Sally

Age at interview: 25
Age at diagnosis: 19
Gender: Female
Outline:

Sally’s depression began when she was a teenager and her parents separated. She continues to struggle with it, particularly during times of transition. Medication has helped, as has her supportive boyfriend, her pets, and organizing her life with a combination of flexibility and structure.

Background:

Sally lives with her boyfriend, dog and cat in an apartment in a suburb. She is in graduate school part time and works as a researcher. She is Middle Eastern/Egyptian.

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Both of Sally’s parents struggled with depression throughout her childhood. Her own experiences with it didn’t begin until the second half of high school, when her parents separated and questions about where she and her brother would each live loomed large. That first episode of depression lasted only a few weeks long, but when she went to college a couple of years later the same symptoms returned and this time did not quickly fade away. She felt overwhelmingly sad, struggled with basic everyday tasks like brushing her teeth, was lonely and overwhelmed, and had trouble eating, During her second year of college, her mother took her to the doctor for help and she began both therapy and medication.

For Sally, therapy has been very helpful – but only when she can find the right fit with a therapist, someone who “clicks with you” the same way you want to click with people in other non-professional relationships. This has not always happened; for example, she had one psychiatrist who projected his own values onto her in an objectionable way. She has also had some excellent therapists in the past. However, changes in insurance eligibility has made it hard to stick with that person. Medication has also been useful, helping to correct a chemical imbalance which returned in full force when Sally stopped taking it to see if it was really necessary. Medication is a bit of a mixed bag though, because it can cause weight gain and make her feel “flattened.”

Sally works as a researcher, and also goes to graduate school part time. Repetitive tasks like laundry remain challenging, but she gets through them. She also tries to adapt her circumstances to minimize stress, for example by finding a job with flexible work hours and being able to sleep a little later some days so that her busy schedule doesn’t become “too draining” on her. Her boyfriend is an important part of her life and support system. Although he may not understand what she is feeling all the time, he has learned simply to hug her when she is feeling sad, “Just enough to be present but not overbearing”. Her cat and dog make her feel less lonely and are “very helpful” when she is sad.

Sally wants other young people with depression to know that they are not alone, but “we’re like, sort of hidden… [but] there are people around that are feeling the same way you are.” She says it’s important not to “hold everything inside” and to realize there is always some person or some pet to talk to and be with.

 

Sally says a lot of people don't realize depression is a real thing - a chemical imbalance you can't just make yourself correct.

Sally says a lot of people don't realize depression is a real thing - a chemical imbalance you can't just make yourself correct.

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Well, like I said earlier, like even my boyfriend who sees my behavior every day, he still doesn’t understand like, what depression even is. People are, a lot of people are like, oh like you’re sad snap out of it you know, like they don’t understand that depression is a real thing. You know most people, everyone experiences some kind of depression at one point or another, but those people who have like, I wouldn’t say chronic, but depression may feel for many years or you know uncontrollably you know like for me like definitely a chemical imbalance. You know, it’s different, it’s different than like bereavement, experiencing death in your family, different than like you know feeling sad because your boyfriend broke up with you or something like that. Like, it’s that but like, twenty times worse.

Genetics – that is, traits or susceptibilities passed down through biological families – was also named by many as a cause of depression. Marty thinks his depression was passed on through his mother’s side of the family; his siblings are not affected, but he “drew the short straw.” Maya said she thinks there is a genetic component to depression that “dictates sort of your set point for happiness.”

 

Sally talks about how depression is a mental illness, and the fact that violent acts are sometimes committed by mentally ill people increases stigma around depression.

Sally talks about how depression is a mental illness, and the fact that violent acts are sometimes committed by mentally ill people increases stigma around depression.

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On top of all that, depression is considered a mental illness, so, mental illness in and of itself is like a stigmatized thing in America. Like with all these shootings and everything, and all these things that are going on, people are like, “Oh he had to be men–, he had to be, he had to be crazy, he was crazy ’cause he had depression.” Like the Sandy Hook thing that happened. He, yeah, he had depression, he had anxiety, he probably, they just talked about him having anorexia, Asperger’s, he had access to guns. He had all these different things like, there were so many triggers for that, but then it comes down to, “Oh no, no, no. He was crazy.” That was what it came down, he had a mental illness. So he was “crazy.” And so everyone like, is quick to jump to conclusions when you say like, you have a mental illness, or you have a mental issue, or you’re seeing a therapist.

 

Sally did eventually tell her partner about her depression and the relationship survived, but she wished she had told him sooner.

Sally did eventually tell her partner about her depression and the relationship survived, but she wished she had told him sooner.

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I remember when me and my boyfriend first started dating. God, it was a long time ago, it was like 4 years ago now. I was like feeling … I had just finished college and everything was like so great. You know, college was so crazy-busy and I was always doing something every day, every hour like, was so busy and then I graduated and I had a line up for a job, but I didn’t start for like another month. So I just went from like, super busy to absolutely nothing. And I got so depressed, just like, didn’t want to do anything, just stayed in the house all day and like I couldn’t do anything because I didn’t have any money, and like, I lost like interest in sexual activity and I didn’t want really, I wanted him around but I didn’t really know what to say, and I was just very distant. And he like got to the point of almost like leaving me because he had no idea why I was like, all of a sudden so distant and like, changed my attitude toward him and he said like, what did he … I can’t remember what like the wording he said, it was something about like, like where, like, “You’re a different person now. Like what happened, what did I do?” Stuff like that. Like, I remember like, we would, you know, like, have sex and stuff, and I would just be, there, but not really there. It was kind of just very, bland and, I was kind of just like dead, with like no emotion, at all, and like, he would, he’d notice, obviously, it’s not something that, you know, you just see someone and they’re normally one way and then all of a sudden like, like, snap your fingers and they’re completely opposite but … So we got into a lot of issues about that, at the time, and, and so like he almost left. So like, that would have been horrible, because now four years later we’re like, living together. But yeah, that’s, so like talking about the symptoms and like things that could happen … probably, better to do beforehand rather than have it come up.

And he didn’t, know about your depression at all before that?

No, it was too new. You know? It was like, way too personal of a thing to tell someone, like we were dating for, I don’t know, I guess like 2 or 3 months. So it was like, yeah, we saw each other most, you know, a few days a week, or if he would spend the night and stuff, but it was very like, new. So it’s not something you, you don’t want to like, air your – I don’t know, don’t want to say “dirty laundry” – but like, you know, the negative things about yourself to someone you’re trying to impress. So, you know? Proceed with caution, I guess. Kind of, tread lightly with that kind of stuff. But yeah … That’s kind of where it came from, I guess.

Yeah. So if you were advising someone else, you’d say – on the one hand – be a little cautious, but don’t let it go too far before you’d tell somebody you were close to?

Yeah, at least, like, give them some hint or, some, I don’t know, anything, say anything about it. But, don’t just leave it in the air, or just act like you’re perfect. Because no one’s perfect and like, you know, this, you know, if you have diabetes you wouldn’t be embarrassed about it, but, you know, everyone, is a more of a stigma with depression but, you know, you definitely have to say something if you’re the type of person that can switch from being normal and everything’s great, to all of a sudden having no desire, what so-ever.

 

For Sally, tasks that need to be done repeatedly, on a daily or weekly basis, are hard to manage. Anything she has to do just once is much easier.

For Sally, tasks that need to be done repeatedly, on a daily or weekly basis, are hard to manage. Anything she has to do just once is much easier.

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But like I have trouble doing arbitrary tasks, things that, that have to be done, that need to be … that have to be done and need to be done to live, but that have, like, repetition, that, like, they never have an endpoint like, like putting away laundry, and doing laundry, and hanging clothing, stuff like that I have always had trouble with, but definitely got worse in the last like 5-6 years. Like my boyfriend will do laundry and it will be folded and sitting on the bureau for weeks at a time and I just won’t be able to put it away. Just the whole idea of it is just so tiring, and then I finally get the courage to do it, or not the courage, I guess, like the motivation to do it and then it’s finally done, it’s so relieving and then like four or five days later, there’s just another pile of clothes and I have to do it again. So it’s just like, constantly, you know, forcing myself almost, to do it. Same with like, dishes. Same sort of thing, there’s no end point. With school, because I’m in my master’s now, I find that’s completely different for me, because like, with school work, it’s like, “Okay, I have 20 pages. Finish these 20 pages and then I’m done.” There’s like an end point, there’s something to look forward to. Where as some tasks, like what I mentioned were, were, not able to overcome them very easily.

 

Sally notes that in her insurance network, psychiatrists are considered specialists and the co-pay is a lot higher than for doctors who are not specialists.

Sally notes that in her insurance network, psychiatrists are considered specialists and the co-pay is a lot higher than for doctors who are not specialists.

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I don’t know if it’s the best way, but then at the same time psychiatrists are considered specialists for insurance, so it’s more expensive with co pays and stuff like that so you know, it’s really, it’s really difficult to, you know, find a place where you could be. You know, get therapy and get the help you need and get the medication you need and not you know like fall in that crack.

 

Sally describes how to her a sign that the therapist is a good fit is that she thinks about the points that were made in the session afterwards.

Sally describes how to her a sign that the therapist is a good fit is that she thinks about the points that were made in the session afterwards.

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Yeah, I guess it’s hard to explain. It’s sort of like, it’s sort of like, with someone you meet and you want to be in a relationship with them. Like, there’s some sort of spark that like, you know, that happens with the first day you meet them even. Like, something about the way the session goes or something about the way that. Like when I leave the session, I want to know that I, I want to still have the thoughts in my mind of the things that we talked about. The point that it had an impact on me even after one hour. So if that’s like, you know, the case then, then I feel like, you know , something, that, that might be the right one for you. If you have that like in the back of your mind, “Oh that was a really good point she made” or “I never really thought about it from that perspective.” You know, if you’re able to have that revelation or that thought that you never had before, you know, obviously something is coming of it. So I guess that’s kind of where it comes from.