Age at diagnosis: 19
Brief outline: Sam (age 23) was raised in a religious family. His symptoms started with his loss of faith at age 14. After inpatient treatment, he dropped out of college and therapy to pay the debt, but still uses what he has learned to control his symptoms.
Background: Sam works as a young professional to earn money to resume his university studies. He lives in an apartment with a roommate. He is White.
Sam has been living with depressed feelings on and off since age eight. Early on, he had no words for “depression or mental illness,” but spent “many nights lying awake in bed feeling this kind of gnawing emotional pain without an overly identifiable cause”. Raised in a conservative religious family, Sam thought about his angst “primarily in religious terms … that I was not pleasing God or God was not happy with me.” Throughout early childhood Sam tamped down these feelings. Sam credits his religious upbringing for instilling in him that “my fundamental purpose was to make other people happy” and thus made him “a significantly less angry and abrasive person”. His first bout of severe depression occurred at age 14 when he decided, “I no longer believed in the tenets of the religion I was raised in”. He was living with this “nagging fear of ‘what if I’m wrong, what if I go to hell’?” He also realized he had been “sacrificing too much of myself in order to meet the needs of other people”. These repressed feelings anger, fear insecurity combined to spark “a very long depression that lasted a couple of years” in high school. Sam now sees the experience as “an important step in my maturing and being able to empathize” with others.
Sam entered the university and began studying theater, but says he “had not begun to deal with the issues that had driven me to feel depressed before”. His first romantic relationship that started in high school was “marked by codependence on both of our parts”, and it became “clearly unsustainable” when his girlfriend threatened suicide toward during his first year of college. He ended up “dropping all of my classes that quarter” and “spending hours a day in my room, sometimes never leaving my room”. Sam had been seeing a counselor with the university for most of that year. At first, they discussed “very surface” matters; later, during a series of “emergency” visits, he felt “this sense of being overwhelmed was overwhelming”. At that point, he was referred to an in-patient psychiatric hospital. He says his entry was somewhat disingenuous on the grounds that, “I was deemed a danger to myself and others”. But he credits that the therapy combine with Prozac, “really forced me to take stock with my life and to kind of delve into the issues of my past that have led me to this point”. But stresses from the expense of the unexpected hospital stay “took a toll very quickly,” Sam says, and created a sense of “shame and stigma”. That, compounded by further bills, “sent me into kind of the same spiral that I had been in when I was 15 …and processing my deconvergence from Christianity.” Sam decided that, “come hell or high water,” he would earn the money to pay his debt and resume his studies.
Sam is now on leave from the university to earn enough to pay his debts, he. He can no longer afford therapy session or his Prozac. To sustain his mental health does artistic work in theater, and continues to study things he enjoys. He is also drawing on his experience and personal resources to control his depression. He says from therapy, “I gained a vocabulary in which to engage with ideas about what it is I’m experiencing and why I experience it and how to navigate it”. Further his “access to education about my symptoms” has allowed him “to develop plans and methods for dealing with them.” Sam acknowledges that he been “privileged” by various “mitigating factors”. He appreciates that depression is “taken seriously more than most” other mental illnesses, and that he has “been in a supportive environment”. Finally, he values having “close friendships that allowed me to work through my symptoms in a healthy way.” For all of these reasons, Sam says he is now “happy with the person that I am today”.
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