"The good physician treats the disease; the great physician treats the patient who has the disease." ~ William Osler

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**Disclaimer -- I am not suicidal, I am in no danger of hurting myself. I am, however, struggling with recent events.

I've been through a lot of things in the past 54 years. Emotional turmoil, divorces, child death, deaths of my parents, job changes, moving, custody battles, legal issues, financial issues, physical ailments -- all take a toll on the mind and body. I've been to counseling - family, marriage and personal. I have a deep, deep faith and belief in God.

My first foray into counseling, as a child, was with my mother and sister. At the time, I was suffering from trichotillomania (although I didn't know what it was called). I was in junior high, as was my sister. Stress was extremely high and I had pulled out my eyelashes and eyebrows as a result. The counselor sat there in front of me, and stated that she thought I'd be fine and focused on my sister's issues. A young teenager without eyebrows or eyelashes is not . . . FINE. I didn't do it to get attention, I did it because it was the only way I knew how to deal with all the stress I was under. I never felt more invisible in my life, as if I didn't matter.

Many years later, after some severe legal issues, I sought the help of a counselor. We discussed what was happening, my thoughts about the situation, and I filled out a depression scale questionnaire. Although my EAP approved six visits, the counselor opined that I didn't need any further visits past the first one as he felt I was "resilient and handling the situation quite well." My symptoms didn't register on the depression scale -- he was treating the scale, not listening to what I was saying.

Let's look at some of the items on the scale, whether it is the PHQ-9, Beck's, or the Hamilton.

  • Sadness - being depressed doesn't equal being sad, sometimes it's anxious or afraid or uncertain
  • Failure - not every person with depression feels like a failure, if it's situations beyond their control they may recognize that it's thru no fault of their own that these things are happening
  • Guilty - see above, not every situation is caused by the person who is feeling depressed, therefore they have no guilt
  • Punishment - life happens, bad things happen - to good people even, bad things are not necessarily a punishment
  • Activity level - depressed people may stay active if they feel that it can help their depression, depression is not always about staying in bed or not being able to get dressed
  • Work - especially if there is family who is dependent on the depressed person, they may still go to work and function because they HAVE TO, not going to work is not optional if the depressed person is the sole provider
  • Eating - some people who are depressed realize that they must eat, and will do so even if they aren't necessarily hungry or have no appetite. Especially if, as above, they are the sole provider for their family, they realize that quitting everyday life by giving in to the depression is not an option.

Recently, we've had a very stressful situation arise. It is beyond my control, there is nothing I can do to change it. The responsibility lies on another person. Until the situation is investigated and a resolution is reached, the stress is here. I can acknowledge that it is stressful, I'm dealing with it the best I can but I don't want to talk about it ad nauseum. I've had others mention that I am handling it "so much better than (they) would." Really? If there's another option, I'd LOVE to hear it. Unfortunately there isn't. Screaming and yelling accomplishes nothing. Crying just gives me a headache. Going on about the days with the regular rhythm and routine is what has to be done until we learn something different.

The saying is out there, "Be kind to everyone you meet, you have no idea what they're going thru." How absolutely true is that? Most people, to look at me, would never guess that I am struggling. I still accomplish many tasks, more than most, throughout the day -- certainly more than a depressed person would be able to do, right? Sometimes staying busy is one way of dealing with the depression and anxiety. I'm still upbeat and smiling but that is only the face I show, not everyone is privy to my innermost thoughts.

Depression is real and affects different people in different ways. While there are many symptoms indicative of depression, we need to understand and acknowledge that some people, such as those with high functioning autism -- those that deal best with logicality, may not exhibit the routine symptoms of depression. We must lost the ideology that symptoms of depression are cut and dried, and LISTEN to the words that are being said.