adjusting to cystic fibrosis and the loss or reasonable hopes

[Guest guest]

There has been a lot of discussion on several cystic fibrosis lists about

so-called " mental illness " and " depression. " I am a retired psycholo

gist, neuropsychologist and psychotherapist, amongst other things.

I detest over-pathologizing things, over-diagnosing personalities and

finding a " mental illness " term for every emotional state, or emotion.

There is a large category of recognized adaptational states commonly

referred to as " adjustment disorders, " and " grief, " and " loss " and of

course " post-traumatic stress disorder. " (like, maybe the hospital???).

I think of much of what we must adjust or adapt to with cystic fibrosis

as a combination of lost, though reality-based, dreams and hopes, of

a loss of a foreseeable future, of actual grief over these. That anti-de

pressant medications may help many go through these and to adapt,

that psychotherapy may help--all of the above--does not in my mind

mean that what many of us experience is " DEPRESSION " in any of

its formal or hair-splitting senses of the meaning of the term. I think that

we grieve, as we attempt to adjust to loss, we cope with anger, and with

actual medical abuse in clinics and in hospitals, thus becoming trauma

tized.

I say this from several prospectives: I am a person with cystic fibrosis

who had to leave her career before she had planned to; I am the mother

of an adult with cystic fibrosis and of two carriers of it. I am a widow,

though not due to cystic fibrosis, but to cancer. I have found it easier to

adjust than have some. I think that may be in part to what my parents

sweetly referred to, in describing me, as " congenital cheerfulness, "

which abounds in my family save for a few. Also, I am a psychologist,

neuropsychologist, psychotherapist and medical clinic administrator

who lost much when she had to retire on disability. And I do distance

myself somewhat from this as I slowly face the remarkable fact that I

am still here and appear about to experience " geriatricity! " I do other

things now, many other things, but I will never be able to return to full-

time employment in the career I so loved--but I did have the education,

the years of working for a very long time.

What disturbs me is the idea of everyone having a self image of being

depressed, whether or not they take anti-depressants, and whether or

not they have psychotherapy. I loved what Stern, M.D., of the

Cleveland Clinic once said at a conference when asked about mental

health issues: " these must be considered in light of and in consequence of

the physical illness and condition of the individual. "

I cannot say it better. I think any of us should feel free to benefit from

anti-depressants, and/or to have psychotherapy, but we should, by and

large, be realizing that we are persons with cystic fibrosis, with futures

that we have less predictability of than does the average person, and

that we are, by and large, adjusting to and adapting to life and the qual

ity or lack of it in our lives, imposed upon us, or our children, or our

siblings or even our parents, by cystic fibrosis. By and large, I think that

we are mentally creative, rather than mentally ill.

This is what happens when someone writes to me about all this. I just

start thinking out loud--feel free to disagree and/or to delete.

Love to all at cfparents: parents, kids, youth, adults, grandparents, sis

ters and brothers, aunts and uncles, friends and neighbors,

n Rojas