Posted by fallsfall on February 28, 2005, at 17:32:59
I have been severely depressed for 10 years (at least that's how long I've been diagnosed), and disabled from working for 8 of those 10 years. I've been hospitalized twice. I did manage to go back to work for 2 years in the middle, but I would say that I was still depressed when I was working.
My therapist and I have been talking about going back to work. I would like to go back to work, but I'm terrified to do so.
We talked today about what I'm afraid would happen if I did go back to work: I'm afraid I would crash again.
I quoted statistics: If you have had one episode of depression you have a 50% chance of having a second one. If you have two episodes, the chance rises to 70%. With three, it is up to 90%. [Take these numbers with a grain of salt, I don't remember what the real numbers are, but it is clear to me that I have a much better chance of having another episode of depression than I have of not having another]
I do believe that I will crash again. I think that I will crash sooner and harder if my life is more stressful (i.e. if I am working), but I think that I would crash again even if I never went back to work. So, for me, the question about going back to work seems to boil down to whether I can find a work environment that will be less likely to speed up and deepen the crash, and whether I can have a support structure in place to keep the crash from being worse than it absolutely has to.
My therapist wasn't thrilled with this thinking. He thinks (and he is probably right) that if I go into this expecting to crash that it will be a self-fullfilling prophesy. My argument is that I need to have contingencies for the real risks I would be taking.
He said that if he thought there was even a 50% chance of working triggering another crash that he wouldn't accept those odds. And here I am thinking it is more like 90% (How many "episodes" is 10 years? At least 2, but I would think more, since most "episodes" are more like 6 months).
That was validating in that I interpret what he said to mean that my fear about going back is valid (because I think there is a very good chance that working will trigger another depression).
So he is thinking that less than 50% chance of success (I believe he is defining success as no future crashes - I would be happy with having a period of working that is longer than my periods of depression) - he thinks that less than 50% chance of success is not good odds. I'm feeling very optimistic because I think there is a 10% chance that I won't crash again. This is an improvement from the 0% chance that I felt 1 1/2 ago.
But what kind of choice do I have? I only have one life. I can spend it being depressed because I'm not working/can't work/are afraid to work. Or I can hope for some good years and prepare for the inevitable crash.
Trying to believe that I will ever be "well" seems a lot like lying to myself.
I do understand that "90%" doesn't mean that I will get 10% better. It means that if you took 10 people just like me, 9 would stay sick and one would get better. Statistics are black and white: better, not better. I do know that there are shades of grey in getting better (hey, this is progress for me - I just typed the word "grey"... or is it "gray"?). So it really isn't as simple as 9 stay sick, one gets better. But the bottom line is that the prognosis isn't very good. But the prognisis for me being happy on disability for the rest of my life isn't good either.
I don't know what I'm asking here. But comments would be appreciated.
poster:fallsfall
thread:464547
URL: http://www.dr-bob.org/babble/psycho/20050225/msgs/464547.html