Depression is...

As salaam alaikum,

I cannot survive without writing. Writing has become such a big part of my life, that even though I'm going to have to get up in less than 7 hours to finish clinic notes from today, darnit, I'm going to write! If I don't write before I go to sleep tonight, I'm going to explode!

And sometimes, that's what self-care during residency means. Exchanging sleep for doing something that will make your soul make sense.

Speaking of one's soul making sense...I, just a few seconds ago, over the course of several hours, whipped myself into a frenzy of sorts. I've done a lot of reflection about my place in religion, my place in Islam, my place with God, all of these things. This, in addition to facing a patient today who recently had suicidal ideation and a plan, got me feeling pretty depressed.

Soon, everything around me was depressing.

The fact that I had a patient who was 25 and a parent already while I'm 29 and single was depressing.

The fact that my best friend from med school is pregnant with her first child and I'm 29 and single, perhaps indefinitely, was depressing.

The fact that my younger cousin is enjoying the first few weeks of motherhood whereas I remember her being the age of her daughter and I feel no closer to motherhood than I was when I was her age was depressing.

The fact that over half of my friends from medical school are married and have already had their first child and I may never get married and or by the time I do I may be infertile was depressing.

The fact that I am overweight and currently hairy was depressing. No one would ever want me, and my SO would realize that and leave me, and that was also depressing.

Then I talked to my SO about God, a topic he shies away from with me because I usually have heavy thoughts. I talked to him with how my patient rationalized her severe reaction to the death in her family with God's plan and about how I realized that I've never been comfortable with God's plan. Not God's plan itself but the term, the simplified concept. I realized that it's always depressed me when it's suppose to be a source of comfort. He was not ready for this conversation at nearly 10pm at night, so I hung up the phone and brooded on my own.

And then I had an epiphany that brought me up from the depths of my self-constructed depressive episode.

For me, depression is believing that God has no plan for you, or that God's plan is for you to fail. In Qur'anic terms, that you are one of the ones who God is hardening your heart to prepare you for hellfire, and there is nothing you can do about it, because it's God's will.

This was the source of my depression when I was a teenager, and I hadn't felt that way in a long time. I don't believe it now, but I got a whiff of it as I found myself sinking deeper into my self-made funk.

That is the root of depression for me. Those times when I feel so remote from God that I begin to doubt the purpose of my existence...those are hard times.

And that is how my patient felt when she wanted to shoot herself.

And that is how I felt as an adolescent.

And that's how I would continue to feel if I didn't take a break from sleeping this evening and keep vigil by my laptop and write things out.

Depression for me is doubt in my purposeful existence. My only remedy, then, is belief.