The accident wasn't serious but I think the nature in which it happened was such a shock he got what I can only think of was post-traumatic shock. I wanted to record how the illness had affected us as a family and to keep a record for either future occurrences or as an aid to help someone else suffering.
The symptoms shown were typical of clinical depression.
The first signs that Adam was showing symptoms of depression was about 5 weeks after the accident. His parents were visiting that Sunday and the weather was pleasant enough to suggest taking the children to the park. Adam would usually jump at any chance to be outside when it's sunny but this time he seemed reluctant and nearly gave back word saying he was tired. He remembers feeling it was out of character at the time. This happened just a week before he was due back at work. Come Thursday and more of the symptoms were prevalent. He began feeling heavy and had his first emotional outburst. When we talked it over we deliberated whether he should go back to the doctor or to see how he went on going back to work. But then on the Friday he had another outburst and was feeling worse. We decided it was best to go back to the doctor rather than return to work and risk him being worse than ever. He saw Dr Savage and he found her really understanding. She suggested him trying without medication for a couple of weeks and see how he went on. He had been on Fluoxetine on a previous occasion but we were keen to see if we could get through this without medication. She signed him off work another 2 weeks.
- persistent sadness, anxiousness or 'empty' mood
- loss of appetite
- insomnia, early wakening or oversleeping (the oversleeping came later in the episode)
- restlessness and irritability (Adam wasn't too bad irritability wise but he would be more short-tempered with the children)
- feelings of worthlessness, inappropriate guilt, helplessness
- feelings of hopelessness, pessimism
- difficulty thinking, concentrating, remembering or making decisions
- loss of interest or pleasure in interests or hobbies and activities that were once enjoyed (Adam loves walking and keeping up to date with football and cricket and all these he lost interest in)
- withdrawal from social situations, family and friends (Adam never totally withdrew from society, although it required a real effort from himself to attend social gatherings particularly with friends or family and then would force a "brave face")
- decreased energy, fatigue, feeling "slowed down" or sluggish
- persistent physical symptoms that do not respond to treatment Adam would occasionally get tension headaches, which I suppose were a result of mental strain. They weren't overtly persistent though)
- weight loss or conversely overeating and weight gain
- thoughts of death or suicide or attempts of suicide
The first signs that Adam was showing symptoms of depression was about 5 weeks after the accident. His parents were visiting that Sunday and the weather was pleasant enough to suggest taking the children to the park. Adam would usually jump at any chance to be outside when it's sunny but this time he seemed reluctant and nearly gave back word saying he was tired. He remembers feeling it was out of character at the time. This happened just a week before he was due back at work. Come Thursday and more of the symptoms were prevalent. He began feeling heavy and had his first emotional outburst. When we talked it over we deliberated whether he should go back to the doctor or to see how he went on going back to work. But then on the Friday he had another outburst and was feeling worse. We decided it was best to go back to the doctor rather than return to work and risk him being worse than ever. He saw Dr Savage and he found her really understanding. She suggested him trying without medication for a couple of weeks and see how he went on. He had been on Fluoxetine on a previous occasion but we were keen to see if we could get through this without medication. She signed him off work another 2 weeks.
When he had to go back to see Dr Milne, his own doctor, he signed him off again for another two weeks and under Adam's suggestion try without the medication. He didn't seem to improve much. He was having emotional outbursts everyday and his mood seemed to swing between very low days followed by quite elated ones. On the next visit to the doctors Dr Milne decided it would be best if he tried medication. When Adam was on the Fluoxetine he just seemed really fatigued and a bit doped all the time and yes he was stable, but it was a constant dull low level. So, this time Dr Milne suggested trying a different anti-depressant called Citalopram. I looked up about it and found it was in the same family of anti-depressants as Fluoxetine but may react differently on Adam. The most common side-effects were different. Reading different people's experiences of Fluoxetine I found many of them seemed to experience the same reaction as Adam, with extreme fatigue and a doped feeling. With the Citalopram most seemed to experience insomnia, which wasn't very encouraging. I think I'd rather want to sleep all the time than have the inability to do so. Adam did start experiencing insomnia during his first week on this drug (20mg) but I read that someone who had been on it only experienced insomnia during the first couple of weeks and then it seemed to settle down. It was as if the body had to get used to it. Well Adam's insomnia did settle down just less than a week into taking the drug. The general advice about anti-depressants is that they usually take 3-6 weeks to take effect, which sounds an eternity if you are feeling so low, but with Adam his emotional outbursts stopped immediately after starting on the drug and he did seem to stabilise quite quickly. It is very true what they say about most forms of depression that it's 2 steps forward and 1 step back. For the next 4 weeks there was a considerable improvement from the previous 4 weeks but then it seemed to plateau and the improvements seemed minuscule. You would feel he wasn't far off getting back to work and then he would take a set back, like a roller coaster ride. The last two weeks he has seemed much better and when he went to the doctor today he felt he was ready to go back to work. He only had one day with an emotional outburst and one other day where he woke up feeling a bit heavy with that nervous feeling in his stomach during the last two weeks. The doctor asked him how would he feel if he had to send him back to work tomorrow and Adam told him what I'd asked him on that day he was feeling low on. He'd said that previously when he was having a bad day he knew he couldn't return to work, but on the day I asked him he felt he could work despite the low feeling he had. The doctor said that he wasn't just right yet and said he would give him another 4 weeks off. He said it sounds as if the Citalopram was beginning to stabilise him and that it was up to Adam when he felt he was ready to go back. Dr Milne knew Adam had a great desire to return to work and knew he could trust him to make the decision himself when he felt he was ready. He said if over the course of the next 4 weeks he felt ready to return then he would supply him with a return to work form.
As I have lived with some form of depression most of my life, my dad having manic depression, it meant I had valuable experience and understanding when Adam had his episode. Of course the two conditions are very different but there are similarities in the depressive symptoms and the handling as such. "Understanding" - a funny word when it comes to depression as I don't think anybody really understands what's going on inside their minds. The reasons why it occurs, is it preventable? is it curable? Clinical depression certainly isn't cured by "pull yourself together" treatment. As my mum always says about my dad, the thing they would pull themselves together with is what is poorly. She has lived with severe manic depression all her married life, 54 years, during a time when there was no tolerance or understanding by the medical profession. My dad has had it since he was 16 and now he is 80 years old. There were many times when he had to come off work because of it and when he went to the doctor to sign him off he was told to get back to work and "pull yourself together". He would go back and obviously found it impossible to work and would come off again. Often they were living off three days pay a week and my dad not getting any better, with no medication and circumstances that just exacerbated it. They had 4 young children at the time and were robbing Peter to pay Paul to try to make ends meet. Eventually the doctor would sign him off but then they would be waiting two weeks before any money came through for state sick pay.
My mum tells of well meaning people in an attempt to be concerned ask questions that just imply they don't understand. You get weary of the questions of "Is it because he's frightened of returning to work?" or "What's he got to feel guilty about, he's a wonderful father and husband" They don't realise that the guilt is a result of the depression not the other way round.
Being a Christian also brings different opinions from other Christians. How can a Christian have depression if he's really got a close relationship with the Lord. Your faith and trust in God is continually called into question. They can't accept it's a clinical condition not spiritual depression. Advice of "Cast your care on God..." and "Don't be anxious about anything.." or "Put aside your fears..." These are all excellent pieces of advice if the condition is Spiritual Depression. BUT IT ISN'T!!! There is nothing wrong with Adam's faith or trust in God. I live with him and can see that with my own eyes. He trusted God before this happened, he trusted him through the illness and will continue to do so after he is better. Adam is casting his care on God, the real Adam isn't extraordinarily anxious about anything. When will they realise that it's the depression that brings guilt, fear, hopelessness. If anybody wants to encourage him tell him to continue to believe and trust in God, don't accuse him of not doing.
Now I've got that off my chest -
Thank you God for whatever circumstances you allow us to go through, because there's always a reason why. Even if it is only to help others that are going through the same circumstances. That's what you mean when in James 1:2-3 you say "Consider it pure joy, my brothers, whenever you face trials of many kinds, because you know that the testing of your faith produces perseverance." This doesn't mean we should go around with a false smile or a sadistic sense of joy at the trials. It means there's a higher purpose, a bigger picture, why You allow us to go through them in the first place.
Thank you for your faithfulness, you've been with us all the way through. Like the Footsteps on the beach, when there were only one set of prints it was then when You were carrying us.
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