Facing Depression: What Steps to Take

Elizabeth kept her distance from me unless she needed someone who spoke English. The other Mexican women sought me out, asking a myriad of questions about the United States and, once I started eating pickled jalapeños, I became fast friends with the children in the orphanage. Even the adult patients at the in-house medical clinic were shyly beginning to share their life stories but Elizabeth continued to avoid me. As a young college student I was working hard to acclimate to the people and place of Juarez, Mexico and her coldness was a puzzle.

Elizabeth was in her early seventies with a short, severe haircut she proudly maintained herself. I soon learned from others that she was a single woman who had supported herself as a secretary until a car accident made it impossible for her to sit for long periods. She used up her savings on medical bills, eventually losing everything. Her identity had been as a strong, independent, single woman; she didn’t know how to be dependent on others. I was warned to steer clear of her sharp tongue and quick temper.

I took this advice for a few weeks but soon I was tired of side-stepping her. I brought her favorite snack to share: homemade tortilla chips dusted with chili from the tortilla factory next door and orange soda. I looked her in the eye and asked why she didn’t like me. She met my gaze and, as her eyes welled up with tears, said, “Why would I not like you Amy? The person I don’t like it myself.” I slowly released my breath as she grabbed my hands and let loose a torrent of emotion; pain, sadness, anger, rage, hope, despair, suffering, and joy mixed in with a constant stream of tears and mucus enveloped me. Although this was not a new experience (people have been sharing with me since I was a little girl), I was still taken aback. Elizabeth confided that she had been depressed for years and hid it from everyone with her tough exterior. On the inside she experienced feelings of sadness and worthlessness, struggled to feel pleasure in her regular activities, overate often, battled insomnia and low energy, had difficulty concentrating, and sometimes felt suicidal. She had many positive (well-researched) coping mechanisms in place—strong emotional connections to friends, meaningful work, belief in something outside herself, basic needs met (home, food, clothes, job), enjoyable hobbies, several pets, regular exercise and frequent outings—however, she still suffered.

Although at the time I didn’t know what a “treatment plan” was, I worked with her and her closest friends to create steps to address her depression. First she underwent a physical exam with the doctor at the clinic who altered some of her medications and added an anti-depressant. Second she committed to meeting weekly with a therapist to talk about her present emotional experience as well as processing some difficulties in her past. Third she met with a nutritionist to address her overeating. Over the next few months Elizabeth learned what research tells us, addressing depression with a multi-prong approach tends to offer the best results. She began to experience relief and soon was known for her sharp wit instead of her sharp tongue.

Symptoms of depression can creep up on any of us, especially those of us who live in a community that values independence and individuality. Take some time this new year to come learn how to balance self-reliance with good mental health.