“Depression is common after stroke, affecting approximately one third of stroke survivors at any one time after stroke (compared with 5%–13% of adults without stroke), with a cumulative incidence of 55%.”

https://www.ahajournals.org/doi/10.1161/STR.0000000000000113

When I was extubated after my aneurysm surgery, the doctors explained that depression is common after a stroke. They asked if I was comfortable with starting antidepressant therapy. I agreed.

Unfortunately, I’ve been through multiple medication trials since then. I see a psychiatrist every three months. His brother in law, whom he considered his best friend, died of a ruptured brain aneurysm. He seemed so empathetic with my situation. Are the meds working? Maybe a little, I’d say.

I still experience sadness, hopelessness, emptiness, and sometimes wish I hadn’t survived my rupture.

I try my best to cope with these feelings. Writing helps somewhat. I might just be screaming into the void, but at least it’s not echoing back to me.

I’ve tried therapy twice in the last year. It didn’t go well either time. Talk therapy just seems to make me anxious. What will we talk about this week? I feel like I need to come prepared with a checklist of issues I’ve faced in the previous week. Sometimes, I didn’t have any issues that week.

My first therapist was just OK. She just listened. ‘Is this all there is to it?’ I wondered. When she did offer me advice, it was sometimes OK and sometimes REALLY not OK at all.

After my rupture, I didn’t recognize that I had PTSD. I started to do things in response to my trauma. I began restricting my eating and over-exercising. I lost almost 50 pounds. For context, I was overweight at the time. I had just birthed triplets a year earlier. I told my therapist about the burgeoning eating disorder and instead of trying to get to the root issue, she would just ask me, “are you eating?” And I’d lie and say I was.

One day, she shamed me for what I was doing. She said, “you are going to end up in the hospital! Do you want to do that to your kids? Who will take care of them?”

I now realize just how fucked up this is. Instead of actually helping me understand why I was doing what I was doing, and helping me, she used shame to get me to stop doing it. Great idea for a trauma patient. She hit below the belt by making it about my kids. Plus, apparently, I should put everyone’s needs over my own. Who will take care of my kids, after all? No one ever seemed to ask, “are you taking care of yourself? How can I help?” I’m the one who is struggling, but let’s pile on guilt and shame. That’ll help for sure.

I stopped seeing her shortly after this exchange.

I’ve managed to gain about 15 pounds in the last several months. I no longer restrict and I don’t obsess over my step count.

I started seeing a new therapist in the summer of 2021. She was a licensed psychologist with her own practice. I said I wanted to do EMDR. https://www.emdr.com/what-is-emdr/ She agreed. We had about 10 sessions together. It was more of the same crap. “How has your week been?” I asked what we were doing, how we were getting to starting EMDR and never got a straight answer other than, “we are building up to it.” I asked how, and again, didn’t get a straight answer.

Before he was officially diagnosed, I told her about my suspicions of my son having ADHD. She told me to give him coffee to see if that helped him. Coffee. To a five year old. This woman told me to give my young son caffeine to treat his ADHD. I was dumbfounded.

She told me during every single session that it was such a shame I didn’t live in Pennsylvania. She kept lamenting about how the services there are so much better for special needs kids. Uprooting my life to move to a different state was not helpful advice at all. Repeating it multiple times was a complete waste of time. She even would say, “I know I tell you this every session, but you really should move to Pennsylvania.” It’s like she didn’t have any other ideas to help me.

She told me she was taking a trip to Yellowstone Park and we would miss the next session. I found myself relieved and questioned why I felt that way. I wondered if I was wasting my time with her.

About a week later, iI received a postcard. It wasn’t signed. It was addressed to my whole family. On the front was a picture of Yellowstone Park. I was confused at first, and didn’t know who it was from. The message was vague. It said she was having fun with her daughter and hoped everyone in my household was getting ready to go back to school.

Once I realized it was from her, I was furious. She took my PHI with her on vacation? What if it had been stolen? How could she cross this boundary with a patient? People would definitely react differently if a male psychologist had sent this instead of a female psychologist. But, that’s not really fair. There shouldn’t be a difference. What she did was out of line and a breach of my privacy. We are not friends. This is a professional relationship.

I canceled my next appointment with her. She eventually texted me to ask if I wanted to reschedule. I have a hard time with confrontation. It sends me into fight or flight. But, I felt the need to advocate for myself and for anyone else she might do this to. I mustered some courage and texted back, “No. I don’t want to reschedule. I did not appreciate the postcard or that you took my PHI with you on vacation. I feel like this crossed a boundary.”

She didn’t reply. I reckon this is because she knew what she did was wrong. She couldn’t admit to it without the possibility of me reporting her to whatever board certifies her. She also couldn’t gaslight me by saying, “no, I didn’t send you a postcard.” I assumed that would be a breach of her ethics. That assumes she even has any.

I’ve been taking a break from talk therapy. It’s hard to start over. It’s hard finding someone you like. Even with insurance, it’s fucking expensive.

I’d love to try EMDR. Everyone says it works wonders for trauma. But, I’m comfortable taking a break for now. I’m frustrated with the overall process and the lack of results.

Sometimes I’m not sure if my symptoms are a result of my depression, the meds I take for the depression, or if it’s the PTSD.

Depression sucks. It isn’t cured with medications or therapy or eating well and exercising. It’s always there, lurking, whispering half truths which I usually believe.