My Five Stages of Depression
Elisabeth Kübler-Ross’s breakthrough concept of the Five Stages of Mourning: Denial, Anger, Bargaining, Depression, and Acceptance is a perfect template for my own Five Stages of Depression: Anger, Anxiety/Exhaustion, Depression, Treatment, and Recovery.
Anger sometimes comes on quick, like an explosion, or it can smolder in a slow burn. By age twenty-seven, I had experienced a miscarriage and two positive pregnancies within three years. In addition, my husband was changing jobs quicker than I was changing diapers, so we had several moves during the early years of our 30-year marriage (and also later years). I would barely get the curtains hung when we were off and moving to another city to catch his rising “career star.” I had so many different sized curtains I could have opened a window treatment shop!
Two kids in diapers without a washer and dryer in our apartment was one of the problems. This was the mid-1960s, when disposable diapers were new on the scene—we used cloth diapers because that’s what I knew. I would run over to the laundry room in our apartment complex while my babies napped and rush back before they would awaken. I was angry and anxious the whole time; angry I had no washer and dryer in the apartment and anxious about leaving the children unattended.
Additionally, we had only one car, which my husband used to commute to work and so I felt trapped in our apartment. I felt caught with a constant assault of diapers, dishes, and douches! Anger grew and resentment reigned.
Finally, I had very little experience with infants. As a teacher, my school students were already walking, talking, tying their shoes, and using the toilet. The constant attention required raising children, with a little help from my husband, wore me down and, with each move, my energy depleted further. I worked part-time as a substitute teacher and also as a waitress on weekends. It was exhausting, but hoofing it between tables with a pot of coffee in one hand was how I earned good money.
Finally, the exhaustion became critical. I couldn’t, or wouldn’t, get out of bed. I made a feeble attempt at hurting myself (with a superficial cut to one wrist), my cry for help, and ended up in a mental hospital—that’s how it was called in those days, not a psychiatric hospital or crisis facility—a lunatic asylum. I remember hearing noises all night and the light in my room never shutting off. I felt really alone and scared, but did not know how to reach out.
My husband was told that I was schizophrenic and would never recover. Remember; this was the 1960s, when mental illness was very much misunderstood. I did not suffer from delusions or psychosis, so I’m not sure why that diagnosis was made. (I did recover, but the road back was rocky. Maybe that’s why I don’t like Rocky Road ice cream!)
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Returning to my parents’ home in Central N.J., where my two small children were lovingly cared for by my mother and father, with my husband commuting to their home on weekends, I started sleeping more and more until I could not be awakened.
I remember that when I slept, I felt the world I was in would go away, so sleeping became my escape from the depression.
I was rushed to the local hospital and given ECT (Electro-Convulsive Treatments), better known as “shock therapy.” I don’t remember this because I was catatonic and the subsequent treatments are vague in my mind, since I was put to sleep for the “therapy.”
While recuperating from the treatments for major depression at a hospital near where we lived in North Jersey, I was raped by a male hospital attendant who was later fired, but our lawyer decided going to court would be too stressful, so we did not press charges. When I shared the rape with my husband, he became angry and blamed me. This certainly didn’t help with my recovery. The only redeeming fact about my depression is that the rape was an out of body experience (OOBE) for me, that is, I did not feel that I was the one being raped, but rather someone else, and I was just an observer. I did discuss this with my therapist years later, and I do consider myself a survivor of my hospital trauma, but I do not think I suffer from PTSD.
Lots of people believe that ECT is dangerous. Maybe it is. It doesn’t work for everybody, but it worked for me, because I am alive and well enough to tell my story. I think the road to recovery is a difficult one, requiring all kinds of therapy, including dietary supplements, which were only beginning to be used in the 1960s. Many years later, I read that depression is the way the body withdraws to survive, and that makes sense to me. However, at the time I experienced this trauma, mental illness was still something to be ashamed of, and guilt and embarrassment superseded all other feelings. I think a better diet, a long vacation, and more help with my children from others would have been positive steps I could have taken had I known more about my own illness.
Fast forward to 1990, when my thirty-year marriage ended and, after two years of struggling financially and emotionally, I had another breakdown of body, mind, and spirit. At the same time that my divorce was eroding my sense of self, I started experiencing the first signs of menopause. The hot flashes were minor, but the lack of sleep was major, creating problems at my job, which wasn’t paying all the bills anyway and creating more stress than I could handle. I became depressed and was hospitalized for about one week, moved back to Central PA, near where we had lived once before in one of our many moves.
My good friend, Hope, a perfect name, hired me to help her ship organic produce to her clients, before it became available in stores later on. She is also a homeopathic physician/body worker, and she treated me with massages and other healing modalities in her home office. I felt safe and nurtured.
The main thing, I believe, that put me back on track was pulling the weeds from Hope’s large garden on her mini-farm. I would go to the library every day for a book after helping with the produce orders. In the late afternoons, as the sun would be setting, I’d take the wheelbarrow out to the garden and pull weeds for at least one hour, every day. Digging in the dirt, breathing country air, and doing something repetitive, satisfying, and useful helped me feel better. At night I would read myself to sleep. I repeated this for an entire month and I slowly regained a sense of balance.
I also started seeing a female therapist, and she helped me rebuild my self-confidence. I felt more comfortable with a female therapist with a woman’s point of view about marriage, children, and working wives. I still see her periodically or have a phone session, since I now live too far to see her regularly. She is my touchstone. Her memory is so sharp that she remembers things I told her years ago that even I have forgotten! Hope’s natural foods, pulling up the weeds, and having a therapist to talk to are the three main aspects of my recovery. Also, my family was very helpful and supportive, both financially and emotionally, but too far away to be physically present.
Because depression runs in my family, with suicide on both sides, I realize there is a genetic predisposition to serious mental health challenges. Two of my four siblings have also had bouts of depression, and two of my nieces have had similar issues with anxiety and depression. I began to understand that this predisposition means that I don’t have to beat myself up because I became depressed, especially because several years later my older brother went through a depressive time, as did my younger sister. I wasn’t the only “crazy” one in my immediate family! And by then, mental illness was better understood and less stigmatized, although some people still do consider mental illness not an illness, just something you can snap out of with medicine.
My guilt feelings about depression, and asking for help, have been transformed into empathy and support for others who experience deep depression. During my time at Hope’s, I joined a support group, Even Keel, which also helped. The stigma of mental illness slowly receded and my focus for the past few years is to stay vigilant about my health, seeking help as needed. A big lesson for me was learning how to ask for help from family and friends and to seek help from professionals in the psychiatric field.
I believe that, in addition to psychosomatic illness, that is, that the mind can be affected by body illnesses, I also believe in its reverse, that is, an imbalance in the mind can trigger an illness in the body. Our body is one unit and balance is important in all aspects: body/mind/spirit. As such, it requires ongoing TLC; just like the fragile flowers in Hope’s garden.
Mental illness is not shameful. I want to reinforce that fact that support for a person experiencing mental illness does not, and should not, differ from support for someone with diabetes, renal failure, Parkinson’s disease, or other health issues—mental or physical—that people experience. My therapist summed it up nicely when she said that my divorce and concomitant depression were like a big cloud over my head. The cloud is still there, probably always will be, but now the cloud is tiny and manageable. Struggling my way into wellness was like surviving a storm and walking back into the sunshine. The world is new to us each morning, and I face each day with that thought in my ever-healing mind, body, and spirit. I am no longer in pieces; I feel whole.
When I read Elisabeth Kübler-Ross’s autobiography, I learned that developing her five stages of mourning and facing the topic of death was not something hospital staff really talked about openly. She introduced something quite radical by having terminally patients talk about their death to doctors and other hospital personnel. Likewise, mental illness needs to be talked about so that those who are being treated do not feel they are “crazy,” and those who stigmatize mental illness need to be educated that illness is the proper term for the different kinds of depression some people experience. Additionally, those who do experience mental problems should not be blamed for their illness, but treated compassionately.
We have come a long way from my bouts with depression decades ago, but I think we still need more education and empathy to understand that, like any other illness, mental illness needs to be treated with care, concern, compassion, and support from family, friends, and health practitioners.
To Sylvia’s Belljar 1970s
(This is dedicated to Sylvia Plath, who died by suicide, leaving behind two small children and a husband. I had suffered post-partum depression after my second child in 1965 and the belljar concept struck a chord in me.)
When the Belljar descends, I feel my life’s ending;
for without Hope, there’s no way I can cope.
Everyone has her Belljar, which smothers her life’s breath—
Be it her job, mother, spouse, or herself.
No one is without one.
The trick is to break it, so It can’t cause you pain;
for if it closes around you tightly,
you’ll spend your days fighting, and slowly losing.
(The pain is in the dying.)
I’m always ready for my Belljar to descend,
so I keep a constant vigil
It closed about me once,
and dying once is enough for anyone, isn’t it?