and we said goodbye to her inert body. Both cats were just five years old when we lost them. I mentioned that we were interested in any stray or unwanted kittens that might be dropped off there. Surprisingly, we were able to adopt a kitten the same evening–not to replace the cats we lost, but because neither my husband nor I were ready to have a no-cat home–and we were hoping to distract the dog, who seemed depressed with both cats disappearing from home. The kitten was to be euthanized after closing, but my cat’s death allowed this kitten to retain her life. I suspect that the kitten was still alive just in case we were thinking of adopting a new one.

Shortly after I was told I needed colon surgery, and feeling a little down, I began to read books that always made me feel good and made me laugh. During our two-week stay near the Mayo Clinic, I began to download all the books by my favorite author, Terry Pratchett. It had taken several years before the first volumes of his Discworld Series were available electronically. I decided I wanted to read all the books from the first to the last because they made me laugh (and more than half of my Pratchett library was in a storage facility in Glendale, California). In an effort to cheer myself up, I read all 40 books of the series in roughly six weeks. The day after I finished the most recent book, Terry Pratchett died, leaving me jarred from the coincidence. In the meanwhile, I made a new friend here in the community, and she pulled me out of a good deal of my funk. She had me going to the beach and helping her find things to stock her new store at the Jersey shore, and I was finding myself perking up quite a bit. When she returned to the US, I began to sink again, the only thing saving me was the drawing lessons I started taking, thanks in large part to my friend’s chatting up a gallery owner on the French side of the island. My instructor also got me interested in oil painting. In addition, I got involved with a business that forced me out of the house. So I had a few new activities to throw myself into so that I could avoid seeing Depression sneaking up on me.

That day when I was pondering my last therapy session made me realize that Depression had grabbed me in its clutches and wasn’t letting me go, accounting for my ups and (mostly) downs.  Why hadn’t my therapist seen this, or why hadn’t she suggested the possibility that I might be depressed? My husband, who notices so little about me (think Sheldon on The Big Bang Theory), was preparing himself to broach the subject with me, but had some hesitations about how to begin. When I told him I thought I was depressed, he was relieved, and confessed that he thought so, too. So why did the therapist not notice two weeks earlier? It’s not like she didn’t know about all the events that had transpired over the past year. Why didn’t she see that many of my newer activities were an effort to pull myself out of a dark pit?

Fortunately, I am not a person who believes that there is ever a time when no hope exists. The idea of a purposeless life crosses my mind on occasion–like when Depression is stalking me–but I never really believe that things will never get better. I don’t always make lemonade when life sucks, but I tend to take a proactive approach to my existence. So…

The following day, I went to see my doctor. I told him I was pretty sure I am depressed. I explained my fatigue, my inability to motivate myself to perform even the easiest of tasks or my favorite activities, the hours of extra sleep, the restlessness, the inability to concentrate on anything. He agreed that I was probably depressed and prescribed some medication. In general, antidepressants take anywhere from two to four weeks before any improvement in mood or attitude is noticed. I’ve been on enough of them in my life to know. But when they kick in, the world takes on a whole new meaning. I’m almost three weeks into the antidepressants, and I’m feeling better every day.

Depression, you may take your sweet time taking over body and soul, but you’re not unbeatable. You are not a permanent fixture in my life. It may have taken me a while to notice that you have sneaked up on me again, taking the color from my world, and damping down the moments of joy that pass almost unnoticed because of your presence. Depression, you are being pushed out much more rapidly than you have entered, and I’m feeling good that I recognized you even when a psychiatrist did not. So yeah, maybe I do turn my back on situations that I deem immature or demoralizing or just plain stupid. But how is that bad? There are a lot of people I know who have some strange qualities–whether stranger than mine, I don’t know; I can’t judge–but it doesn’t mean I don’t like them despite their quirks. I don’t assess people on whether they agree with me or not, but on whether they are good-hearted and caring people. They can be self-centered, annoyingly upbeat, frustrating, flighty, overly single-minded, funny, klutzy, cute, ugly…but if they’re “good people,” I can usually set all those things aside and like them for who they are. Heaven only knows why some people continue to like me enough to call me Friend, even after they have gotten to know me and understand where I’m coming from. They don’t even have to understand me, as long as they still believe I’m good enough company to hang out with once in a while, or that my heart is in the right place. So yes, sometimes it takes a pill to help me see how many people make up my world. Sometimes, Depression, you can obscure the fact that I am not alone in this world. But you can never make my subconscious believe you because, deep inside, I know better.

Depression, you have been part of my recent life for too long, and you’ve made me blind to many of the little joys in life. It’s time to banish you. There may be a time when I’m off medication and life comes down on me again like a ton of bricks. At some point in the future, you may think you will win. But don’t delude yourself. Even if a therapist isn’t correctly analyzing me, I do a lot of my own self-assessment. I can turn and walk away from situations that will never change. Depression, you may get in and obfuscate, but you will never obliterate. Go away now. I’m turning away and leaving you behind.

#educ_dr

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