Ankylosing Spondylitis, Mental Health, and Therapy
I began therapy in 1992 because of deep, unrelenting depression. A depression so pervasive that I thought I might lose my job, family, and all that Sheryl and I had built together. All of this occurred before I was diagnosed with rheumatoid arthritis or ankylosing spondylitis.
I was at the point that I could barely order off a menu at a restaurant, for fear of making the wrong choice. This from a man who wrote and managed a $40 million budget, negotiated labor contracts and oversaw three large operations involved in food service, bus transportation of 6,000 children each day and supervision of the maintenance and cleaning of over one million square feet of space. When you are performing in a job like that, and you cannot make a simple decision about what to have for lunch, something is about to break. I did not even have a name for my issue. When my therapist suggested I might have depression; I was shocked. "Depression?" I said. It took over a month to come to grips with the diagnosis.
Different approaches but one goal
Over the years, I have seen four therapists, each with a different approach and each seemingly just right for that stage of my life. While I have usually done one on one therapy, I have also participated in group therapy.
Sometimes I have attended a session with a specific issue to discuss, and other times, I have kept my appointment with no aim or topic in mind. Often, we discuss the latest diagnosis and prognosis from my medical team. It helps me to spread the burden of those medical issues to a caring yet not directly involved outside party.
Getting my life back
In 1994, thanks to my therapist and the help and support of my family, I got back on track. Regular therapy and medication management is something I have maintained for most of the rest of the time since I first started. My therapists have helped me deal with the diagnosis of RA, then AS and complications stemming from long-term diabetes.
They also have helped me navigate changes in job, retirement, and living situation. I would say that today I am about as happy as I have ever been in my entire life. My relationship with Sheryl (my wife of 42 years) has never been better, and I am busier than ever. Despite ongoing health issues related to chronic illnesses, I have been able to keep my illness in perspective, and I have stopped catastrophizing every new symptom and concern.
While I place a high value on therapy, I also put a high value on my medication management doctor. Over the years, I have had four of these as well. They understand the drug interaction that might be at play with the antidepressants I use, and they look for interactions with the many medications I take outside of the mental health team.
Recently I discussed pain management with my medication management doctor. It may seem odd to discuss pain management with the psychiatrist that helps me deal with the mental and emotional strains of depression and chronic disease. But unlike my other specialists (I see 16 annually) his practice is integrated into all the other doctors I see. He then translates the world of physical medicine into treatment ideas for depression and vice versa.
There is no shame in prioritizing mental health
The reason I am writing about this topic is that I hope in some small way, I am easing the stigma associated with mental health services. I am fortunate to have learned that when I incorporate mental health services into my treatment plan, I do so much better at managing my three chronic diseases.
Mental health and ankylosing spondylitis
As an example, exercise therapy and medication management are integral parts of living with diabetes and arthritis. I hope that if you are suffering from symptoms of depression or other mental health issues that this note will give you the courage to step out, establish those relationships for mental health issues, and be brave. I know from experience it can be difficult, but it is so worthwhile, especially when we coordinate the treatment of our mind and body.
How much about your AS do you share with others?