I've been in a serious funk for the last two weeks. We've had a family crisis which made me sad with feelings reminiscent of depression. I've had a hard time concentrating and motivating myself to get anything done. However, while usually when I am depressed I suffer from insomnia, this time I slept from 18-20 hours a day on the weekend. I can't recall ever doing that before. I come home from work, throw something in my stomach, hit my bed and sleep for nine or ten hours. That is not like me
      Coincidentally, Wednesday, February 7th was the anniversary of my discharge; five years out of the (psychiatric) hospital. That is a record for me since my first hospitalization in 1988. And my 51st birthday is today, February 13th. I have even more to celebrate than at my 50th birthday when at a lovely party that my brother gave me, I was suffering from an anorexic relapse and threw up twice on the floor of the restaurant. It wasn't purging; the source of the vomiting was conflict between wanting so desperately to enjoy my party with my closest friends and family, to savor the delicious food which I had been denying myself for months, and the fear of the calories and putting on weight.
     After the party as I continued to lose weight, I considered admitting myself to the same eating disorder unit where I was last hospitalized. I felt so out of control I actually spoke to the admissions coordinator at the hospital and made tentative arrangements to be admitted which I later cancelled. I was too afraid of losing my job.
     The turning point for me came a month later when I was admitted to a medical hospital. As I was laying in the ER I asked myself what I was doing there among the elderly patients gasping for breath and the beeping heart monitors. Ironically, I began to eat the awful hospital food.
     Throughout these functional years, one of my worst fears has been falling back into an intractable, suicidal depression. I was in that state for years and I don't want to slide back into the abyss. I have the utmost empathy for my patients who find themselves in that state, and for anyone who has been there. The dread that idea brings to mind is terrifying; it sets off my heart beating and my thoughts racing.
     I was unable to write, even barely move last weekend; every time I made it to my computer I would be overcome by a strange sense of weariness and I would have to return to my bed. Flashes of my prior depressive states flew though my head and I wondered if this particular family situation would drive me back into myself, into my old destructive ways.
     My patients who have begun to take steps toward recovery express the same fears when they encounter a setback in their life. They are afraid that an impediment will cause them to fall all the way back into the state which drove them to seek therapy in the first place. I tell them I understand their fear, but they don't have to go all the way back to that dark place. I tell them they are stronger now, more resilient, with increased abilities to cope with life's stressors.
     If my patients start to slip, I encourage them to talk about what is causing them distress in the early stages; not to hold their feelings in as they might have before which is what most likely contributed to their depression. When they speak up, they are often surprised by the relief they feel and their anxiety that they are falling back into the depths is alleviated.
     I do the same with my psychiatrist and therapist, Dr. Adena* and I know that I am, as I tell my patients, stronger and more resilient, but it is the fear that my medication will stop working, the fear that a crippling biological depression over which I have no control will sneak up and kidnap me that haunts me. Given my history and my genes — depressed parents, and depressed paternal grandparents, I continue to believe that this is a real possibility.
     I intend to keep forging ahead in therapy continuing to gain new insights, working hard at my job and at my social life. I want to keep writing and reading and just balancing everything. I (naively?) wish every year to be better than the last and on today my 51st birthday I simply say to myself and to all that have stood behind me and have had faith in me, Thank you so much and good job.