In Two Years: Divorce, Marriage, 4 Kids, Job Loss, and More

Reader’s Question

I am a 27 year old female. In the past 2 years I have gone through several major moves, a divorce, a marriage, a new baby (on top of 3 other kids), a loss of a job, and a death of the only family member I was close to. I don’t have a car, and I can’t afford to get one; we only have a work truck (that I’m not supposed to drive) and we can’t fit the family in it. My husband works hours such that it is impossible for me to find a job in the town where he works. I haven’t really been out of the house in more than 8 months. We have money stresses.

I can’t seem to even manage to do day-to-day activities anymore. I’m depressed, always worrying, anxious. I have what are apparently panic attacks twice a month. I am always edgy, and have so much anger. I always promise myself that today I won’t be this way, but I can’t stop myself. It’s getting to be so hard to even fake a good mood anymore.

I don’t know what to do anymore. I think about suicide, then I worry about the kids. I’ve tried to talk to my husband, but he doesn’t understand. Our insurance doesn’t cover therapy, and we can’t afford it any other way. I don’t have a regular doctor, and I really don’t know how to go to a doctor for the first time and tell them that I am crazy and I probably need medication — even if somehow I could manage to get to one. Please help. I’ve tried Welbutrin and maximum dose of Zoloft for Post-Partum Depression after the baby was born (6 months ago), but they didn’t seem to help.

Our Consulting Clinical Psychologist’s Reply

You are describing emotional and physical exhaustion, as well as clinical depression. As you describe, prolonged exposure to a very high stress level quickly overwhelms our emotional and physical systems. We become severely depressed, fatigued, and socially withdrawn.

When we have limited or no insurance, how do we find help in our community? Here are some guidelines:

• Most communities have mental health or social service agencies. In the phone book, they may be listed under “mental health”, “counseling”, or “government agencies”. Call these agencies and describe that you are seeking help for depression but you have no insurance. They should know which agencies have a “sliding fee scale” based on your ability to pay.
• A family physician is a community gatekeeper — an individual who has the knowledge in the community to make referrals for just about anything. A community medical clinic is often a starting place for help. You can also return to the physician who prescribed the Wellbutrin or Zoloft. It’s very possible that your post-partum depression has continued due to your high stress level. Family physicians often have medication samples available until funding for medications can be arranged.
• Any professional that is linked or related to mental health will have information on community resources — local clergy, emergency room physicians, etc.
• If you were prescribed antidepressants for post-partum depression only six months ago, and now receive no medications, you weren’t on the medication long enough. This is something we often see in the use of antidepressants by general practice physicians, prescribing the antidepressants as though the depression were a temporary situation. In truth, the presence of depression and the time required to become severely depressed tells us it’s a long-standing situation and needs more than three months on an antidepressant medication.
• Research depression on this website. Take some of the screening tests. Print the results and take them to your physician. It’s important that you are able to identify and discuss your symptoms with any physician working with your case.
• Most importantly: . Physicians are not mind-readers. With each visit, you need to speak up and discuss your sleep, social withdrawal, lack of sexual interest — whatever.
• Keep in mind that your situation is very common, especially considering the history of post-partum depression and the number of stressors you’ve experienced over the past two years. This isn’t related to “crazy” or a mental breakdown. It is a situation that you need to bring under control as quickly as possible however.