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Sally

Age at interview: 25
Age at diagnosis: 19
Brief 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.

More about me...

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 that 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, 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.
 

Sally talks about how depression is a mental illness, and the fact that violent acts that 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 itself is like a stigmatized thing in America. Like with all these shootings and everything and all these things that have been going on you’re like, oh he had to be mental, he had to be crazy, he was crazy because 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, he had Asperger’s, he had access to guns. He had all these different things like, there were so many triggers for that, but when it comes down to it oh no, no, no he was crazy that was what it came down to, he had mental illness. So he was crazy. So everyone is like, quick to jump to conclusions when you say like, I 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.

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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, I just finished college and everything was like so great. You know college was so crazy busy and I was always doing something like every day, every hour just so busy and 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 just 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 interest in like, 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 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, I can’t remember what like the wording he said it was something about like “You’re a different person now. Like what happened, what did I do?” Stuff like that. 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 no emotion at all and like he would 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 snap your fingers and they are completely opposite but. So we got into like a lot of issues about that at the time and so he almost left. So like, that would have been horrible and now four years later we are like, living together. But yeah, so like talking about the symptoms and like things that could happen probably are 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 that. We were dating for, I don’t know, I guess like 2 or 3 months. So yeah, we saw each other most, you know, a few days a week and you know, he would spend the night and stuff, but it was very like new. So it’s not something that you want to like air your, I don’t want to say dirty laundry but like, you know the negative things about yourself to someone you are trying to impress. So, you know, proceed with caution I guess, have to kind of tread lightly with that kind of stuff. That’s kind of where it came from, I guess. 

Yeah, so if you were advising someone else you would say, on the one hand, be a little cautious but don’t let it go too far before you 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, just act like you’re perfect. Because no one is perfect and like, 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 normal and everything’s great and then all of a sudden you have 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.

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But like I have trouble doing arbitrary tasks, things that have to be done, that have to be done and need to be done to live, but that have repetition, 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 within 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 is just another pile of clothes and I have to do it again. So it’s just like constantly you know forcing myself to do it. Same with like, dishes. Same sort of thing, there is no end point. With school, because I’m in my master’s now, I find that’s like completely different for me, because like, with school work, like ok, I have 20 pages to finish and then I’m done. There’s like an end point, there’s something to look forward to. Where some tasks, like what I mentioned, where I’m 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.

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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.

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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 a session, I want to know that I, I want to 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.
 
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The suicide of a fellow student was Sally’s wake up call to get help for her depression.

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Like, I was living in a tower, I lived in the 22nd floor so I lived on the top floor and there were five towers and then someone had committed suicide right outside my, my building. 

… He jumped off like the 17th floor of the other tower. 

… And I got to that point and I saw the cops and I saw, I heard it like I heard like, the ‘splat’ pretty much. 

…  It was hard, it was horrible and at that point I was like, “Oh my god.” Like I never, you know, that wasn’t ever like my thought like to jump from the tower, but like I need like, I don’t want it to ever get to that point, like you know, like, I don’t want to keep thinking it’s going to get better and it’s not.
 
… So like that was kind of a revelation for me 
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