I don't know if the following is relevant. I have had periods of unhappiness before and have generally been very secretive. Now, I have been depressed for months.
As I was growing up I felt life was throwing everything at me. I'm from a comfortably off, academically high achieving family. In my early teens, my illusions that my parent's marriage was perfect was shattered when I discovered a note, obviously intended as a suicide note, written by my mother. I confronted her and found she'd been saved by a phone call.
My mother had always emphasized how important it was she had only ever had one partner, so when I became sexually active young I felt guilty. A cousin introduced me to heavy petting and other sexual stuff when I was twelve and slept with me by the time I was fourteen. At 16, I was raped, gang-banged. I felt the perpetrators must have known I was wicked. Meanwhile, I was failing at school; I gave up the idea of studying medicine as I couldn't be bothered with the effort. I didn't believe I could ever amount to anything. I felt fat and frumpy, though I was only a pound or two overweight and I became promiscuous, looking for comfort in others, always believing relationships would be long-term.
At 22, I had a late termination abortion, not knowing who the father was and unable to face my family with the pregnancy. I felt threatened, cornered; I didn't feel I had coping mechanisms. This was followed by 15 years of marriage to a man who couldn't have children, which I often felt was fate getting back at me. I went through years of fertility treatment, suspecting it was his fault, not mine, but feeling I had no right to ask him to be investigated.
Two years ago, with young children at school, I went back to university. My youngest brother died suddenly at 38. I slowly became very depressed. Ten months ago, I sought treatment and have been on increasing doses of antidepressants since. I feel better for a while and then tumble. At these times, I overeat (I now AM fat and frumpy), sleep badly, and snap at the slightest thing. I get headaches, and do not want a physical relationship with my husband. I also take a razor blade and cut small neat lines into the back of my wrist. I think I may do this because I can't cry.
Since my brother's death, I have felt everything is futile. I go through the motions of running a home, but I haven't felt capable of looking for a job. I feel completely inadequate; despite completing my studies, I feel I will fail, so why bother? I can't see why I go on living. I feel I do so as not to hurt my family, but it seems a stupid reason to go on. I go on because it would take an action to stop living. I know life hasn't always felt like this, but I feel this is me, not an illness. When I see my doctor, I try to be honest, but sometimes tell him what I think he wants to hear as I don't like disappointing people.
During the last months, I have been trying to keep on top of things, but my house is a mess, I have no social life, I avoid my husband and children, and spend hours doing trivial things on my computer. Out of the house, I say I'm busy so that I can run away from conversations. I feel uncomfortable and inadequate with almost everyone and act like an actress with my family.
How can I regain some energy, hope, self-confidence? Will joie-de-vivre ever return? Who should I turn to? Or is this just life?
NO, this is definitely not "just life". You're right that the problems that you describe having now are not necessarily an illness, but they are also not "just you." They are the result of the many traumatic experiences you have had which have never been fully addressed. It sounds as if you had no counseling until 10 months ago, so all of the feelings you had regarding your mother's suicide note as well as your experiences of sexual abuse, rape, and the other life experiences that followed have never had a chance to come out, be expressed fully, and be resolved.
It makes sense that although you are on antidepressants; these alone are not providing you with a full "cure". Your depression sounds to me as if it stems not from a biochemical condition which requires medication but instead from an accumulation of life events that have deeply affected you.
You don't indicate whether your meetings with your doctor are for counseling purposes or for medication management only. Under most managed care systems, patients meet with psychiatrists for only 15 minute sessions once every few weeks or once a month so that the psychiatrist can monitor the level of medication and make adjustments if necessary. What you need in addition to such sessions is regular (probably once per week) sessions of 45 -50 minutes each in which you can talk about all of these events that you went through and the ways in which they affected your self esteem and outlook on life. You may also want to participate in a group for women who have been sexually abused. The pattern you describe of sexual abuse being followed by a rape in which you felt that you were to blame (you were NOT) as well as a decline in self confidence and searching for comfort in others through promiscuity is actually quite common in women who have been sexually abused. It can help to realize that others have been through similar experiences, and women in these groups can help each other to heal.
The path to regaining the energy, hope, self-confidence, and joie-de-vivre that you want to experience is a difficult one. It requires that you stop trying to pretend that everything is OK and that you stop telling your doctor what you think he wants to hear. He needs to know that you cut yourself with a razor blade and that you don't see a point to continuing living. You won't get better by pretending. You will only get better if you stop trying to force yourself to feel happier than you do and allow yourself to feel all of the grief, rage, hurt, anger, and other emotions that are inside of you as a result of all that has happened to you. The hours you spend doing trivial things on the computer may distract you from feeling uncomfortable feelings, but by doing that you only prolong the period of time in which you feel miserable. A better choice would be to talk to your husband, assuming that you and he are close and you feel comfortable confiding in him, about what you're going through. Tell him what you are feeling, talk about why you do not want a physical relationship with him (again, this is not uncommon for women who have been sexually abused), let him know how inadequate you feel, how scared to look for a job. If you do not feel able to share so much with him all at once, then begin incrementally. Instead of pretending all is well, you could talk about how you are going through a hard time but aren't ready to talk about the details with him just yet. I recognize that the pattern of secrecy which you learned from your family is a hard one to break. But clearly, keeping things secret is not working for you any longer. It is time to try a new approach to see if it might restore the energy and hope you are missing in your life.
Usually people feel a sense of relief when they stop pretending and acknowledge how they are feeling to others, even though it can be a scary thing to do. Another good idea would be to keep a journal in which you write about your feelings. Since it will only be you reading it, there is nothing preventing you from being honest. You can write about how you feel today, but also about how you felt years ago about losing your brother, about the late termination, about the years of fertility treatment, and about the early experiences with your mother's suicide note and being sexually abused. Once you open the floodgates to all the emotions that have been stored up over the years, it may feel for a while as if there will no end, as if you will never stop feeling so angry/hurt/sad, etc. This is a why a therapist is so important, because he or she will be with you throughout the experience and will help you to realize that it is a process, and not something that happens all at once. Ultimately, you will feel better, much better.
This question has been answered by Susan Maroto. She is a Licensed Clinical Social Worker working out of Mount Laurel, New Jersey. She uses an eclectic approach to holistic healing, mind-body relationships, life transitions, depression, and anxiety.For more information visit: http://www.therapywithsusan.com/