Depression, Grief, Prayer, Rheumatoid Arthritis, Roomy Toe Boxes


The stages of grief, as described by Elizabeth Kübler-Ross are:

  1. Denial:
    • Example – “I feel fine.”; “This can’t be happening.”‘Not to me!”
  2. Anger:
    • Example – “Why me? It’s not fair!” “NO! NO! How can you accept this!”
  3. Bargaining:
    • Example – “Just let me live to see my children graduate.”; “I’ll do anything, can’t you stretch it out? A few more years.”
  4. Depression:
    • Example – “I’m so sad, why bother with anything?”; “I’m going to die . . . What’s the point?”
  5. Acceptance:
    • Example – “It’s going to be OK.”; “I can’t fight it, I may as well prepare for it.”

On sunny afternoons and rainy mornings, on walks with the dogs and alone
in the midst of dark nights, I have worked my way through the first four stages of grief since the first symptoms of Rheumatoid Arthritis began hampering me in March. It’s hard to believe you can be in denial when your knees and shoulders feel approximately as if sharp knives are being driven into them, but some of us are more stubborn than others.

There has been anger (mostly turned inward, because that’s my favorite flavor) and bargaining (sure, I can still do a new church start, after all you set your own schedule!), and a whopping portion of depression that we just won’t talk about, if you don’t mind.

In many ways, today, the first day since May that I am flying without the oxygen mask of prednisone, is the first day of the rest of my life. I woke up realizing that unless I am one of the lucky ones who experiences a remission via medication or inexplicable good fortune, I’m likely to spend some time every day of my forever recognizing and adjusting to my symptoms.

Welcome to chronic illness.

Over the weekend I received the gift of a long conversation with a church member who lives with RA, whose illness has been both acute and chronic since her 20s. I heard her reassurances that with all the new medications, my story WILL NOT be like hers. I listened to her urging that I take all the medical profession can make available and also heard her testimony that certain things, diet and exercise in particular, matter a lot, but will not be of great interest to doctors.

We talked about our feet, and what kind of shoes we can and cannot wear.

Roomy toe box shoes
And I believe that’s when I made the move. I began to recognize what sort of practical, long-term adaptations will be required of me (barring the possibilities of luck), and I Googled a few things, and found a blog that reviews shoes with appropriate support and roomy toe boxes, among other things, and I saw footwear that was not up to Peace Bang’s standards, but that I thought could be cute on my relatively small feet.

I’m grateful to the people who have been praying for me over the past six months. I hope they will keep praying for me. Having direct conversation with God about this new development in my life has been difficult. If you’re in Denial, you’re not talking about it. If you’re angry, well, I’m far too gently raised to get angry with God, despite advice in the past that God is big enough to take it. Bargaining meant trying to work it out for myself moreso than taking it to the Deity, though I found one brief shining moment of comfort in that phase.

Really, I had to get to Depression before I felt able to pray much, and at that point, I felt too miserable to be articulate. Coming from a tradition that eschews pre-programmed prayers, I had few resources. My mother loved the Unity Church’s prayer, “God is my help in every need…” It carried her through illness. But I found myself awake in the night summoning up the words of the Serenity Prayer. As an OA dropout I never learned it, really. But it’s out there in the ether, and in the dark of one of my worst nights, I prayed those words.

God grant me the serenity to accept the things I cannot change,
courage to change the things I can,
and the wisdom to know the difference.

The night I murmured these words over and over marked the first peek around the corner to Acceptance. And looking at shoes feels like taking the first step into that new and unknown Land of Roomy Toe Boxes.


Thanks for speaking up, Brooke!

In case you haven’t seen it, Brooke Shields had an op-ed piece in the New York Times today. I’m so glad that she found a way to respond to the ridiculous off-spouting of Tom Cruise over the past weeks.

Shields writes:

I never thought I would have postpartum depression. After two years of trying to conceive and several attempts at in vitro fertilization, I thought I would be overjoyed when my daughter, Rowan Francis, was born in the spring of 2003. But instead I felt completely overwhelmed. This baby was a stranger to me. I didn’t know what to do with her. I didn’t feel at all joyful. I attributed feelings of doom to simple fatigue and figured that they would eventually go away. But they didn’t; in fact, they got worse.

I couldn’t bear the sound of Rowan crying, and I dreaded the moments my husband would bring her to me. I wanted her to disappear. I wanted to disappear. At my lowest points, I thought of swallowing a bottle of pills or jumping out the window of my apartment.

I couldn’t believe it when my doctor told me that I was suffering from postpartum depression and gave me a prescription for the antidepressant Paxil. I wasn’t thrilled to be taking drugs. In fact, I prematurely stopped taking them and had a relapse that almost led me to drive my car into a wall with Rowan in the backseat. But the drugs, along with weekly therapy sessions, are what saved me – and my family.

I have been mildly depressed, and I have also survived a severe postpartum depression, complete with the sort of suicidal impulses Shields describes. A mild depression can be influenced favorably by exercise and other non-pharmacological interventions. But a severe postpartum depression, left untreated, can be a risk to the life of the mother, and as we saw in the Andrea Yates case, to the children as well.

One of the keenest memories I have of that period in my life is the shame I felt about taking anti-depressants. I wasn’t supposed to be weak; I wasn’t supposed to need help. My primary care doctor prescribed the meds but did not recommend therapy. Without that extra supervision, and without the aid of a psychiatrist in prescribing the medication, I ended up, after several months taking Zoloft, in a manic episode, during which I convinced myself I no longer needed the meds. I also stopped sleeping, spent money I didn’t have, became hypersexual–a huge shock to my then-husband, who was thinking of leaving me already–and was convinced that I could solve our marital problems if only I found the right song, poem or quotation, something that would make him see things as I did.

From there it was a downward spiral to thoughts of suicide, which I could only describe as “dark thoughts.” When I was finally hospitalized, the psychiatric nurse told me, “When you’re in the car, and you’re thinking of driving it off the road, it’s not just an idea. It’s a plan.”

Zoloft was not a good medication for me. The second time around it made me sleepless without any of the “fun” stuff mentioned above, and I also became highly anxious. But at least this time I had a therapist and a psychiatrist to negotiate the deep waters with me, and when I left it behind I was weak but beginning to mend.

Nine years later, I am still prone to depression, although it has never been that serious again. The big difference is that I’m not ashamed anymore. I know the problem I had was medical, not “just emotional.” I know that if I found myself in such a state I would ask for help, and I could receive it without punishing myself for needing it.

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