Chapter One – Dad
In March of 2019, I drove my parents to the hospital in order for my dad to have an outpatient procedure performed. At each step of the registration and pre-op, the professionals assured my mom and I that my 82-year-old dad would be going home after the procedure, which would take just a few hours.
In the surgical waiting room, there was a t.v. screen on which one could see the names of surgeons, but not patients, and see the progress as your loved one moved through pre-op, surgery, and into recovery. My dad’s surgeon stayed in surgery for much longer than expected.
Because my mom is the most private person I’ve ever met, ironic I know, I’m not going to detail the experience we had. Suffice to say, dad never left the hospital. He remained in ICU for three weeks. He was never going to leave the ICU because of the level of care required. The only facility equipped to provide long-term care for him was hundreds of miles away. As a family, we eventually made the difficult decision for comfort care. The machines were unplugged. My oldest sister and I held his hands as he drew his last breaths.
After my dad passed, I asked if we could have a celebration of his birthday two months down the road because we didn’t have any kind of memorial in the immediate aftermath of his passing. I poured myself into putting together lots of pictures depicting my dad’s life. The birthday celebration went well, but when it was over, I felt a serious let down. I was overwhelmed by the strength of the grief.
It was about this time that suicidal thoughts started floating through my mind. Because of my history with depression, I know that suicidal thinking is an early symptom for me of worsening illness. I identified then that I needed a mental health tune-up. Problem was I didn’t have a mental health professional since Dr. Liz had suspended her private practice in 2013. Since then, I’d had primary care provides prescribe my antidepressant medication. I had discontinued a second antidepressant along the way because I was doing fine and wanted to decrease the number of prescriptions I was taking. I’d also stopped taking my anxiety medication; but, while my dad was dying, my primary doctor had started me on a new anxiety pill.
Now that I could see I was on a downhill slide, I really didn’t want to monkey around with my medication. Over the decades, I’ve been on several different antidepressants. Coming off of one and going onto another can take weeks and there can be side effects. I missed Dr. Liz and wished I could see her again but didn’t even think to google to see if she was practicing currently. I really liked my general doctor, but my experience also tells me that choosing a new medication with a primary care doctor can be akin to throwing a dart at a medication chart. Instead, I went on a girls’ weekend.
My two best friends and I had planned a weekend in July in Arizona. I know, right? Phoenix in July. I was not sure I could physically make the trip, so sick was I with grief. My friends assured me I could just lie down for the three-day stay. After all, we wouldn’t be spending a lot of time outdoors in 110 degree heat.
One of my friends had lost her mom just before I lost my dad, and we were going to stay in her mom’s condo. We’ve all been very close for 30 years, so this was like a memorial journey. It was a wonderful time with the closest of friends. We laughed and cried, but the laughter certainly outweighed the tears.
I border on being a Luddite, only knowing how to use technology I require for work and daily living. I’d never used a voice-controlled remote or looked at the internet on a t.v. I know, can you believe it? We watched YouTube videos, last night show excerpts, and some internet-only programming like David Letterman’s interview show or Zach Galifianakis between two ferns. I laughed harder, longer, and more frequently than I had in years.
I felt renewed following this escape. Suicidal thinking still skirted around the edges of my mind but this had become standard operating for me. This may seem shocking to some, but just because you consider the pros and cons or methods of suicide, it doesn’t necessarily mean you’re acutely suicidal. It’s not okay that I was unphased by the suicidal ideation; but, I’d become so accustomed to it, I was able to convince myself I was getting better and didn’t need an immediate mental health assessment. Over the past year, I kept telling myself that all I really needed was some time between seriously stressful life events in order to even out. I hoped that’s what was ahead.
Unfortunately, I completely underestimated the impact of the first anniversaries of two events that I’ll cover in another chapter, the death of my sister-in-law and a major, life-altering, injury event suffered by someone I love very much. Heading toward my October birthday, I started to experience a fraction of what I imagined post-traumatic stress disorder must feel like. I haven’t been in war or a victim of violence. It became harder to breathe. I was on edge, waiting for unexpected trouble to appear around any corner. I later learned from Dr. Liz that this was acute stress disorder.
In 2018, someone I love a lot had suffered a serious accident and injury the day before my birthday. I wasn’t looking forward to celebrating in 2019, and we had no real plans, which suited me just fine. Four days before my birthday, my husband and I became aware that someone we love a lot was suffering from a serious medical illness, a severe condition, which required all the time, energy, resources, and attention we could bring to bear. I was all in. I had a focus. I began handling the situation, particularly making and accompanying this person to all appointments. As we met with professional after professional, each would inquire of me how I was holding up and handling the stress. My reply to all was, “I’m hanging in there. I do need a mental health tune-up,” but I didn’t follow through.
Eventually, I googled Dr. Liz to see if she was practicing and she was! I called and left a message. Dr. Liz responded and said, although her practice is full and she wasn’t accepting new patients, I wasn’t technically a new patient and she would fit me in. The first appointment she had available was December 19, seven weeks out. I felt relieved that Dr. Liz would see me and hopeful that she would have recommendations that would result in appropriate, targeted management of medications. She had been so helpful to me a decade earlier.
I accept that I have a chemical imbalance in my brain. It was shown itself repeatedly and responds to appropriate medication. Counseling was also helpful for a year in 2003-2004, which gets its own chapter later. Since that time, it has become obvious to me that I require antidepressant medication to keep my brain chemicals balanced. I have complete confidence in Dr. Liz’s ability to guide me, so I really though I just had to hold on until December 19th.
I thought the family member who was very ill was getting better, but it became clear quickly that it wasn’t going to be that easy. For weeks, I’d been in bad shape, some would argue months, but this awareness of my loved one’s long-term prognosis was the proverbial last straw. I kept focusing on 12/19, when I would get to see Dr. Liz, because I know, from my prior history with her, she was going to be able to explain to me what was happening and what I needed to do about it. Was my current antidepressant not effective for me any longer? I soldiered on because that’s what I do.
On 11/22/19, I texted to my sisters, “I’m in terrible shape. There’s nothing anyone can do. I can’t talk. Please pray for me.” One of my sisters did call and, as I sobbed, she talked to me. She had a very soothing voice and told me how much she loved me. Eventually, I was able to talk some. I don’t remember most of that conversation. A short while later, she called back and told me she’d spoken to someone on a hotline in the town where I reside. She wanted to know if it was okay to have the hotline call me.I hesitated. These thoughts I’d been having, could I actually say them out loud?
Suicidal thinking had begun in the summer of 2019. When I drove on a winding road, I’d imagine veering off the side. I was afraid I wouldn’t die but instead be terribly injured which would result in major medical bills and months of recovery – and I’d still have to live through each day. These kinds of scenarios or wishing I’d just drop dead of natural causes have been such a wallpaper in my mind, when I’ve been seriously depressed in the past, that I could turn them away by thinking of the people who love me and how it would affect their lives, especially if I did it intentionally.
As it became more and more difficult to get through each day of work, thoughts of suicide had increased and I’d begun to consider them seriously instead of dismissing them. I didn’t have a real plan, but I started to think of one, seriously, for the first time.
On Friday, November 22nd, my sisters texted me repeatedly, checking on me and loving me. A woman from the hotline called in the late afternoon. She was easy to talk to. She led me through some risk assessments. When I told her I was just hanging on until 12/19, she asked if they could have a counselor check in with me in the meantime, and she suggested I call Dr. Liz on Monday and see if she could possibly see me earlier. I agreed to chat with someone on the phone as I waited for help.
I felt relieved to have answered her questions honestly and it wasn’t the end of the world. I called in sick for work for the next day at my husband’s urging. Saturday, I think I mostly stayed in bed. At some point that afternoon, the thought occurred to me that now I’d said it out loud, that I had suicidal thinking, so no one would be surprised. I’d softened the blow with a warm up and, thus, now was the perfect time. I was so empty and exhausted. I was so done with this illness.
I’m not going to say what my plan was but I settled on one Saturday evening, and then I felt calm. The scales had officially tipped for me; the physical, mental and emotional pain brought on by this dark disease now outweighed the pain I would leave behind. I’d allowed myself to believe I’d conquered this insidious condition after my second episode of major depression in 2009-2010, which I’ll cover in another chapter. Somehow I thought I’d handled it, but now I saw I would never really escape it. Even if I did the work to get the chemicals balanced, it would just recur later after another year of trauma, loss, and hardship – because I know there will be those. I’d get a good patch of maybe nine to ten years at most but then this disease, which feels like a mold growing on the inside of you that no one can see, would creep in again, find a shadowy place in my mind for fertile ground. Ugh, the thought of that was more than I could bear. I was empty. I was done.
I dragged myself out of bed the next morning, only because I needed to purchase items for my plan. I wrote my suicide note and, when I’d finished it, I felt a whoosh of energy out of my body. My purpose in life had been to weave love and compassion into the fabric of life wherever I am, whomever I’m with, whatever I’m doing; but now I had nothing left to give. I had served my purpose.
On my lunch break at work, a friend, whose friendship precedes our employment at the same place, sat with me in the break room. She knew I’d been struggling for a while. I sat with tears streaming down my face. She put her hand on my arm and said, “Let’s get together Wednesday,” with concern in her eyes. I whispered, “I might not be here.” She asked me to repeat myself, which I did, and she immediately said, “Oh no. You can’t do that.” “Why?” I looked her in the eyes. “Why?”
She needed to get back to work. I used the bathroom and splashed my face with water. When I emerged from the bathroom, there she was, waiting for me. “Come one,” she said. “We’re going to HR.”
Our HR person, my friend and I sat in the office with the door closed. “I’m suicidal,’ I said, with tears just pouring now. “I’ve written a note and I got things together that I need.’ The two of them talked me down while we waited for my husband to come and get me. My HR person told me I needed to go on medical leave immediately. She called my manager and told him I wouldn’t be back from lunch.
Once my husband arrived, I walked out carrying my suicide supplies and my farewell note.
Shortly after arriving home, I phoned Dr. Liz. I knew she wouldn’t be working on a Sunday but left her a message saying that I was suicidal and desperate. As I was talking, she picked up the phone. She’d just happened to be in her office and heard me on the answering machine. She told me she would see me the day after Thanksgiving and made me promise I wouldn’t hurt myself in the meantime. I agreed.
An hour or so later, a counselor from the hotline called to check in with me. I told him everything that had transpired throughout the day but assured him I’d given the supplies to my husband, I’d gotten my appointment moved up, and I’d promised not to kill myself.
And here’s where the hard part is – it’s very difficult to talk to anyone about being suicidal because it’s unacceptable, and especially difficult to discuss your thoughts and feelings honestly with a mental health professional who is legally bound to have a person hospitalized if they’re a threat to themselves.
The same counselor from the hotline called me every day to check in. My husband worked from home for the remainder of the abbreviated week. He prepared Thanksgiving dinner which was attended by our sons and my mom.
Meeting with Dr. Liz on Friday, November 29th, was such a relief. She adjusted my medication and told me she wanted me to sleep as much as possible for the next two weeks.
Relaxing, resting, taking it easy on doctor’s orders – if you’d asked me a year ago if that sounded appealing, I would’ve jumped at the chance. However, in practice, in the depths of depression and stretched thin by anxiety, I struggled with guilt that I wasn’t going to work or doing things around the house.
So, this is the short version of how I ended up in my third, and worst, major depressive episode with a suicide note, plan and intent.
Details of how I work my way out of this will be covered in my journal posts.
Chapter Two – Depression for me
I want to spend some time discussing what depression feels like for me. This is just my experience, and others will have different symptoms.
For me, the beginning of a depressive episode is ushered in by fatigue. For a couple of months, I’ve spent all my off time in bed, when not at work or taking care of my seriously ill loved one. Chores become much more difficult to complete and the house starts to fall apart.
My mind slows down, making it much harder to multi-task or keep track of events in my head. The usual juggling of life events and troubles breaks down. As that happens, I feel less and less capable. I have a lack of appetite, so much so that I refer to this as the “depression diet.” I cry easily or, alternately, have a flat affect with little emotion expressed, positive or negative. Eventually, even the smallest of tasks become great challenges. Not following through on everyday issues, however, causes a snowball effect and I end up feeling totally overwhelmed.
Next, decision making begins to fail. I have a hard time considering factors of a situation and choosing a course of action. Driving becomes more difficult because it’s hard to process all of the surrounding stimuli. My senses are dulled. I also know by this point that my thought process is compromised and, as a result, I don’t trust my ability to make the best decisions. I become paralyzed and feel incompetent.
The spiral seems to speed up as I look around at the undone housework, withdraw from social life due to fatigue, and accept that I’m not as smart as I used to be. Feeling bad about feeling bad insidiously magnifies my negative self-talk. I look to my husband for reassurance, literally asking him, “Am I ok?” I begin to think I’ll feel better when this or that event occurs or a certain amount of time passes. As the identified benchmark or number of days pass and I continue to struggle, hopelessness and anxiety set in.
The physical symptoms creep in gradually and, as a person who suffers from fibromyalgia, I chalk that up to a fibro flare-up. I recognize the sensations as more than that when the weight of depression takes up residence in my chest, abdomen, and limbs. Basic functioning becomes such an effort that I feel like I’m moving through quicksand. Just making it through a day becomes extremely challenging and exhausting. I begin to long for escape from the daily grind.
Initially, I have wishful thinking about dying. I hope for a brain aneurysm or a blood clot to stop my heart. Going to sleep and not waking up sounds like peace. Next, general suicidal thinking starts to flutter around the edges of my mind. As I’m out driving, I imagine veering off the road and slamming into a tree or going over the edge of a steep drop off. Then I think I’d probably just be seriously injured, resulting in astronomical medical bills for a lengthy rehab. In my prior two major depressive episodes, what some may refer to as a nervous breakdown, my thoughts about death and suicide have not progressed past general ideas or wishing for death.
Unfortunately, the presence of suicidal ideation has become something that no longer jars me. It’s in the back of my mind and, on its own, does not spur me to seek help.
This time, writing a suicide note and gathering the necessary items took me deeper down that path than ever before. I’ve heard that suicidal people may seem more upbeat after they devise a plan. For me, it had a calming effect. I decided where and when I would carry out my plan, including measures I could take to leave less of a mess for my husband.
At the deepest pit of depression, I feel like a burden to people who love me. I feel useless and hopeless. Circular thinking focuses on what a mess I am and what a relief it would be to end the suffering.
Depression is not just being sad. It’s a depression of the nervous system and the physical self. It’s not something one can just choose to set aside. If it was possible to act like everything is okay and have that lead to wellness, I certainly would have responded to that strategy. Soldiering on just wears me down and exacerbates the stress on my brain, body, and spirit.
This go-round, depressed appetite, suicidal thinking, and lack of energy and confidence occurred for months. Because it’s not my first rodeo, I was not alarmed, just completely discouraged that I found myself back in this state.
Mid October, I googled Dr. Liz because she provided the best mental health treatment I’ve ever received. I saw that she had resumed her private practice and called for an appointment. The earliest she could see me was December 19. Carrying on for two more months seemed doable. After all, I’d already been mired in the darkness for three or four months – what’s two more?
Over the past 25 years, I’ve been able to turn away from actually taking my own life by thinking of how hurt, confused and devastated my friends and family would be. I could not bring that pain to them.
This time was different. Something that greatly disturbed me was knowledge of several high profile people who have committed suicide – Robin Williams, Chris Cornell, Kate Spade and Anthony Bourdain. If those people, with all the resources available to them, had not been able to escape the agony of depression, what chance did I have? Those suicides shook me to my core. The idea of living the next three or four decades in the midst of major depression or with its specter looming was more than I could bear. The series of life events over the past year, in particular, sent me into greater despair, with a feeling of complete hopelessness, than had been visited upon me previously. I felt empty, nothing left to give, nothing left to live for.
Chapter Three – Early Days
My earliest experience with anxiety was being unable to spend the night away from home until I was in the sixth grade. Each time I asked if I could sleep over with a friend, my mom would ask me if I was sure, and each time I would declare I was ready, willing and able. I was convinced this was true and would implore my mom to let me give it another try. Then, each time, soon after lights out I would start to panic. Nothing could calm me down or help get me through the night, and inevitably I would call my mom to come get me. Thankfully, she would. This routine would play out predictably, but I kept trying, thinking it would be okay this time. It wasn’t until a large slumber party in the sixth grade that I was able to get through the night and from thereon I was capable of spending the night with friends. Adult anxiety recalls that feeling of being alone in the dark, in the middle of the night, trapped by a panic I couldn’t explain or dismiss.
I didn’t experience major depression until I was in my 30’s, but I was easily upset, quite emotional, throughout high school, college and my 20’s. One of my good friends used to say I could cry like turning on a faucet. She also frequently told me I needed counseling when I cried over a difficult work day or conflict with a friend. She had a Master’s degree in counseling and was working on her PhD in psychology. Eventually, I told her to stop referring me to therapy or I’d have to stop coming to her when I was down about something. I didn’t for a second consider I actually did need counseling. Besides, I got my own Master’s in counseling by the time I was 24.
I enjoyed being smart, and school came easily to me. My strongest asset was my intellect. I identified with my brain. I measured my worth, and that of others, by natural intellect. So, I didn’t think I needed help with anything, because I was really smart.
I do recall feeling out of sorts and not knowing why or what to do about it. I was uncomfortable spending time alone. That was something I had to face when, at age 23, my live-in boyfriend met someone else and fell in love, necessitating an immediate move. I found a nice little studio apartment. For the first couple of weeks, I found something to do, someone to hang out with, every evening after work. Eventually, I had an afternoon with no plan and no one available. I can still remember the anxiety that instilled. I successfully spent that evening alone and, after some time, I found I enjoyed my alone time. This was a good time for me, learning to be more comfortable with myself.
Later, the anxiety or uneasiness with no identifiable cause would occur occasionally. I remember being on the phone with my next boyfriend, now my husband, saying, “Everything is a mess. My car is a mess. My apartment is a mess. My classroom is a mess.” I was teaching third grade by this time. His response to me was, “Well, let’s clean them up.” It sounded so simple, but I knew that the messes weren’t the real problem and cleaning wouldn’t really fix me.
So, my general strategy for dealing with any mental health issues, which I did not identify or accept as mental health problems, was to bat them away and move on.
It wasn’t until my late 20’s that I begin to experience a sense of hopelessness. I can vividly remember sitting in my car at a stop light, looking at a convenience store gas station, and thinking, “What is this all for? What are we doing? We’re like hamsters on a wheel, going round and round, and for what purpose?” I wasn’t able to shake that feeling, those thoughts.
I was married by then and we’d moved from Southern California back to my hometown. I made an appointment to establish care with a general physician; and, when I filled out the paperwork, I first hesitated and then checked the box for depression. A week later when I went for my first visit, the doctor met with me in his office. He sat behind his desk and thumbed through the papers on which I’d outlined my health history. We discussed the fact that I’d had high blood pressure since college and some troubling female issues throughout my 20’s. Then, he looked up and said, “You checked the box for depression. Is this new or an ongoing problem?” I had completely forgotten I’d marked that. Tears sprang to my eyes. I explained that I wasn’t sure but described the pervasive sense of hopelessness or meaninglessness I’d been experiencing.
He prescribed an antidepressant, to which my husband was totally opposed. The first few days on the medication were rough. I experienced my first real panic attack, unable to choose something to wear or go to work. The Paxil lifted me out of the mild depression I was suffering; but it also caused me to not feel full when eating, and I think I gained 5-10 pounds. Because my husband didn’t like the idea of me being on the antidepressant, and since I was feeling better, I went off the Paxil after a very short time. Going off the Paxil was hard and weird. I felt scared, panicky, and confused. My primary care doctor said he didn’t think these feelings were from discontinuing the Paxil; he hadn’t heard about that kind of response. A few days later, however, I saw an episode of Dateline or something that talked about that exact thing, people having a hard time getting off Paxil. For that reason, I’ve chosen not to use that particular antidepressant since. It’s probably unique to each individual and works really well for some, but my experience wasn’t positive.
At that time, I was using my Master’s degree, working as an educator for the regional health district. I taught child care center staffs about child development, positive discipline, stress management, age-appropriate curriculum, etc. I also taught parenting classes. I very much enjoyed that position, but it was grant funded. When the grant end date came near with no new funding on the horizon, I left that position and became program director for a crisis nursery that provided fee, short-term, 24-hour care for children ages six and under while parents dealt with stressful situations. I managed the house staff and worked with parents, doing intake, counseling, and facilitating parenting classes. This was all before I had kids, but I was trained to teach the curriculum.
I injured my back lifting a child, and it took nearly a year of physical therapy, chiropractic care, massage, and acupuncture to return to full function. By that time, they’d replaced me at the crisis nursery.
It was during this time that my husband went out on his own as a carpet installer. I began doing the books and taxes for the business.
Later, after months of trying, I got pregnant with our first son. Soon after, without planning, I was pregnant with our second son. They are a year-and-a-half apart. Postpartum and with two little ones, I started on a new antidepressant. I stopped and started medication over the next few years, always going off when I felt better because my husband was so strongly opposed to ongoing psychiatric medication, and my general physician went along with my decisions.
We were very involved in a small church, and I mostly listened to Christian radio. One day, as I was driving alone, I heard a speaker say that joy is a choice. Well, that really knocked me for a loop. I was unable to choose joy. I had a panic attack in response.
Those early years as a stay-at-home mom with two small children in diapers and bookkeeper for my husband’s business were very up and down emotionally and physically.
Chapter Four 2003-2004
One winter day in January of 2003, my three-year-old and I prepared to go into our backyard hot tub. My five-year-old didn’t want to join us, and he was downstairs watching t.v. I had my little guy wait at the top of the stairs so I could get the hot tub open and then help him. I thought the stairs were wet but, instead, they were covered with black ice. My first foot slipped. I stepped down with my second foot but both feet went out from under me and I fell down the full flight of stairs, landing spread eagle in the snow beside the lower deck which surrounded the hot tub. It took me a minute to get myself together and crawl back up the steps. My sweet little boy asked, “Can we go in the hot tub now?” I explained that we wouldn’t be able to go in this time and I needed him to get his brother.
My older son came right away. I told him I thought I had broken my leg and needed the phone to call for help. I called one of my sisters, and she and her husband came over right away. While my brother-in-law stayed with the kids, my sister took me to urgent care. Much to the surprise of the medical staff, x-rays did not show a fracture. I had a badly bruised leg bone and also did a real number on my shoulder. The next day, I felt like I’d been in a car wreck, hurting from top to bottom.
My husband was self-employed as a carpet installer at the time and had to work. A little neighbor girl came over and helped take care of the boys while I stayed in bed for a couple days. That bruised leg bone took months to heal.
The next month, February, my husband began working on a hotel in Utah. He would fly home each weekend. This went on for six weeks. During that time, I began an online course in medical transcription, so I could bring in some income. I tried to work on it when my older son was at kindergarten and my younger son at preschool, but that was also when I tried to go grocery shopping and run errands.
I’d earned my Bachelor’s Degree in Education and my Master’s Degree in Counseling, but I found the curriculum for medical transcription more challenging than either of those. Coursework included learning anatomy, names of medical procedures and medications, and being able to accurately type a variety of dictation. My progress was slow but steady.
Then, in May of 2003, someone very close to me was diagnosed with breast cancer, requiring a mastectomy. I hired a babysitter two mornings a week, so I could help my loved one during this time. I started doing my coursework with the t.v. as a babysitter, so my two little boys would be doing their little boy thing, loudly, while I tried to concentrate on essentially learning a foreign language.
One June day, while the boys played outside, my husband and I were talking about my medical transcription program and progress, or lack thereof. He suggested, “Why don’t you just get up an hour earlier each day and do it then?” Something inside me broke. I dropped to my knees, shaking my head no, and sobbing with sounds coming out of me that sounded like a wounded animal. Just then, my now four-year-old came running into the house for something and saw me there with my husband kneeling next to me. His eyes got big as saucers. My husband told him to go back outside and said he’d come out in a minute.
He helped me to our bedroom, shut the door, and called my parents to come and get me. They came right over, helped me into the backseat of their car, and drove me to their house. On the way, I was crying and saying, “I can’t do it all. I can’t do it all,” over and over. My dad said, “Can’t never did anything.” For the first time in my life that I can remember, I talked back to him. “Take me home. I’m not going to listen to this bullshit.” My mom explained they couldn’t take me home because it wasn’t good for my sons to see me in that condition; they were scared. My dad remained quiet for the rest of the drive.
When I got to my parents’ house, I first rested. Then my mom and I talked about all that I was juggling – caring for my boys, doing books and taxes for my husband’s business as well as household finance, and studying medical transcription. I returned home the following day, much calmer, and went to see my primary care doctor soon after.
My doctor diagnosed me with depression, started me on a new antidepressant and referred me to a counselor, Carly. I called the online school and put my coursework on hold. I went to see Carly once a week for months. My mom and my sister each came over once a week through the summer for a few hours so I could have a break from full-time parenting.
In September of 2003, my husband began installing carpet in a new hotel across the state from where we live. He drove home each weekend. When I tried to talk to him about what I was going through, he sat silently. I told him my counselor thought it would be a good idea for him to come in with me, so he could learn more about what depression was and what I was going through, but he resisted.
In October, my husband and I went out for my 39th birthday. We shopped at a mall and I picked out a leather coat. We went to dinner at a steakhouse. After we’d ordered, I broached the subject of my depression with him yet again. I told him that I really felt like he didn’t want anything to do with me or what I was going through, saying it felt like he was really absent all the time, not just when he was out of town. I asked why he couldn’t be there for me in this really difficult period of my life. He answered, “I don’t know. I don’t know. I’m not happy.” “What do you mean, you’re not happy? With me, our marriage?” “Yes,” he said. “I’m not happy in our marriage. When I’m gone working, I think about you and us. I don’t love you and I don’t think I ever really did.” Well, you can imagine, this knocked the air out of me. When the waiter brought our food, mine sat untouched. “Are you talking about divorce? You want to get a divorce?” He explained that he thought about divorce a lot while he was working out of town.
After dinner, I asked him to take me to my parents’ house. I felt like my world had just fallen apart and didn’t feel like I could be around the kids just yet. I spent the night. The next morning, I remember everything looked and felt different, foreign. My mom took me home, and my husband left town to go back to work.
My actual birthday was a couple of days later. We talked on the phone, but it was stilted and uncomfortable. I said, “I love you,” when we were saying goodbye and he didn’t respond. We hung up and I called him back immediately. “After ten plus years of marriage and two children together, on my birthday, you can’t even say ‘I love you’?” He said, “I don’t feel it and I’m not going to say it if I don’t feel it. All these years you’ve talked about how we were meant to be together, and I’ve never understood what you’re talking about or felt that way.” The boys were in bed and I was standing alone in the kitchen, holding onto the stove with one hand to steady myself.
Okay, not only had he become dissatisfied with our marriage and was thinking of leaving, but nothing I thought to be true over the past decade had been real? How could that be?
During that week, my parents took on my “craft” room as a project. I use the term loosely because I never really did any crafts there. It had just been a catch-all room since we’d moved into the house in the spring of 2001. They sorted and cleaned. They installed shelving in the closet to hold boxes of business taxes. At one point, my mom showed me a card she’d found that my husband had given me in which he’d written, “I love you so much. We are definitely soul mates.” There! There was proof that I hadn’t imagined it all or just willed it into being.
I wrote my husband a long letter in which I recounted how we’d met, what an unlikely pair we’d been to match up, and how we’d stuck together when times were tough. I outlined how we had beaten the odds over the years. Yes, I said. Yes, I do think we are meant to be together. I put this letter in the card my mom had found and included pictures from our earliest days of dating to our most recent Christmas holiday card picture with our two young sons. I put it under his pillow.
The next weekend, my mom and I were scheduled to attend a women’s retreat through my church at a beautiful lake camp. My husband came home to take care of the kids and we just saw each other in passing.
The theme of the weekend was how fire is used to forge gold. The speaker had posters that showed all the different stages miners go through to sift, sort, and produce gold from what looks like a pile of rubble. It spoke directly to me and helped me look at my current troubles as the refiner’s fire. On the way home, at the end of the weekend, I told my mom I had no idea what was ahead with my marriage but whatever happened I would be okay.
When I got home, my husband embraced me. He said that seeing the card he’d given me, reading the letter I’d written, and looking at the photos of our life together had caused a flood of emotions to wash over him and he remembered his love for me.
For him, that was all there was to it and everything was good, back to normal. I, however, felt like I had whiplash and wasn’t so ready to just put the episode behind us. We did move forward. I continued to see Carly, but my husband never did go in and meet her.
I’m so glad I had the opportunity to decide I would be okay whatever happened before my husband told me he wasn’t leaving. It made me feel much stronger. I made really good progress in counseling following this. My appointments were spread out to every two weeks. I started back with my coursework. Eventually, I saw Carly just once a month for a few months and then felt I was done. When I first sought help for this episode of major depression, it had been hard for me to believe there was light at the end of the tunnel, let alone see it, but after a year of medication and counseling, I had come out the other side.
I did go on to finish the course in medical transcription. The year that my older son was in first grade and my younger son was in kindergarten, I became employed, working from home, transcribing for a variety of doctors in another state.
I stayed healthy for several years until my second episode of major depression in 2008-2009. That’s another chapter.
*I want to note that my husband gave me permission to share this part of our marriage. Over the years, he has become understanding, empathetic, and supportive. We’ve been married almost 28 years now. I wouldn’t have survived these last seven weeks without him. Putting that in writing, seven weeks, gives me perspective. It really hasn’t been that long that I’ve been working to recover from this third, and worst, depressive episode. I need to be patient with myself.
Chapter Five 2008-2009
By 2008, my sons were in elementary school, my husband was working for a carpet store instead of running his own business, and I was working from home as a medical transcriptionist. This worked so well. If one of the boys was sick, he could stay home in bed and I could take care of him and continue to work.
I also had the opportunity to work as a student teacher supervisor. It felt really good to be back in the classroom in some capacity, using my degrees. Each quarter, I had three or four student teachers to visit once a week. I cut back on the transcription, so it was part-time.
During the fall of 2008, I volunteered to fill the position of Director of Women’s Ministry at our large church. I didn’t feel qualified but I’d been on the leadership team for years and, at a day long retreat, the consensus was that it should be me. At the end of the day, as we ate together around a long table, I said, through tears, “I don’t feel like I’m up to this. I’m just a vessel for God to use.” One of the other women said, “Oh, Sara. We’re all assholes for God sometimes.” Apparently the look on my face was priceless as I processed what she said and replied, “Vessel, I’m a vessel.” We all roared with laughter for quite some time.
So, I was working part-time doing medical transcription, part-time as a student teacher supervisor, serving as director of women’s ministry and attending bible study each Tuesday morning, a couples’ small group with my husband on Wednesday evenings while our kids were in the children’s program, and church each Sunday morning.
In September, I decided to take myself off my antidepressant and anxiety medication because my prescriptions were running out and my insurance didn’t cover doctor visits. For years, while my husband was self-employed, we paid for a policy that was considered catastrophic coverage; it kicked in to cover hospitalizations and surgeries. When my husband went to work for the carpet company, I continued on the outside policy because it was less expensive than adding me to my husband’s work benefit package.
As we headed into the holidays, I had a break from supervising student teachers. In early December, we had a women’s tea to celebrate Christmas and then took a break from ministry activities. I continued to work from home doing medical transcription.
It was very nice to not be on the go all the time. I stayed in my sweats and only showered every other day. I began to not feel well and stretched showering out to every third day, staying in my pajamas most days without bothering to change into sweats. The Christmas break from school started early due to a major snow storm. We ended up getting six feet of snow in ten days. Most businesses in our area closed. People were taking measures to clear their roofs so they wouldn’t cave. My husband was busy full-time clearing snow from the driveway, the deck, the roof and then starting all over again. He had to clear paths through the snow for the dogs to get around. The snow was as high as our fence. The Christmas break was extended past its scheduled end due to the continuing snowfall. My work, however, did not stop. I worked online for doctors in another state where they were not experiencing a major weather event.
I’m not sure why, but I felt like the unusual conditions were reason to drink. I drank a lot. I invented my own drink, using what we had in the cupboard, because we couldn’t get to the store.
Finally, school was back in session. I drove the boys to school because they had a history of getting into mischief on the bus. After I dropped them off for their first day back and was returning home, I turned a corner and saw what looked like someone had vomited across the snow. I broke into tears, which progressed to sobs, and when I pulled into our garage, I thought, “I could just close the garage door and leave the car running and this would all be over.” I called my mom and told her how I was feeling. She said, “Sara, you’re scaring me.” I replied, “I’m scaring me!”
My parents came over. We sat together in the living room. My dad asked why I hadn’t been to the doctor and I explained that my insurance didn’t cover doctor visits. A neighbor, who also struggled with depression, had given me Dr. Liz’s information but I hadn’t called. The neighbor even volunteered to pay for me to see her because he was so confident in her, but I didn’t feel like I could accept that. I admitted to my parents that I’d gone off all my medication and had been drinking a lot. My dad pointed out that alcohol is a depressant and was making things worse. I knew this intellectually but I’d been using it to self-medicate. I told my parents about the recommendation I’d received to see Dr. Liz. My dad told me to make an appointment and assured me that they would help financially.
I called Dr. Liz. I told her I had a history of depression and anxiety, had been off medication, and was feeling suicidal. She asked if I had a plan. When I told her I didn’t, she told me she could see me in two weeks. It surprised me that feeling suicidal was not an emergency unless one had a plan. My parents were planning to leave for Florida but postponed their trip so they could stay in town until I saw Dr. Liz.
When I first saw Dr. Liz, I explained to her that I had been through counseling and didn’t necessarily feel like I needed more talk therapy. This time, the depression felt very physical; my whole body felt sick from depression. Dr. Liz agreed with me that it was, indeed, physical. She showed me an MRI scan of a normal brain next to one of a depressed brain. The difference was startling. The depressed brain showed much less activity than the healthy one. She gave me a tutorial on depression, helping me to understand it more than I had from my own previous experience or my completion of a Master’s Degree in Counseling. She started me back on antidepressant medication.
My parents went ahead with their trip to Florida, where my sisters and I planned to meet them at the end of February to celebrate their 50th wedding anniversary. I plowed ahead with all of my obligations, supervising three student teachers, doing medical transcription, and serving as well as attending church activities. I dragged myself through each day with many of the symptoms I described in Chapter Two.
I did manage to travel to Florida for the anniversary celebration but was not able to go on day trips with the others.
Back home, I went to physical therapy to address pain I still had throughout my body because I hadn’t thoroughly addressed the injuries I’d sustained in the fall down stairs five years earlier due to the costs. I saw Dr. Liz regularly and responded well.
Unfortunately, it seemed I picked up every virus with which I came in contact at the multiple schools and the church. As much as I could, I rested and drank fluids between my many activities. I didn’t go to my doctor because I was sure he would just tell me to rest and drink plenty of fluids. This went on for months. As soon as I thought I was getting better, I’d get wiped out with another round of symptoms.
Mid May, I was lying in bed, so sick. I’d finished my student teaching supervision for the year. I’d stepped down from the women’s ministry team after a meeting in April at which I had kind of imploded from the stress of trying to recruit new team members in the midst of my two part-time jobs and ongoing illnesses. In bed, I’d feel freezing cold, so I’d put on mittens, a hat, and an extra blanket until which time I was overheating and sweating, when I would take off the mittens, hat, and blankets. This went on for days. I was throwing up anything I ate or drank. One day, I was unable to get to the kitchen to get myself something to eat or drink, although I knew I needed hydration. That evening, after my husband came home from picking one of our sons up at a friend’s house, he entered the bedroom where I was moaning miserably.
Immediately, he said, “Come on, baby. We gotta go to the hospital.” This surprised me because my husband hates going to doctors or hospitals. He told me my lips were dark blue and we needed to get help. I vomited one more time while he called my parents to come watch the boys. Our neighbors agreed to watch the boys in the meantime, and my husband helped me out to the car.
We went to the closest emergency room where I explained that I’d been sick with one virus after another all spring. They took urine and blood samples. Late in the evening, the doctor came in and explained that, while they couldn’t say for sure what was wrong with me, they couldn’t let me go home because my blood work results showed that I was seriously ill and at great risk of seizure or other complications. I told my husband to go ahead home while I waited to be admitted, which ended up happening about one o’clock in the morning.
I was placed in a two person room with an older woman who cursed like a sailor, loudly, at anyone who came in to see her, family or hospital staff. I was too sick to care. I had a fever over 103 degrees and terrible aches and pains throughout my body but particularly in my neck when I swallowed. It was excruciating. They started me on antibiotics and pain medication. I drifted in and out of sleep. When the woman sharing my room was discharged, a nurse brought me a little necklace from the gift shop that had a scratch on one of the charms, and probably couldn’t be sold. She said they wanted me to have it because I’d been so good about putting up with my roommate.
At one point, I got up to use the bathroom while two caregivers were in my room, and I had trouble walking the few steps back to my bed. The nurse and the CNA got me back in bed and checked my oxygen saturation. It was in the high 70’s, which is really bad. They started me on oxygen and placed an oximeter on my finger full-time. I continued to run a very high fever in spite of the antibiotics.
Because of the drop in my oxygen level, I was moved to the critical care floor. They took chest x-rays which showed that both of my lungs were compromised. They continued to draw blood repeatedly and run tests. They inserted a catheter so I didn’t have to get out of bed to use the bathroom. I was seen my the hospitalist, a pulmonologist, an internist, a cardiologist, and I don’t know who else. No one could tell me what was wrong with me other than I was in critical condition. They wanted arterial blood to measure the gases. The first phlebotomist was unable to draw blood from an artery in my leg, despite several attempts. They called in another, more experienced clinician who also had a difficult time but did eventually access an artery. That was very painful.
Daily, they wheeled me in my bed down to radiology for x-rays of my lungs; I’d have to get out of the bed and stand long enough for imaging. One day they did CAT scans of my head/neck, chest, and abdomen. They didn’t use iodine because there was some concern I was allergic to it. It was very painful to move into the machine and hold myself still while they took the pictures. The next day, after I clarified that I was not allergic to iodine, they did the three CAT scans again using iodine. In two days, I had a total of six CAT scans. They told me they needed to do a thoracentesis, where they use a really long needle to draw fluid out of the lung. The vocabulary I’d learned as a result of medical transcription really helped me understand what the doctors meant when they talked to me. When they took me to radiology for the thoracentesis, the doctor said to his nurse, “She’s not on blood thinners is she?” I answered, “Yes, they gave me warfarin earlier today.” The radiologist was really upset because doing the procedure with blood thinner in my system greatly increased the risk of complications. The only reason I knew that I had received a blood thinner was because of my transcription work. I was taken back to my room until enough time passed and then I was taken back down for the fluid draw. They removed a third of a liter from one lung but it was not informative. The CAT scans had shown nodules in the bottoms of my lungs but the fluid didn’t show any specific infection.
The next step was a lung biopsy. Because of where the nodules were located, they had to go through my ribs to reach the “ground-glass” nodules, rather than being able to go down my throat. The surgery took hours longer than planned because when they collapsed my right lung to get a sample, my left lung would collapse as well. After they finally got the biopsy, I was moved to the surgical floor with a chest tube inserted between my ribs to drain off the fluid. Having a chest tube between your ribs is excruciating. Every little movement causes terrible pain. It stayed there for three days. When time came for its removal, the dressing was taken off and the surgeon cleaned the area. He told me to get ready and counted down, “Three, two, one” and yanked out that tube. As painful as that was, it was such a relief to be done with it. The biopsy didn’t give the doctor any useful information.
I continued on antibiotics and pain medication. Finally, my fever went down and my blood work numbers normalized. After a total of ten days, I was released. The official diagnosis was bilateral viral pneumonia with viral overload resulting in multiple organs being compromised. My T cells were almost completely wiped out and I was anemic. I had follow-up visits with the pulmonologist and my primary care physician. I healed from the surgery but for months I had difficulty being up out of bed.
I stopped supervising student teachers and quit going to church. I returned to transcribing doctor reports after I’d been home two weeks. Not long after, I went back to see Dr. Liz. I told her everything that had transpired. She told me that if I hadn’t begun receiving help for depression earlier in the year, she was very sure I would not have survived the whole thing.
When I wasn’t typing, I was in bed. This went on for months. I thought I would never return to full energy and function. My younger son told me he didn’t like me being in bed so much. My husband, my mom and one of my sisters were all encouraging me to spend more time out of bed, but it was so hard.
After a year, I went in for an annual check-up. My doctor told me that I was still as anemic as I’d been when I left the hospital. He said they had assumed the anemia would resolve as I recovered from the pneumonia and surgery. It hadn’t. With treatment for the anemia, I was able to improve but it was another year before I felt I was functioning fully.
I continued to see Dr. Liz quarterly until she suspended her practice in 2013.
SurvivingSara 