How I Deal With Thyroid-induced Depression

With our family histories of mental illness, I think Rob and I are both secretly afraid that one of us is going to crack up some day. Hence, the worried expression on his face when I wake up in tears. Literally. Coming out of the fog of sleep, there is a weight pushing down on my chest, making me feel acutely, profoundly, sad.

He asks me what's wrong. I don't know. He asks if it's something he did... No. He asks if I had a bad dream... No. He asks if something has happened... No. It's not rational. I've experienced a rational grief before when my father died. I know when it's justified. This time it's not. It feels like someone has died, but nothing serious has changed in my life.

If you have read my blog before, perhaps you know that I was diagnosed with Hashimoto's disease, which makes my thyroid under-function. This depression happens occasionally, I believe, due to hormonal fluctuations, despite the medication I take working fine most of the time.

And so the way I deal with it is this: I think of the depression as something separate from me. It's not me; it's a symptom. I deal with it the same way I deal with a bad cold. When a virus hits you, you do what you can to get through it. I'm sad for a day, or a few. I let myself be sad. I cry at sappy commercials, feel pessimistic about the world, feel lonely, turn off the chat clients, and unplug the phone (and I'm usually more productive at work- like a cold, it's not debilitating, just annoying).

Then, over a few days, I gradually begin to feel better. I giggle at something. I put on a dress and make-up. I clean something, want to go out, and at some point it dawns on me that the dark cloud has passed, much the same way you realize after a cold you are not coughing or blowing your nose anymore.

Depression is really not as big of a deal as commercials for anti-depressants make it out to be. If it went on for months with no end in sight, then it would be a problem. But temporary mild or even moderate depression is nothing to be afraid or ashamed of. It's not "crazy." It's just part of life. If it weren't for depression, we wouldn't have half of the great poetry that exists in the world, or Russian novels.

I think there is too much pressure on us to be in a good mood all the time. Where does this pressure come from? Is it an American thing? I don't know, but it's just not life. Embrace your melancholia. It makes the happy times that much more enjoyable.

My Experience with the Argentine Medical System

As you may know, I was diagnosed as hypothyroid, which means I have to consult with an endocrinologist, take meds every day, and go get my blood checked once every few months. I have done all this here in Buenos Aires, so I thought I would give a little summary of what the experience has been like.

Argentina has a national health system, which is free for its citizens. I have heard two things about this: 1) It's free for everybody and isn't that great, and 2) Don't use it if you can avoid it, especially the hospitals. They also have a private health system, which can be paid for with insurance, or by cash.

Since the cost is low enough for me, I pay cash. It's simple. No forms, no hassles, and you know how much everything costs. No one turns you down for anything. I get the tests I want. (Libertarian rant: Does anyone who is in favor of national health care consider that if health care is nationalized it will go the way of eduction--crappy? That seems to be the case here. The private system is superior.)

I got diagnosed with Hashimoto's when I went to an OB/GYN for a regular yearly exam. He asked me how I was feeling generally, and when I said fatigued, he sent me for some blood tests. He has a small office in a high-rise building run by just him and his secretary. I never wait more than two minutes past my appointment time. He never has more than one patient at a time in the waiting room. It's quiet, comfortable, and I pay around $200 pesos per consultation (about $55 bucks). This is pricey. He is very exclusive. His office is five blocks from my apartment. But he is wonderful, and he practiced for years in Chicago.

I go for the blood tests at a lab 1 1/2 blocks from my apartment, taken by a little old man who has been doing it for years. There is no one else in the lab. I am in and out in ten minutes. I pick up the blood tests MYSELF a couple days later. I bring them to the doctor. I think my thyroid tests cost me $50 pesos ($14 dollars).

This is a major difference here. With a few exceptions, I have picked up my lab results for a mammogram, thyroid ultrasound, and blood tests myself. I keep them myself. They are owned by me. It is a little more work on my part to get them and keep track of them, but I can take them to a different doctor if I want, or research the numbers myself online. My thyroid biopsy was done at a hospital, and they kept the results because it is the hospital where the endocrinologist practices.

My endocrinologist is a $20 peso taxi ride out to another neighborhood. She is excellent. Like the OB/GYN, she spends time talking to me, writing all my information down by hand on an index card. She speaks English (just got back from a conference in the U.S.) She charges $70 pesos per consultation (about $20 dollars). She gives me the change out of her pocket. She writes me a prescription for some medicine, and I go to the pharmacy down the block for it. I don't even have to show them the scrip. I just tell them what I want and they give me a box of bubble-wrapped capsules. $14 pesos (about $4 dollars-- granted, this medicine is cheap in the States, too.)

I need to go through the blood test/endo appointment thing about every three or four months, and go back to the OB/GYN each year.

So this is my experience-- good health care, low cost (at least for me. I know my financial situation here makes me very lucky), extremely efficient. I feel more in control of my health here than I did in the States.

At Least You Have Your Health

I haven't been posting as much as I wanted to over the last few months, mostly due to health issues: I was diagnosed with Hashimoto's Thyroiditis, which means that my thyroid isn't producing the hormone it should. The result is that I get wicked bouts of mood swings and days that I am so fatigued I can't get out of bed for more than a few hours at a time. I thought I was just extremely lazy, or getting bouts of the flu.

The good news is, I've been taking meds for it, and feel my energy coming back. The mood swings are fewer and farther between, so I am not insane or driving Rob insane. I have had very positive experiences with the medical care here, which I might expand on in another post. The other good news, had a biopsy on the nodules on my thyroid, and there is no cancer. So. I've dived into a few new projects, so I will probably have more to blog about:

1) I'm getting paid to blog about expat issues for a site that wants to build a community around it, so I will definitely be blogging on a regular basis there, and here.

2) I'm taking singing classes. Fun, fun, fun. The teacher is Viviana Scarlassa, a tango singer. I recommend her highly. Enjoying myself. I like a singing teacher that starts classes with a medical diagram of the respiratory system.

3) I have a couple of book ideas. One is about my experience teaching for the B. Family for seven years as their private teacher, and the other is a book on managing digital information for the non-technical person.

Of course, I still have my regular work and Rob has a business project in the works. So I am glad to get the whole hormone thing sorted out.

It's so true that if you don't have your health, you don't have anything.