How My Physical Illness and Depression Relate

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The link between physical illness and depression is undeniable. After my stroke in 2018, I experienced a depressive episode that required me to return to therapy and also required an adjustment in my psychotropic medication. Fortunately, with that combination of treatments, I was able to emerge from the depression and recover while simultaneously recovering from the deficits the stroke left me with.

Since then I’ve been relatively free of depression even as the medical conditions continued to accumulate. I take a lot of medications, both psychotropic, and mostly non-psychotropic, and have a long list of doctors who are specialists. I don’t know if the long course of my mental illness has made me particularly susceptible to physical illness later in life or if I just drew unlucky genes.

About a year ago, maybe a little more, I passed out in my bathroom in the middle of the night and hit my head. I went to the emergency room because I was on blood thinners and they found out I was severely anemic so they admitted me. Since then I’ve been chronically anemic and when my hemoglobin gets low I deal with the more pronounced effects of anemia: severe fatigue, dizziness, heart palpitations, and shortness of breath. This, combined with the insomnia I’ve been experiencing for the last several years, sometimes makes it difficult to function. I’m glad that I work at home. If I need to, I can lie down for 20 minutes or so to rest.

In May of this year, my hemoglobin got so low that I needed a blood transfusion. They admitted me again and did an endoscopy and colonoscopy and found an anal ulcer as the source of the bleeding. We’re still working on how to best manage that.

In June I had three mysterious episodes in the space of one week of passing out — vomiting, confusion, and loss of speech. The last one happened while I was in the ER. I thought they were transient ischemic attacks (TIAs) – mini-strokes. I was admitted to the hospital again. My MRI was normal. My general neurologist referred me to the stroke center at a major medical center. I happened to have an appointment with my migraine specialist (who is also a neurologist) and she is not so sure those episodes were TIAs. She happens to work at that major medical center and is going to expedite that referral.

This past Friday, I suffered a concussion when I walked face-first into an automatic sliding glass door in my building. I had a headache and nausea for a couple of days. I finally went to the ER because I’m still on aspirin and I had read a frightening article stating that “Researchers found a significant increase — 38 percent — of intracranial bleeding among the people who took daily aspirin compared with those who took a daily placebo pill.”

The National Institute of Mental Health (NIMH) states: “Research suggests that people who have depression and another medical illness tend to have more severe symptoms of both illnesses. They may have more difficulty adapting to their medical condition, and they may have higher medical costs than those who do not have both depression and a medical illness.”

I felt the tentacles of depression reaching out to me several weeks ago, but I tried to ignore them. Which wasn’t wise. Due to my history of severe depression, I need to be extremely proactive about my mental health. I used to look forward to going to work every Monday morning. I used to be at my desk well before 8 am each day. Not for the last couple of weeks. I just want to hide under my covers and ironically, although I love working from home, each time I pass the doorway to my bedroom, it’s tempting to dive back into my bed and eschew my responsibilities for the day. I feel overwhelmed with all these medical issues occurring at once and frightened for my immediate future.

The same article from the (NIMH) reports that “people of all ages with depression are at higher risk of developing certain physical illnesses. People with depression have an increased risk of cardiovascular disease, diabetes, stroke, pain, and Alzheimer’s disease, for example. Research also suggests that people with depression may be at higher risk for osteoporosis.” I developed osteoporosis as a result of my years of anorexia; this spring I suffered a stress fracture in my foot and was in a boot for two months.

A 2006 study found that severe depression “is the major problem that may preoccupy any ill patient—to the point where he or she may commit suicide. Indeed, a formal major depressive episode can occur in association with virtually all other psychiatric and physical diagnoses.” It’s been nine years since my last suicide attempt and my last psychiatric hospitalization. My psychiatrist, Dr. Lev, said following that terrible time that she didn’t think I would ever get to that point again. I was not so sure, knowing there are no guarantees.

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I need to contact Dr. Lev. There’s just one obstacle: She has always been very generous in adjusting her fee so I could work with her for as long as it took for me to be able to recover. I contacted her at the beginning of the year when I was feeling overwhelmed at my new job, but she had raised her fee for me to her usual rate, which would have been difficult for me to manage. I didn’t end up seeing her then. I guess right now I have no choice. I asked her if I could pay it in two installments and she said no problem.

I have a plan.

Thanks for reading.

Andrea