Diagnosis – Peace of mind

by Anna (pseudonymous)

I have been seeing a therapist regularly for the past several months to help with my deepening depression and increasing anxiety. She has helped me a bit, giving me strategies for reducing stress such as progressive muscle relaxation and breathing exercises (which I usually forget to do. Oops). And while I have improved in some respects – for instance, forcing myself to do more household chores and listen to music again (have you heard Lady Gaga’s new single? I love it!) – my mood continues to deteriorate. She decided it was time to explore my options regarding antidepressant medications. I agreed fully: at this point, I’ll try anything that might make me feel better.

Therapist referred me to a psychiatrist and I had my first appointment yesterday. The person I saw is actually a NP, but that didn’t seem to make a difference: she was wonderful. She read me like a book and after talking with me for a little over an hour confirmed the things I have suspected for some time but had no way of validating on my own.

I started by telling my story as concisely as possible: I am a mother, wife, and graduate student, very close to finishing up my doctoral degree. I have a number of chronic conditions including fatigue, epilepsy, and autoimmune thyroiditis. I’m anxious and depressed. I became permanently estranged from my abusive parents over six years ago. I am in therapy now but have never been treated for depression. We talked for a little while, she asked a lot of questions. Then she asked me to fill out three surveys, one dealing with anxiety, one with depression, and one with ADHD. When I finished, she scored them and said, in a very empathetic tone, “You are depressed.” Then she turned to me and said, “Kiddo, you have PTSD.”

I knew it. I knew it!

Not only did she confirm what I have suspected based on my own research, she also confirmed that the PTSD is very likely the cause of all of my other issues. The epilepsy (for which no MRI or EEG has ever uncovered a physiological source), the autoimmune disease, the fatigue, and of course the anxiety and depression. She said, “You are on ‘red alert’ at all times; you are not worried that something bad might happen, you know it will and you are constantly on guard waiting for it.” She explained that this constant state of vigilance was a necessary coping mechanism when I was a child in an abusive household, but now it is making me sick. She also said that I am quite intuitive and good at “reading” people – after all, I had to be growing up so that I could predict the oncoming storm and give myself a chance to get away – and when people are impassive I often interpret those social cues (or lack thereof) as judgment or rejection. And I have a terrible habit of internalizing all judgment and rejection, perceived or real, because in my parents’ house I was always safest when I kept silent.

She knew all of that just by our brief conversation and my survey responses. She has seen it all before hundreds of times. And she was so dead on, I almost felt naked. I couldn’t help but cry.

She was very careful to point out, repeatedly, that none of this is my fault. She said that I am a survivor – and although I have used that word to describe myself, nobody else ever has, not even my therapist. She said that she is amazed at how well I have managed life up to this point, but now I need help. And she’s right, I can’t do this alone anymore. So we discussed my options with regard to medication, and in the end decided the most important thing right now is to deal with the anxiety. I mean, the depression SUCKS, but the fear is what keeps me from getting work done and leaves me feeling like a nervous wreck. It is also making the depression that much worse. She suggested Zoloft, which is indicated for depression, anxiety, and PTSD, and also has fewer side effects than many SSRIs. She said that I shouldn’t expect my mood to change for several weeks, but that it should help with my anxiety right away. It sounded great to me.

I’m on day 1 of Zoloft and haven’t noticed a huge difference yet, but I know that these things take time. I have high hopes. I am finally optimistic that this is something I will get through. The definitive diagnosis of PTSD is a little alarming, though not surprising, and it explains everything. EVERYTHING. My enemy is no longer faceless. It has a name, and now I can learn more about it with the knowledge that I definitely have it, rather than a vague, unsubstantiated suspicion. I don’t know how everything will play out from here, but this is progress.

There is hope.