adjustment disorder

Reading my journals

Peggy Rice2 Comments

I just finished reading my first journal. The one I wrote when I started into depression. It began at the end of March 2008, and went to mid-October. From my first appointment with my therapist, to the diagnosis of adjustment disorder, through my first panic attack, my subsequent climb out of depressive symptoms in the summer, and the beginning of my descent into full-blown Major Depressive Disorder.

I’m reading to refresh my memory of what I felt at my worst. I’m reading to see God’s faithfulness to me in my angst. I’m reading to discover my symptoms and how I behaved in my depressed state.

I had forgotten that my sleep schedule was all messed up. During the beginning of my experience, I repeatedly woke at 4:30 or 5:00am each morning. That is not me; I sleep until 7:30am most mornings. But I didn’t see that sleep disruption at the time – I just went with it. Looking back on it now, I recognize it as a classic symptom of depression – a change in sleep patterns.

I remembered that I used to drive to a boat landing to be alone with my loud music and the thoughts that made it past the beat-beat-beat in my earbuds. I didn’t realize that the pattern had started all the way back in the beginning; my memory told me that I didn’t develop that habit until I was severely clinically depressed. But my journal tells another story – I found respite at the water’s edge early on in my journey.

I learned in re-reading my journal that several of my distinct memories of depression actually occurred during that first stint – when I was diagnosed with “adjustment disorder with anxiety and depressive symptoms.” Many of the encounters that I read about were early-on, not much later in my experience, as I had previously thought. Funny how vivid those first memories are.

I’m glad I’ve waited until now to read through the journal. And I intend to read all of them from the first seven years of my depression – that’s 12.5 books of writing. But waiting was a good idea – I’m emotionally stable enough – mentally healthy enough – to go back to those memories without getting sucked into the emotion of them. I can handle them.

What is Depression?

Peggy Rice3 Comments

According to Mayo Clinic, “Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn’t worth living.” (mayoclinic.org)

Depression is more than just feeling down or blue for a few days. There are strict criteria for a diagnosis of Major Depressive Disorder, including 5 characteristics that must be present for two weeks or longer to result in such a diagnosis.

My depression started as adjustment disorder.  That’s a diagnosis for when a stressful situation – in my case, relocating – creates out-of-the-norm reactions for such an occurrence.  Usually, adjustment disorder resolves itself within a few months. My story is that I had moved back to the town where we had lived for many years, and while I knew that relationships would be different, things just didn’t pick up where they’d left off. Yes, I went back to the woman who had always cut my hair. And I found a new doctor who I liked very much. But my friendships had changed. The church leadership was different, and I wasn’t supported in my volunteering with Vacation Bible School, which I had previously directed many times. I was lonely even with old friends around, and everyone was so busy with their lives, I felt alone and isolated.

I was easily irritated, though I tried not to let it show. I was anxious and worried about a lot of things, which had never been a problem for me before. I began to experience physical symptoms – backaches and headaches. Stomachaches, feeling a hole in the center of my body.  I had trouble sleeping – either too much or not enough. It became a chore to do simple things, like take a shower.

I got my old job back, and found a new church where I was accepted and given leadership in Women’s Ministry. From the outside, all things looked good. But my mood was consistently low and I had no joy.

When the adjustment disorder didn’t resolve within in a timely manner, it became Major Depressive Disorder (MDD). My mood continued to darken, I found it very hard to concentrate and focus, and life seemed blah. I began to feel hopeless, like things would never improve.

In my case, depression was a progression from adjustment disorder to MDD. For others, it can seemingly come out of nowhere. It can be related to past hurts or abuses. It can manifest itself as anger. There is no single cause of depression, which makes it difficult to treat.

For me, the prayers of others, the proper medication, and cognitive behavioral therapy and talk therapy were hugely instrumental in my healing. It wasn’t an easy path – it took several years to find the right medications.  But that’s a topic for another blog post!