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Anxiety and Stress Disorders

Dealing with Temporary Depression

10/24/2006

Question:

I am a 42 yr old female . I have been an RN for 21 yrs. In May 2005, I had to go on disability through my work on advice of my doctors due to being dx`ed with a progressive neuromuscular disease. I am now in the process of trying to get SSDI. It has been very difficult to leave my job which I loved (I worked in Labor and Delivery. Before leaving my job, my boss encouraged me to see a counselor at work through EAP.I did and the counselor was horrible. For an hour he yelled at me, berated me and wanted to know why I was letting the disease control me, why didn`t I fight, what did God think about the way things were now.that it was probably because of my lifestyle that this was happening and on and on it went. (BTW, I am married,have only had my husband as a partner ,do not smoke, drink etc- in reference to my lifestyle). Needless to say, he did not help much. On advice of the hosp. administrator to who I complained to , I saw another therapist who was very helpful and likened my situation to a loss where grieving was normal.I feel like I have lost part of my self and identity. I don`t think I am depressed per se but I have recurring dreams where I am going back to work -most of the time for just one more night. I always feel sad when I wake up because I miss nursing and my coworkers. I loved seeing babies enter the world and share in such a special occasion with people. I guess my question is , how long does it take to get over this? As a result of going on disability, I lost my insurance and now have a very low quality plan and medical bills are racking up which is a new experience for me as I have always had good insurance. I have 2 children and a husband who are supportive but sometimes I wish I could just talk to someone who would understand. Do you have any suggestions as far as how long this takes? I am not looking for a dx as I know you cannot so that over the web but thought you may be able to point me to some reading or whatever.

Answer:

It sounds like you have gotten some wise advise from your second therapist -- a major life change like you are going through is a grieving process.  You have "lost" your career as you previously knew it, your previous financial status and probably a significant part of your identity.  As you know about grieving, there are "stages" people go through.  While many are familiar with the Kubler-Ross's stages of grief (denial (this isn't happening to me!); anger (why is this happening to me?); bargaining (I promise I'll be a better person if...); depression (I don't care anymore) and acceptance (I'm ready for whatever comes)), not all people pass through all the stages, nor do they spend the same amount of time at each stage.  Some never get past anger or get stuck at depression.  Others fly right from denial to acceptance.  Others cycle through all the stages many times.

As you wonder how long you are going to feel bad about what has happened to you, the answer is probably a long time.  Even people who are accepting of the loss and are ready for whatever the future holds, still have times of sadness and sorrow over what they have lost.  The difference is that these people spend MOST of their time in a productive, accepting state and only a bit of time being angry or sad.  The move from being sad most of the time to being sad only some of the time is gradual.  Mental Health professionals are often of the opinion that in the case of a close loved one's death, after 6 to 9 months an individual should be well along toward acceptance.  Feeling extremely sorrowful, tearful, with difficulty sleeping and eating after this length of time would probably be considered a clinical depression, and not just ordinary grief.  On the other hand, if someone was still occasionally sad, or some event triggered a special memory of loss and there were a few tears, that would be considered quite normal.

I encourage you to continue counseling.  Many churches, synagogues or counseling services have sliding scale or low cost options that might be possible for you.  Look for a support group of others with chronic illness.  Find time for family and friends and let them comfort you.  As a nurse, you were probably used to "giving" comfort all the time.  It felt good, and nurtured you as a nurse.  Now is the time to let your loved ones feel needed, and accept their support and comfort.

Good Luck.

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Response by:

Nancy   Elder, MD Nancy Elder, MD
Associate Professor
College of Medicine
University of Cincinnati