It’s January. Ten years ago on MLK Day, I had a rare day off because the outpatient developmental pediatrics clinic in which I was working was closed for the holiday. This should have been a joyous occasion for a newlywed who had been working 80 hours weekly (that the government knew about, anyway), not counting the hours agonizing over every decision once I got home to attempt fitful sleep at odd hours. I was homesick and mourning the loss of a beloved family member, but don’t those challenges happen to everyone?
But I woke up that morning sad that I was still there. I wasn’t suicidal–just apathetic and wondering how on earth my very happy life seemed beyond restoration.
Has anyone else lived through this?
This was uncharted territory. I’m an unquenchable optimist. My favorite color is yellow. I loved (almost) every minute of medical school. During an icebreaker game on the first day of intern year, we had to choose one alliterative adjective to describe ourselves: I chose “joyful.” Every day of my life had been infused with wonder and delight. I married the love of my life, and he was more perfect every day. I had matched at my top choice for residency. I have a loving, supportive family. My every dream had come true! I tried the Dr. Phil approach: “Hey, stop being sad!” I prayed. I called my closest friends.
Smith, not knowing what to do with his wife of just a few months, was steadfast. He listened. He spoke truth to me. He surrounded me by people who loved me. He encouraged me to find better separation between work and home so that I could truly rest. And on that sad MLK Day, he decided to take me on a cold weather adventure to paint pottery in a nearby town. We painted a dog dish for our beagle, Lucy, that has stayed with us longer than Lucy did. To this day, when I look at this dog dish, I remember how much my husband loves me and wants the best for me.
Soon thereafter, I was working on the pediatric floor in a particularly severe respiratory virus season and had to send a child to the intensive care unit every night I was on call. At the time, I was so bone-tired and unmoored that I just knew that these children became sicker because I was such a horrible doctor. I thought that my decision to be a physician (my dream for longer than I can even remember) was the sole reason for my state, but I couldn’t fathom doing anything else. I didn’t have the insight to know that I was clinically depressed, but even so, there was little time to deal with it if I had known. I grieved through our Valentine’s Day date and could hardly talk to my husband, my favorite person in the world. Food lost its taste. I would sit through church and cry. Outings with beloved friends became joyless. I would drive home post-call and not really care whether I made it over the expansive Betsy Ross Bridge safely. Realizing that none of this was normal, I saw a counselor. He offered that “practicing medicine isn’t for everybody” and appeared to be reading from a template that I was a “high achiever due to high parental expectations and needed to earn love.” This was ludicrous–my parents would have loved me and would have been proud of me if I had worked at the same dog food plant that gave my grandfather a gold retirement watch for his years of honorable factory labor. I paid the counselor and left, determined more than ever to find someone to help me. I was thankful for a spark of anger—motivated that I could feel anything at all.
Why am I sharing something so raw and so real?
Because you might be in the same place. Because, on MLK Day 2018, we took our children to paint pottery and watched them cheerfully create some truly hideous ceramic mermaids. I am a practicing pediatric specialist in an underserved area. I am incredibly happy. My faith is strong. My life is full of joy. And if I hadn’t hung in there with the hard work to heal back in 2008, I wouldn’t have had such a magical day–such a magical life. Smith is thriving as a pastor–and speaks of my time of depression as formative in his decision to leave a military career to go to seminary.
Looking back, I see God everywhere. I dug as deep as I could, trying to find the answers for the suffering of innocent children as I encountered over and over again the brokenness of our world (that’s a book, not a blog post). In doing so, I built a strong foundation to serve me the rest of my career. I examined my priorities. Fellow residents and attending physicians talked openly with me and extended lifelines. I took an antidepressant for a few months until I was able to maintain reasonable self-care off medication. The following year, I was ready to face a melanoma diagnosis with strength and resolve rather than devastation and defeat.
I’m begging you, if you’re struggling, reach out for help. You may have to reach out repeatedly, as I did after my ill-fated first counselor experience. (Please hear me: counseling with a qualified professional is incredibly valuable. And spoiler alert, your pastor or other religious authority may not be a “qualified professional.”) I asked my long-time friend, psychiatrist Julia Wood, MD, for her tips on finding the right counselor. She emphasized, “Fit is incredibly important, so if you don’t have that, don’t be afraid to move on. You can even ask the counselor themselves for another recommendation. They may have good ideas. Also, look for someone who has a modality they draw from—such as cognitive behavioral therapy (CBT), for example. A therapist should be able to explain his or her approach—it’s not just chatting or listening.” She also suggested checking http://www.NAMI.org or a Celebrate Recovery group at a local church.
Here are my other tips, based on your experience:
- Find your village. Find people who you can speak openly to, ones who won’t accept “I’m fine” for an answer when you’re not fine.
- Establish good boundaries. Do not assign blame to yourself that is not yours to own. There’s no prize for burning yourself to a crisp, and the people you serve won’t benefit from your martyrdom.
- Don’t be afraid of medication. Depression is ultimately a neurotransmitter problem that needs to be corrected. Refusing treatment is as foolish as rejecting insulin for diabetes or antibiotics for infection.
- Exercise. Even if that’s running up the hospital stairs instead of using the elevator.
- Food doesn’t fix depression. I promise. When you’re a bottomless pit of despair, food will not fill it. (Neither will spending more money, so I’m told.)
- Find every opportunity to be grateful. Gratitude is light in the darkness. I read Ann Voskamp’s One Thousand Gifts nine years too late, but it’s a gem; I’m currently loving Katie Davis Majors’s Daring to Hope.
- Pray. Pray, and pray some more. Meditate. Center. Talk openly and honestly with God–read the Psalms for inspiration.
And perhaps, here’s my most important piece of advice. January is a hard time of year. It’s like the White Witch’s Narnia–always winter and never Christmas. It’s dark almost constantly, and the sun is so very far away. Healthcare workers are especially vulnerable–hospitals are full and busy, we often work despite our own sickness, and surrounded by others’ suffering, we feel that we can never emerge with any joy intact. If you’re a seasoned hospital worker, keep a sharp eye for people around you who are struggling. Offer them warmth and light in a season that seems void of both. You might just save a life that isn’t on your patient census.
I’m reminded of my former senior medicine resident Carletta, who was instrumental in shepherding me through my struggle from across the country. She told me about a young participant (let’s call her “Susan”) of a Bible study she was leading who came to a session visibly distraught. Susan confessed that she felt awful since stopping her medication, Lexapro, but that she was feeling so much better in her vibrant church community that she felt taking it was a sign of weakness. Carletta smiled at her and asked, “Well, who do you think made Lexapro? It’s a gift from Jesus Himself!” As Christians who believe that every good and perfect gift is from above (James 1:17), isn’t this the truth? Fortunately, Susan resumed her medication and continued to thrive. This speaks to the lack of openness in the church at large to address emotional as well as spiritual well-being. Fortunately, the tide is turning. Check out Christ Presbyterian Church’s pastor, Scott Sauls, who has written widely about his struggles with anxiety and depression (one particularly excellent post here: https://scottsauls.com/blog/2014/06/20/anxiety-depression-strange-friends/). I am devouring his most recent book, From Weakness to Strength. I am hopeful that continued efforts at honesty from those who have suffered and welcome to those who are suffering that we can lead the way for healing and wholeness for everyone.
Remember, I’m a pediatric endocrinologist, not a psychiatrist or psychologist. My experience was mine alone. I hope by sharing it, though, that I can encourage others to seek out help for themselves or their loved ones.