(If someone else experiencing struggles with low moods is not for you right now, please skip this post!)
Trying to fight anhedonia
Anhedonia = inability to feel pleasure, and right now I feel like I’m struggling with this a little bit. The good news is that it isn’t complete.
Thinking back to yesterday, I remember feeling joy in snuggling with G after putting her to bed. I felt a sense of peace after my yoga practice. I enjoyed listening to NPR All Songs Considered’s “Even More Songs to Calm the Nerves” on my morning commute.
(Because for real, I NEED some songs to calm the nerves right now.)
At this very moment, I am finding at least SOME joy in the decaf cappuccino I am drinking right now (at a Starbucks — post drop-off and pre-orthodontist appointment, made because I think one of the Invisalign attachments broke off and took a piece of my tooth with it. I am on call but I can head in late today without too much of an issue, so that worked out at least.)
But when I look ahead I’m usually filled with a vague sense of positive anticipation, and right now I just feel like that’s just kind of missing. It’s not a lack of things on the calendar – so I find this confusing.
I also have felt really sad in the evenings. Yesterday I just started crying for no specific and identifiable reason.
I am seeing a therapist weekly, which helps some — I think. I really like the therapist and the sessions go by quickly.
To be clear, I am absolutely still functioning. Doing the things. Checking the boxes. Seeing the patients, writing the notes, recording the episodes. When I’m immersed in a task, I am fine. I am able to concentrate. It’s the moments when I’m not doing these things that feel hard.
One thing I’m noticing is that I feel like I’m (subconsciously? and impatiently?) waiting for some kind of ending or resolution, but I’m not sure what exactly that would be. I guess I think a tiny part (or not so tiny part) of me is hoping that at some upcoming appointments there will be news that changes things. An “oh, never mind, it’s not actually that bad!” reckoning of sorts. This is most likely a dangerous thing to be hoping for because it’s a setup for disappointment. But at the same time, I don’t feel like I can let this shred of hope dissolve until it’s really gone.
Sublimate?
I guess one solution is to keep leaning into the present, into doing things and experiencing things that allow me to focus my energy and thoughts elsewhere. And maybe another equally valid solution is to let myself cry sometimes, accepting the feelings as they are for right now. Both are probably okay.
Gratitude
I know that in times like this gratitude can be a mixed bag. But I think on the whole, it’s a positive. Especially when there is emphasis on the things in life that are still there to be appreciated. I perhaps need extra reminders of these things right now. So, off the cuff:
- I am grateful that I have really good friends that I can text and connect with
- I am grateful that my kids are healthy, and that even though I have a new issue that it’s a manageable one and that I do not have physical pain
- I am grateful for a great team at work
- I am grateful for decaf cappuccinos (!) and that the Starbucks soundtrack seems perfectly curated for an Xennial (rocking The Postal Service right now)
31 Comments
You are doing hard things.
I’ve struggled on and off with depression and anxiety for years, and wanted to share two things that helped me through the worst episode (lasted about 3 years. And it was pre-pandemic. And I cried A LOT)
First, really try and avoid time frames. I would read/hear stories about people who go through it in 6 months or a year or whatever and that just made me feel worse about not “getting through it” as fast as everyone else. I would also get stuck in doom thought loops and while I could recognize it when it was happening I still couldn’t pull myself out and I spent a lot of time feeling bad about that since it felt like everyone else could do it once they were able to recognize it. Not that I’m saying you’ll be here for 3 years, but don’t beat yourself up if you don’t feel better as fast as you want to or think you should.
Second, on gratitude. I had so many people mention it to me and at the time it never felt real – of course I love my children and I’m glad I don’t have physical health issues, but that doesn’t make me feel any better and just feels like a cop out. So one suggestion I got was instead of listing 5 things I was grateful for was listing 5 things that aren’t my problems (at the time most of my issues stemmed from my job and my relationship). So I would list 5 things that weren’t my job or my relationship – anything from “I can’t believe it is still snowing out when it’s the second week of April” to “Why is everyone obsessed with White Lotus, it just makes me want to not watch it” to “I really need to buy new socks.” They didn’t have to be happy (and many were negative) but after a few months it helped me to kind of distance myself from my problems. That helped me to be functional and eventually to work through many of my issues.
Hi Sarah, my heart goes out to you. Things happened so fast so it’s no wonder that you are gradually processing all this.
I’m no expert but I feel you might be going through the stages of grief because you mentioned that this has shifted your sense of identity a bit.
I had a similar time when I changed my career- I felt a loss of identity. I don’t know why but I did!
I think the only thing that helped me was to focus on my priorities in life, what I valued the most in the big picture and how was I serving others- my family, friends, community- to fulfil these priorities and values. It basically helped me to shift focus from myself to what I was doing.
Don’t be hard on yourself and reduce the expectations you have of yourself- the ‘I shoulds’. It’s so tough to figure out emotions and it takes its own time.
You’re so amazing for bouncing back so fast! Please keep inspiring us!
Crying is an absolutely valid and helpful way to process feelings, IMHO. It’s medically proven to help, IIRC.
I’m glad you’re seeing a therapist ❤️
Apologies for not being totally caught up on your recent posts, but this one really struck me. It does seem that you are grieving. I think this is completely normal given everything you’ve experienced – and to be blunt, lost, or at least lost for the foreseeable future until you have more information. Just want to validate what you’re feeling. I hope you find some peace soon, but it’s OK to be in the messy middle for a while. Sending a hug!
PS I’m also a doctor mom who struggles if she doesn’t have her usual favorite coping activities! Feel free to reach out if you want to talk more
I don’t know what to tell you Sarah. I have been having a really difficult time finding anything to look forward to myself either personally or professionally, and I don’t have any good answers. I am worried that the solution is to let go of any hopes or aspirations for myself or to “adjust my expectations” (to what? hating my job and my life?), but what’s the point of existing at all then. Gratitude? Just… barf. It’s just a passive aggressive guilt trip to get you to stop feeling sorry for yourself and complaining so much (“Look see — other people have it worse! So shut up already!”). If gratitude is still working for you, then you probably aren’t in that deep a hole, so maybe you should be grateful about that. Ha! Trust me, things can always get worse, and that is how it goes for most people until you die. If that hasn’t happened to you, just wait. It will.
(Waiting expectantly for the completely trite and unhelpful “Go to therapy” “Stop being so negative!” — here’s a preemptive Suck it.)
If you’re not a religious person, I have an odd book suggestion to fill this gap of “what’s the point” that might resonate. “Determined: A Science of Life Without Free Will” by Robert Sapolsky. He’s a Stanford neuroscientist who also has some great YouTube lectures about depression (probably not new info for doctors), and he also has a newer YouTube/podcast answering all kinds of questions with his daughter. I find his worldview that we are all biological machines oddly comforting, like it fills a hole that most people fill with religion or spirituality when that kind of thinking just doesn’t vibe with me.
I just wanted to say that everything you’re feeling is absolutely normal and you don’t need to make any justifications for any of it! I’m glad that you have a therapist that you’re connecting with and are going weekly. I am currently going through a rough time with my own depression and seeing my psychologist weekly is mostly what keeps me going. I have no real words of wisdom on the anhedonia, but wanted to share that I struggle with that and understand in many ways how you’re feeling. Hugs to you!
Sarah, I give you so much credit. You seem to have just moved on without skipping a beat. But that also concerns me because I feel like you also need to kind of grieve all of this that you’ve gone through over the past month or so. I think the crying and the sadness is completely normal because you’ve gone through a major change in your life. You are doing all you can but ultimately I think accepting the sadness and just walking through it one day at a time is all you can do… and will eventually get you to the other side. Hugs.
So many thoughts, but I’ll try to keep it short.
1. You are a month out from a serious medical trauma and a complete upset to a major part of your identity. Frankly, I would be very worried if you weren’t struggling. It sucks and I so wish it weren’t part of your story but having the wherewithal to recognize these things only a month out is such a good sign. Trust me. You really are doing the right things.
2. We need hope. Don’t let go of that. When one hope gets dashed, move on to another. Realism is good, but pessimism isn’t. Staying positive really does make a huge difference.
3. Life-altering experiences can lead to mental health crises. I struggled for 3+ years with a situation where I felt every negative emotion possible. Before any resolution (and there is, after over 3 years, finally a form of resolution), I had to go on an anti-anxiety/anti-depressant. I felt less-than at first. Medication doesn’t solve all the problems, but medication is there to be a help and it can be an important part of the puzzle when dealing with big emotions. It doesn’t solve the problem, but it can make us better able to cope.
4. Find new things that bring legitimate joy and lean in. Running and being physically active is such a big and important and healthy part of your life. What was something you wanted to do more of that you can lean into now? There will be a time after this and I believe there will be a time when you will be able to be more physically active. But maybe now is the time you take the photography class you wanted to take, or spend an hour a day playing the piano, or have a standing date to go to the movies every Saturday. Maybe you can view this time as a bit of a sabbatical? 6 months to try new things, change your routines, with full belief at the end of those 6 months you will have time to reevaluate and make informed decisions?
Hugs. This really sucks and you’re amazing and sharing this with everyone is inspirational and brave which perfectly sums you up. <3
Long time reader, rare commenter but wanted you to know I am thinking of you and you have my sympathy! I’ve wondered how the lessening of endorphins that were part of your life for so long would impact this transition. You seem very mentally strong with good coping skills and a support network, but know that depression can come quickly and strongly and to be on the look out for that.
Sending hugs! Of course you have all the feelings right now! Being in limbo is my least favorite place to be, even for good things: waiting to start a new job, moving to new house; let alone waiting for clarity on a health challenge. This is a before / after moment in your life which will take a long time to process and come to terms with. So that might mean going through the motions for a while and giving yourself grace on doing that. You have such high expectations and plans as an ambitious person, you probably want to rush past this but the only way is through, which can be the most frustrating thing of all.
Totally agree that you are experiencing a completely valid form of grief. I get being uncomfortable hoping for a take-back on your diagnosis, but I think even a confirmation will be helpful to acceptance and moving forward. Right now you still have a lot of uncertainty as to how your life is going to work, so of course it’s hard to look forward to the future! I bet as you get through the coming weeks and months and start getting some clarity on your limits you’ll find it easier to look towards the future with optimism.
I have gone through periods of depression and I’ve found that just accepting the low moods make them pass more quickly. And some people discount staying busy, saying that it’s bad for you longterm, but I don’t think that’s true. So I guess I’ve found that if I accept my bad moods but continue to work and socialize and stay busy, I feel better. Also crying is really good for you and your heart (or so I’ve read). I believe it increases HRV. You have so much to look forward to, even without running. Sending healing vibes!
I think it’s all been said here, in these incredible comments. You had a life-changing experience VERY RECENTLY. Sure, you can say “but I still have x, y, and z” but you’ve still experienced a loss. I know, you want to feel better NOW, but sometimes you just have to take time to grieve. I agree that getting another opinion will give you some closure (which I think you’re doing next month?)
Anyway… eventually you will be back to feeling like your life is full, fun, and fulfilling. This is the hard part. HUGS. <3
I assume that the time in between you going to bed and you actually falling asleep is also a time when you find that you’ll need to deal with the fluctuations in your feelings, Dr. Sarah Hart-Unger.
I think that you must’ve also made use of the BOBW episode that is “Dr. Lisa Doggett on living with chronic illness”, Dr. Sarah Hart-Unger.
Hi Sarah, I just want to say thanks for sharing!! I’m going through something totally different right now (I’m 15 weeks pregnant and have spent the last 2 months throwing up allllll day every day, despite multiple prescriptions and twice weekly IV fluid sessions) but somehow it’s felt like a great solidarity to hear about your struggles and how you’re handling them admirably. Super different scenario, but somehow it still resonates and inspires me to simultaneously acknowledge this sucks, but I can find things I’m grateful for. What a gift you’re giving, putting your personal hardship and reflections out there for us. Thank you!
awww Lizzy that sounds sooooo hard (nausea is like THE WORST. I had a fraction of what you had, and it was so miserable). I hope you will be improving soon, I know it doesn’t always but maybe you will be one of the people who have a much better 2nd tri! and yes to acknowledging the suck and accepting it as just part of a bigger picture. I hope you have a healthy weekend with less nausea!!!
I’m so sorry you’re going through this. I don’t have a lot to add (this is a great community!), but am thinking of you. I appreciate you sharing your honest story with others. Life is hard sometimes and it’s OK to have crap days.
Remember that your brain is also used to a very steady stream of exercise induced chemicals that it’s suddenly not getting. It needs time to recalibrate. Hopefully your heart will heal from the traumatic event and you’ll be able to enjoy some form of movement that isn’t as intense but still joyful soon.
Also, every single time I’ve been under anesthesia I’ve felt low and weepy for awhile afterwards. Maybe that’s also contributing?
So sorry you are going through all of this – it’s a LOT. Not sure what else to say but I can offer a few of my favorite songs that always seem to calm me down when I’m overwhelmed:
– All Will Be Well by The Gabe Dixon Band
– Both Sides Now by Joni Mitchell
– Landslide by Fleetwood Mac
– Northwest Passage, covered by Show of Hands
– Carolina in My Mind by James Taylor
I am not surprised you’re dealing with some psychological challenges. There is still a lot unknown and uncertainty and how can you relax and return to “regular” life when there are so many open questions? You’ve been going through a lot, it would be strange if you wouldn’t feel a bit down and discombobulated, don’t you think? I hope you can give yourself some grace.
Hey buddy – it’s okay to be sad. It’s normal to be sad. And given that there’s no healthy way to run from your feelings, it’s necessary to let yourself feel sad when you feel sad in order to process what has happened to you and how your life has changed. And it will take time and however long it takes isn’t really in your control – though actively doing your part by going to therapy, giving yourself time to feel your feelings, being proactive in tending to your mental and physical health helps as you move through the process. It took me 4ish years to process my feelings about Simone’s diagnosis and deal with my own health issues. And I’ve come out of it just in time to have my job implode/explode and so now I’m grieving the loss of a good job, a wonderful albeit flawed institution, the carnage being inflicted on my friends. And although everything will be fine – I just got a new job that I’m excited about – I still have so much grief about the situation. And you know what, it’s easier this time because I know that I won’t feel this way forever, and I know if I give myself the time and space to feel my sadness and grief when I feel it, I will move through it faster and will carry less emotional baggage with me as I move forward. I know that, eventually, you will be okay.
Sarah, I just want to say it’s okay to feel lost and sad, they are valid feelings given the situation. I understand the need to move on, resolve or find new source of joy, yet we can still take time to process the shock.
Thinking of you Sarah. This time when everything is back to “business as usual” can be the hardest. The hardest thing to feel is alone…especially at a time like this.
A few ideas:
1. Give yourself grace about screen time. It’s an easy dopamine-hit and you can tell yourself- “I need distraction and dopamine right now.”
2. Make a countdown to your visit at Hopkins. They may not tell you that everything was a false positive…but you’ll get to sit in front of experts who have shepherded many patients like you through this process. They will answer all your questions. I suspect you will feel much better after this visit, even if your diagnosis is confirmed.
3. Ask for help/babysitting to get some 1:1 time with Josh. I suspect he is a significant source of comfort for you, but he not always available during those evenings/weekends when the distractions are gone and the thoughts can run wild. My daughter calls my husband our “real life superhero”- my cortisol levels go down when he walks in the door. But he is also a surgeon and busy! Perhaps that’s why I appreciate his company so much- I’m always wishing for more.
Yeah I mean if I were in your situation I’d be pissed to be honest lol. I agree that you’re handling it amazingly well but working up a sweat and feeling physically fit are amazing things. And I’m no where near your level of physical activity. It is definitely normal to feel a loss and feel sad. Focusing on all of the positives in life (and you have sooo many positives!) is great and important, but I wouldn’t expect that to counterbalance the loss right now. I’m rooting for you and thinking of you.
I’ve been thinking about you so much, Sarah. I really admire your willingness to keep showing up and sharing even while you’re in the midst of it. You’re going to help so many people. And maybe it’s way too soon to look on a bright side of this, but I can envision a future where this experience is going to make the way you talk about planning and promote your book so much richer and really relatable for a lot of people.
But before we look on this bright side, this sucks! And I was thinking this morning that there are similarities with how devastating a terrible breakup can be. You think you’re going to spend the rest of your life with someone and then that future is dashed and that requires a huge adjustment, including a grieving period where there’s no hope for the future or joy in daily things and yes, decaf coffee tastes okay but dang, it doesn’t balance out the heartbreak.
The only thing that’s ever helped me through a breakup is when I get to the stage (after wallowing!) where I can start to notice the opportunities I might have for my life now that I wouldn’t have had with that partner.
Your experience might be even harder because after a breakup, at least you sort of hope to fall in love with someone else someday. You’ve had to totally shift away from big dreams and goals and hobbies and, like you said before, it’s an identity shift too. Crying is 1000% understandable! So is rage and wishing things were different.
Sending so much appreciation and love to you!
totally similar. it’s the quick-change of a vision, and a vision I was happy with. but truthfully I guess everything is always up in the air! and I do see the therapeutic aspects to crying. thank you for your note!!
[…] several bloggers have shared that they’re going through hard times (SHU, Sarah, Noemi, just to name a few). And to them, and all the other bloggers who have shared, I […]
I had to quit caffeine due to MVP and I can confirm it definitely depressed my mood a bit while I adjusted.
I actually didn’t quit entirely – I’m doing (one cup of) half-caf which seems to be a good compromise. I never even got a headache with his transition. But interesting to know!