Today is grief vs. depression day. Depression is so complicated! There are so many different kinds and potential different causes for depression. Different people have many contrasting symptoms ranging from no appetite to stress eating for example. There is a variety of treatment options as well. The key is working with your psychiatrist and / or counselor to find which one(s) work best for you.
So when I left off on our life story, Perry and I recently had Sam. We were living in Mt. Olive, Alabama. Perry was working four 10 hour shifts / week at O'Neal steel. I was still working in Neuro ICU but had transferred into a flexipool position. A flex position for all of you that don't know is an "as needed" position. Flex people are paid more (usually base plus 25%) because they have no benefits offered (no sick, no vacation, no insurance, etc.). I would give the hospital my availability to work and they would work me if I was needed, or cancel my scheduled shift if I wasn't needed. If I wasn't needed in my assigned unit, I could be reassigned to another critical care unit. Initially, I would try to work two 16 hour shifts on Perry's off days so Sam was always with one of us. Unfortunately, that didn't last long before it started taking a toll on our marriage.
We had some of the MOST INCREDIBLE neighbors ever. They loved Sam as if he was their own grandchild. We'll call them MiMi and BB. They had two children of their own, but neither were old enough to be married. They became Sam's Godparents and adopted grandparents. We vacationed together. We did Christmas together. I can't tell you how much this family meant to us. If either of us needed anything, we went to Mimi and BB instead of our own parents. MiMi volunteered to come to our house and keep Sam from 10pm to 1130ish pm so we were still able to keep him out of daycare and have some time together. I started working four 3-11pm shifts / week and Perry was working 11pm - 7am. MiMi filled in the gap between Perry leaving and my getting home. They were great to Sam and to us. We moved to the neighboring city of Gardendale when Sam was 16 months old. We had quickly outgrown our 1st home. I thought we would never have such great neighbors again, but I was wrong. We were still close to MiMi and BB, and we moved next door to a wonderful family there as well.
I remember the day in nursing school when we talked about coup - contrecoup head injuries. I was fascinated. I also remember the first day as a nursing assistant I floated into Neuro ICU. I was mesmerized. I have always been fixated with the way the brain works. Neuro ICU (NICU) will always be my first love as a nurse. Not only did I see some of God's greatest miracles in that unit, I met some of my lifelong friends. I learned to be a nurse there. Nursing school can teach you about anatomy, drug dosages, pharmacology, and insignificant stuff like bed making (which I failed the 1st go around), but the real learning comes from experience and those who train and teach you. I worked in all of the critical care units at Carraway before the hospital closed in 2008. They all had great nurses, but neuro had a very special group with a bond I can't describe. We were a family within the hospital; we were like siblings within our unit. I was taught to use my critical thinking skills and work with all other staff, including the physicians, to care for the patients and their families the way I would want my family or myself to be cared for. The physicians trusted us and we trusted each other.
Once I became a mother, I found working in NICU harder for me to handle. We saw miracles, but we also saw some horrific things as well. As a trauma center and the only hospital with an air medical program at that time, we received the worst of the worst on our unit. It was very unusual to have anyone conscious. We had car accidents, gun shots to the head (including several self inflicted), spinal cord injuries, falls, aneurysms, and strokes (including brain bleeds). Many of the trauma patients were young. Once I had Sam, it resonated differently with me when I had a parent tell me to take care of their baby. I now knew what that truly meant. Because I was flex, I had been going to several of the other critical care units. My least favorite was anything cardiac. Not because of the people or the work, but because the heart scared me to death! Kind of ironic for those of you that know me huh?
The nursing shortage was still horrible and the hospital was offering critical care unit specific contracts. They were paying extra money if you would agree to work in a specific unit 32 hours / week for a month contract. I decided to challenge myself and do a contract in open heart surgery ICU (CSICU). Sam was still only about 6 months old. That decision was one of the best decisions I ever made. Not only did I meet my non-biological sister and daughter I still claim to this day; I conquered my fear of the heart. It's actually much easier than the brain. Plus, it's much easier to do sternotomy, leg, and chest tube dressings compared to wrapping a head!
One Thursday night in August of 1996, I was working a 3-11 shift in CSICU. I had gotten upset because one of my favorite patients had passed away on the step down unit. A little known fact about me is I have cried with every death I have ever seen. Some view me as a very weak person because of this. Others view me as a poor nurse for not being able to compartmentalize my emotions. Through the last 30 years, I have learned (after being chewed out, cussed out, laughed at, and called weak) to deal with the task at hand and then go to the restroom or take a break outside and cry by myself. After that, it is suck it up buttercup, and back to work. Anyway, this particular night I was in "the back" where the sicker patients were located. We sat in front of our patients with a bedside table watching them at all times. I'm not sure how I went from the chair, to the floor, to the empty bed in CSICU but it happened. I was told I "fell out cold". Those pesky nurses in CSICU insisted I go to the ER.
At the time, I was on Perry's health insurance. I was required by his insurance to go to UAB's ER. The only thing hurting was my side. It was rather painful. It was jam packed at UAB. Perry had picked me up and was at the ER with me. Perry and I had been trying to bring Sam a sibling into the world so I had called my OB/GYN. She was concerned it was an ectopic pregnancy. She said I needed to stay and have an ultrasound done. I had been triaged and had blood work drawn. Several hours later, I finally saw a Dr. It was a very short visit. I was told my serum pregnancy was negative so there was no way it was an ectopic pregnancy. He told me it might possibly have been an ovarian cyst that ruptured. I was sent home with instructions to follow up with my OB/GYN if I wasn't better on Monday. No ultrasound was performed.
The following Monday, August 12, 1996, I had plans on going to my OB/GYN because the pain had been intermittent all weekend. I received a call very early that Monday morning from Perry. He had worked the night shift at O'Neal as always. I knew the minute he called something was wrong. He never called that early. As soon as I answered, I heard, "Mike's dead". I could tell he wasn't ok. He told me he would be very late getting home, there was a lot going on at work with investigations. Mike was Perry's best friend. Mike and his brother Jeff both worked with Perry at O'Neal. Perry was friends with both but he was closer to Mike.
As I have talked about in earlier blogs, Perry is not very emotional. I used to joke the only two emotions he had were horny and hungry. He's always been very sweet and caring, but feelings have never been his strong point. He hung out at work with Mike. We had gone to an Auburn game with Mike when I was expecting Sam. It was AUsome! That game was the AU / LSU game where Auburn came from behind with five interceptions! Mike had just helped us move into our new house. Now, shockingly and horrifically, Mike was dead, and Perry blamed himself. I think to this day, he still questions why it wasn't him instead of Mike.
Perry had moved up to being a supervisor at O'Neal. He had been on the forklift that Sunday night / early Monday morning when he was called to go help find an order for one of the truckers. He left the forklift and asked Mike to continue what he was doing. While he was busy locating the order, he heard a lot of screaming and chaos. He ran down and found that one of the overhead cranes had been moving with the chains and hooks down. The hook from the overhead crane locked with the forklift and knocked it over. Mike was thrown out and the forklift landed on him. He was killed instantly from a ruptured aorta. Perry helped lift the forklift off of him. He reached under to try to find a pulse. He told me Mike was immediately cold and his skin felt like an orange peel. This was one of the few times I have ever seen Perry cry. I didn't know what to do to help him. I called our pastor to come speak with him. I tried talking to him. I was really worried he was getting depressed. That's when I realized there was a difference between depression and grief.
I came to realize from this experience and from the grief of losing my grandfather relatively close to this time, grief decreases with time. I have noticed my depression has triggers, as does grief; but, my grief occurs in waves that is triggered by special events such as a birthday of the deceased or the anniversary of the death. I can always tell a difference in Perry on August 12th. I can feel myself grieving for my lost loved ones when I'm reminded of a memory. My depression isn't self limiting like my grief seems to be though. It can last for days to weeks. It can be triggered or just happen out of the blue. With grief, there are the five stages: denial, anger, bargaining, depression and acceptance. With depression, there is just sadness and hopelessness.
Depression statistics are alarming! According to the World Health Organization, in 2020, more than 264 million people suffer from depression worldwide. Depression is the leading cause of disability in the world. Women are twice as likely as men to have depression. The National Institute of Mental Health in 2017 states 17.3 million adults have had at least one major depressive episode. Please speak out and seek help if you are grieving or depressed and need help.
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