Chapter 4: Trust and Belief Catalyze Change

Why are the exam tables in doctor’s offices located under air conditioning ducts? I shivered. The thin hospital gown was open in the back and offered no protection from the icy zephyrs that swept down from the ceiling to torment me.   

I scanned the opposite wall, hoping for a distraction. A rack of pamphlets promised to educate me on subjects from diabetes to AIDS, while Health Department posters revealed what ear infections and heart disease looked like from the inside, enlightening and revolting me simultaneously. One poster featured a worried young woman with her hand on her protruding belly, with the following tagline: “Usted esta preparada para la posibilidad de tener depresion? Se puede tener depresion antes y despues del parto.”

My middle-school Spanish wasn’t great, but I got the gist of this message. “Pregnant ladies, prepare to get slapped upside the head. Depression is in the HOUSE.” Noticeably lacking were any ideas on how to prepare for the possibility of getting the disease, how to identify the disease, or how to recover from or cope with it. Like most of the posters placed in this office by the well-meaning people at the Health Department, it was long on awareness and short on advice and assistance, which rendered it useless.

The calendar pages clutched in my hands crinkled as I shifted my weight. For two months I’d tracked my moods, in an effort to prove to the doctor that something measurable was wrong. It seemed to me the patterns were clear, but my track record with doctors was poor, and I didn’t know how my new doctor would react. Would she be cross with me for trying to self-diagnose my problem, or would she appreciate my methodical approach? Would she believe me, or would she refuse to believe in anything she couldn’t feel for herself?

At last the door opened, and in bounced a human song sparrow: she was rotund, bouncy, bright-eyed and adorable, a petit brunette in a white lab coat at least two sizes too long. “Hi! I’m Doctor Caldwell. It says here on your chart you think you might have depression? Tell me what’s going on.”

I was tongue-tied. There was too much to tell, and I was scared that this cheerful person was going to think my symptoms were all in my head. Maybe she’d tell me to look on the bright side, to turn my frown upside down. In the background of my mind, I heard a voice belt out an old children’s song from Primary; “No one likes a frowny face—change it for a smiiiiile…”

I took a deep breath. “I’m tired all the time, and I’m always sad. It gets worse before my period, it gets much worse in the winter, and it has been really bad since my son was born.” I showed her my crumpled chart, and explained my notes. My emotions were all there, in black and white; I pointed out anxious days, crying days, short-tempered days, sleepy days and sleepless nights.

“I think you’re right,” she told me, and her eyes were sympathetic.

 I was gobsmacked that she believed me.

“It sounds like you might have a whole bunch of different things going on, but definitely depression; maybe more than one kind.”

Then the floodgates opened, and before I could stop myself, it all came pouring out; the irrational fear episodes, one of which made me flee from my loaded shopping cart in the grocery store; the way I ached every day, as though I was going through life inside a plastic garbage bag weighted down with lead; the way things looked so overwhelming, the guilt that smothered me and colored everything I did despite the fact that I’d done nothing wrong, the self-disgust that slapped me down and kept me miserable. “Every day I force myself to get up and take care of my baby and the girls. I don’t have an interest in anything, I don’t have any motivation, and I feel worthless, like garbage. I feel like my family would be better off without me.”

I actually broke down and cried, maybe because being believed was a huge load off of my mind, maybe because her eyes were so kind.

“Do you feel like you might harm yourself?” she asked.

My brow furrowed in frustration—does everyone assume people with depression must be suicidal? “No, of course not.”

“If you do feel that way, you need to let me know right away, ok? Promise? Depression is nothing to fool around with.”

“I promise. But that’s not why I’m here.”

Dr. Dobbs said she thought there was more going on than the baby blues; she thought I might be having panic attacks and that it sounded like I might have something more serious, like major depression, pre-menstrual dysphoric disorder (PMDD) (“it’s like being allergic to your own hormones,” she explained), seasonal affective disorder (SAD), or maybe something else, maybe all of them together. She said I needed a specialist and a real diagnosis, so at last I agreed that she could call a psychiatrist and make an appointment for me, but I asked her to postpone that phone call until “I have a chance to check my calendar.”  She squeezed my hand and told me to call her office and leave her a message so she’d know when I was ready. She wrote me a script for Zoloft, to get me through in the interim.

I was suspicious of the Zoloft, but I promised to take it anyway.

For the next few weeks I balanced on the edge of cancelling the appointment.

I didn’t want to see the psychiatrist, I didn’t trust them. As a little girl, I’d watched a TV show called “Lucan,” about a feral child who was raised by wolves until the age of ten, and then raised by psychiatrists who couldn’t believe the research gold mine that had fallen into their laps. Even as an adult, Lucan had no real hope of freedom, no ability to escape his position as unpaid lab rat. When I protested the injustice of Lucan’s situation, my father told me in all seriousness that this was how psychiatrists were, and of course they’d never let him go. What they were learning from him was more important to them than his own happiness and well-being. I was furious. I didn’t believe the good of the many should outweigh the rights of the one.

Both movies and television seemed to prove my father right. Attempts to involuntarily commit perfectly nice people like Elwood P. Dowd (Harvey) seemed mean-spirited and unfair.  Transforming Murphy into a vegetable (One Flew Over the Cuckoo’s Nest) could only be interpreted as evil. The self-reliant rural culture in which I was raised viewed the entire profession as suspect, and suitable only for people too weak to handle their own problems.

The only person in my family who’d visited a psychiatrist was my mother. She went to him for years, and in my opinion, he never helped her do anything but vent her frustration and enable her to stay exactly the same. I’d hoped, at first, that this shrink of hers would at least convince her to have some self-respect and maybe even help her heal enough to stand up to my father, but it was not to be.

What good could come from a visit to a psychiatrist?

The Zoloft did seem to help. I didn’t feel great, but I did feel better. I could get up and make breakfast and lunches for the children before school without feeling like I was dragging a ball and chain. The downside was the medication’s unpleasant side effects. I now lived with severe dry-eye, headaches and nausea, none of which I had before. The doctor was sure the side effects would soon fade. I wasn’t so sure; every pharmaceutical miracle has its price.