As I mentioned in a recent post I’ll be meeting with my therapist next week to discuss discharge from the therapy program I’ve been in since 2014. Am I cured? No… depression and anxiety are chronic conditions. But like many chronic conditions the outward symptoms can be tamed and the patient can go into remission. Therefore one of the primary goals, as I see it, of my therapy program is to help me achieve remission of symptoms, and, to regain a sense of overall wellness. As I wrote in that previous post, I’m doing pretty well.
One of the ways you can monitor symptoms and their severity is through self-reporting. My therapist and her practice (part of Upstate Medical) utilize the Patient Health Questionnaire-9 (PHQ-9), which you can take a look at here on the Substance Abuse and Mental Health Services Administration website (part of the federal Department of Health & Human Services). As you can see it outlines the 9 major symptoms of depression from the fourth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM IV) and asks the patient how often in a 30 day period they exhibit those symptoms, and then creates a score. When I first began therapy I had a score around 15/16, or Moderately Severe Depression. This, coupled with my anxiety (for which there’s a similar checklist) and my struggles with alcohol, meant that the symptoms were on some level ever-present, manifesting as everything from low energy to suicidal thoughts. If I were to fill out the same form today, I might score a 2.
Perhaps more importantly, I’ve been scoring in the 0-5 range pretty consistently in the past few evaluations. Using the at-a-glance results of the PHQ-9, my therapist’s professional evaluation through our talk therapy, plus my own feelings, I think it’s safe to say that I am in remission.
It’s exciting and gratifying to be at this point, because it hasn’t been easy to get here. All I need to do is browse the archives of this blog to see how hard the work was, to look at the dates of the posts to see how long it’s taken to get here. It’s not the end of a journey, but it’s a major checkpoint.
When I was walking the Camino last summer we were in Portugal, and had completed a leg of the walk that included our highest elevation gain, and it was the most physically challenging part of the journey for me. But it was about one in the afternoon when we arrived at the hostel, which wasn’t supposed to open for another hour or two. As we sat there we talked about how close we were to the Spanish border (we were planning on arriving the following day). With lots of daylight left and having refreshed from the morning’s push, we agreed to press on. We walked about twenty miles that day, over hills, through valleys, on paved roads, cobblestones and rough forest paths. We made it to the border towns of Valença (Portugal) and Tui (Spain) and we walked across the bridge over the River Miño. Looking back over the river that night into Portugal I was proud of how far we had gone, and relieved to have a major section of the journey behind us. Sure, we had miles to go before we eventually arrived in Santiago de Compostela, but Tui was a major checkpoint.
Remission is a major checkpoint. I’ve gone through quite a bit. The journey isn’t over. I don’t know that it ever will be. But I’ve gotten some tough miles on my boots now that will serve me well.