Are you depressed?

         
 ARE YOU DEPRESSED?

Well...are you?
Should you be?
Would you be?

This is the ONLY question my GP ever asks me in an appointment and it's got me in reflection mode.

Over the last few years I have most definitely been challenged more than ever more both emotionally, physiologically and physically. Having a seemingly normal life and then having this horrid illness affect me and hit me severely has definitely changed parts of me. This change has been both negative and positive at times.

I would think most people given my situation would have a similar reaction to me but really, who knows?!?! We are all uniquely wired and our coping mechanisms vary greatly across similar situations. Honestly given my situation I feel I've done OK. Sure at times I've felt broken and defeated and other times I've felt inspired and determined, it's all relative to what's going on and my perceptions of events.

When I got diagnosed I had been in hospital for at least a few weeks/months and been through SO many gruelling tests and scary differential diagnosis. I was told I may have terrible life threatening conditions and to be prepared for bad news while other times the answer was that they didn't have a clue, so when I got my diagnosis I was happy. I was not happy that I had dysautonomia I was happy to put a name to this hell I was experiencing. I needed something to affirm what I was feeling and why I was feeling it. I was happy to have an answer, regardless of what it was as it was more than those horrid words of 'We don't know yet, it's very complex and we have never seen this before'. It was validating my experiences to some degree.

Then came the realisation that I was not a typical case and that I was infact severely disabled and totally reliant on others for every aspect of my life. For any independent young person or older person or anyone, being stripped of your independence and dignity would be challenging. I was no exception. I was sad and upset, I cried, I screamed and I fell asleep with tears rolling down my face. I was angry, I was jealous and I felt I was dealt and unfair hand at life. Things were going well and life was good before this happened so it was so far from my previous reality.

Was I depressed then??

I wondered this from my first day of realisation and I still wonder this at times. Initially, like the very early days, in my head this was all nothing major and that this whole health drama would blow over and I'd be back to normal in no time. I even convinced my friends and family of this because I actually whole-heartedly believed it. Upon realising my severely declined health status I started to question myself, my family and the health professionals involved on my team as to whether they thought I was depressed. Was I coping and dealing with everything or was I in total denial? I did a lot of thinking and a lot of mourning my 'old life'.

This whole journey and experience was always bound to involve interesting thought processes, internal journey and many interesting discussions. My feelings and emotions changed my outlook of each day but the whole time I have done my best to stay positive. In the first few months in hospital I wondered about depression. I wondered about how to overcome this situation and continue to look forwards. Once diagnosed with dysautonomia and other comorbidities I was placed on an antidepressant type of medication for an interrelated pain issue and also as a form of treatment in stabilising the autonomic nervous system which has been used in many literature for co-managing POTS with success. I hated the drug as it did nothing for my unconsciousness and so I was switched to a different one with a more pain controlled focus which worked well. I was not placed on one for depression which I found strange. There were many days I wondered if the medication was masking the depression or helping me, but I came off the medication with no problems so I don't believe it was sustaining my mental health. Did the medication have any significance given that my dosage was below the therapeutic dose for depression?
Did that mean I was not depressed? Or that I was coping ok if I was suffering?
I don't know. Maybe. Maybe not.

My life is no where near adequate or great as before illness but it's the life I've got right now. I have sad and happy days I have deep and dark times and there are moments which I can almost forget about my current state. For me, this changes on an hourly basis, just like the tides in a sea.
So do these emotional changes make me depressed?
This is something I have asked my team continuously over the years.

I have continually been told along my journey that I am having a perfectly normal response for someone who has experienced a traumatic and drastic change to their life - such as this illness. I have constantly been told by professionals that know me extremely well that I am not clinically depressed. So I read up on the true definition of clinically depressed and I agree, I am not clinically depressed. I am devastated and I have downs & ups and high & low times but these are all typical responses to my situation. I sometimes feel depressed or at least what I think it is to feel depressed but this does not mean I am clinically depressed.

I have been honest with myself and my team and family along this ride and I feel confident in their ability to speak with me if they feel something is wrong. Since coming home though, I have a few added members to my team who don't know me so well just yet. One of whom is my current GP.
My GP doctor is kind and lovely. She's not as gorgeous and on top of things as my previous Dr (mr hottie) as he was really good but she does the job. I mostly go and tell her what I need and why, and update her on all of my specialists, but there is always one thing she asks. It's not my blood pressure readings or my heart rates or which antibiotics I'm on, it is always the exact same question...

"Are you depressed?"

I have now seen this doctor for a few months regularly and I saw her again this week where she asked her question and I left thinking to myself is that her management? Is that an appropriate approach to my situation? Is this what she thinks I should be?

I've thought about it and I have become a little irritated. I do not believe she asks every patient who comes to her office if they are depressed, yet because I have chronic illnesses I am automatically assumed to be depressed. If it was only every so often then this would not be a point of consideration, I do not think it is fair and I also think it is quite naive.
It appears to me that her assumption is because I am very disabled and have little function and live my life with a chronic illness, that I must be depressed. I understand and appreciate the subject being touched upon at times but I do not agree that it should be assumed I would or should be a certain way because of what her perceptions are of my life.
I think this professional has a very unprofessional an unempathetic way of asking a potentially serious and meaningful question. If it was incorporated in her conversation or amongst other medical dialogue then it wouldn't seem so brash. I am lucky I have a great medical team and family and support network in my life to speak with and discuss my thoughts and issues with but I don't know if I would find the bluntness and directiveness of her repetitive single question during an appointment helpful or inviting. If I wasn't dealing with my feelings and emotions I do not believe I would feel comfortable and happy to discuss such things, given my feelings that the assumptions she makes are consistently inherited in the question and the tone of voice in which it is delivered.

So this week at my GP appointment I was asked once again "are you depressed?". My answer was that I don't think so. And suprisingly that was sufficient for her. I wonder what she would do if one day I say "Yes". Would she know how to cope? Would she put me on a medication? Would she ignore my admission? Until or if this ever happens what she takes from the answer is unknown to me and what I think about this continual and singular focus is unknown to her. Don't you love human nature and it's mysteries.

After this experience all I know is right now in this minute I am a number of things. I am determined. I am sad. I am happy. I am nervous. And I am hopeful for the future. Right now I am focusing on being the best I can in every aspect of my life. I have good days & terrible days. I am only human. I commit myself to act if I find my mind slipping into a negative or depressed place. Hiding something as deep as depression would be awful and I hope that anyone who needs help can find it.

Although I do not agree with the way the GP asks her infamous only question, it has reminded me to continue to keep my mind in check and ask myself 'are you depressed?' because at the end of the day, I am the one that knows my mind and my body, not anyone else.