True Story: No Fooling

Once upon a time there was a girl who had a depressive episode. It wasn’t the first time she’d experienced depression–in fact, she’d experienced it many times before. But this time was different than all the rest. Every other time, the depressive episode occurred in the autumn as the days were growing shorter. This time, the depressive episode occurred in the spring as the days were growing longer.

Because this time was so different than all the other times she’d had a depressive episode, this girl didn’t realize that was what she was experiencing. She just knew that something was wrong with her.

She went to the doctor and told him all about her symptoms: extreme fatigue that persisted regardless of how much sleep she was getting, unexplained bruising on her legs, very dry skin, itchy scalp, acute colds that came on suddenly almost every week and lasted for a day or two, and persistent chest pain.

She explained to the doctor that she’d experienced most of these symptoms before–but that they seemed extraordinarily severe this time around, and right as circumstances had changed in ways that should CORRECT the problems rather than worsening them.

She’d had dry skin before–a combination of allergic reaction and having to wash her hands constantly in her position in food service management. But just as she switched from the food service management position to a desk job, her skin grew worse.

She’d had colds before–well, actually, she has chronic allergies. But the allergies have been under great control for quite a while. And now suddenly, just as she left her hospital rotation (in which she was regularly exposed to sick people), she was experiencing multiple short-term colds.

She’d been tired before. But she hadn’t been tired at all while she was waking up at 4:30 to be at work by 6:30am–and now, just as she was switching to a more moderate 6:00 wake up call, she was exhausted.

She’d had chest pain before–and she’d attributed it to stress. After all, the chest pain was occurring while she was going to school full-time and working three different jobs and volunteering for a total of 70 hours a week of commitments at more than five different locations. Why would chest pain like that be occurring right as she was switching to a cushy 42 hour a week desk job with practically NO additional commitments?

The doctor listened to her complaints with half an ear and gave the girl some advice that stressed her out even more. But at least he agreed to run the blood tests she wanted.

Trouble is, her blood test results came back with “Within Normal Limits” written on almost every value. She wasn’t hypothyroid. She wasn’t anemic. She didn’t have mononucleosis. Her glucose was normal. The trail was dead. The girl had nowhere to turn. What was wrong with her?

Then one day, the girl was sitting at her computer, typing on Facebook that she was “sick and tired of being sick and tired” when a germ of an idea hit her. “You know, I used to feel that way all the time,” she thought.

She mulled on the idea on her way to work–so much so that she missed her usual turn and had to go the long way ’round. But the result of her musing was that she had a direction to investigate. When was the last time she’d had chest pain like that? It was right before she’d started taking antidepressants to treat Seasonal Affective Disorder (SAD). When was the last time she’d slept for days on end and still been exhausted? It was right before she’d started taking antidepressants for SAD. Ditto on always having “colds” and other unexplained symptoms.

After she got home, she took a depression self-assessment and discovered that she most likely was depressed–even more so then she had been during her SAD episodes. From there, everything began to fall into place. She hadn’t recognized it because the normal seasonal cues weren’t there, but many of the symptoms were there. She hadn’t thought of it because she was still taking the antidepressant for SAD. But it made sense. The onset of symptoms coincided with three medium stressors that combined to pack a big precipitating whomp: a car accident that totaled her car, a need to buy a new car placing her in financial stress, and a job change (from what she’d been doing for almost three years to something COMPLETELY different.) It made sense.

Since the girl was still taking an antidepressant, she didn’t want to run back to the doctor for more drugs. And she didn’t really want to do psychotherapy either. Her insurance would demand a certain provider for counseling–and she didn’t think they would be able to give her any help. If lies needed to be replaced, she would much rather make sure they were being replaced with truth–instead of being replaced with different (humanist) lies. She didn’t feel that the insured providers could provide truth. So instead, the girl embarked upon a self-treatment program.

The first step in her program was to begin writing down her symptoms. She wrote down when she went to sleep and when she woke up and when she ate and what she ate and when she had chest pain. She discovered some interesting things. Every time she looked at her planner, she experienced chest pain. Every time she looked at her checkbook, she experienced chest pain. Every time she thought about money or time constraints, she experienced chest pain. If someone else mentioned time or money, she experienced chest pain. She discovered her triggers–and started working on decreasing them.

Since her planner is integral to her relatively fast-paced life, she knew that she would have to train herself not to have chest pain every time she looked at her planner. So as her first step, she placed some personal limits. She allowed herself five “to-dos” per day–three of which were firmly set. While she could do more in a day, she could not plan on or insist on more than that. That meant she could have two additional things to work on each day. Period.

The girl’s doctor had encouraged her with some sleep hygiene suggestions, which she’d initially blown off. The girl was unhappy with the doctor for not taking her fatigue seriously. She thought the doctor was blaming her fatigue on her own habits (she still kind of thinks so.) But encouraged by her roommate who happens to be a PA student, the girl began to put some of the sleep hygiene habits into practice. Two of the three set items on the girl’s list were 1) turn off the computer by 8:30 pm and 2) turn off the light by 11 pm. Slowly but surely, she began to be able to wake up to her alarm again in the morning.

The third set item on the girl’s list was “word washing”. She knew that since depression often involves inaccurate perceptions of the world, she needed to have some way of seeing the world clearly. While she felt sure that the counselors insured under her plan would be unable to provide her with truth, she was even more sure that the Word of God could provide her with truth. So she set a goal of spending time in the Bible every day.

As the girl followed these few simple steps, she discovered some amazing things. She was able to identify when she was being anxious–and was encouraged to cast her cares on Christ. She was able to relax her expectations of herself and stop living in false guilt (over things like failing to update her blog regularly.) And now, the hope that once seemed dead is alive again.