Written by Gretchen Parisi

Despite common misconceptions, depression is not a choice

Although Melissa Goeman has a "wonderful and amazing" life, she also has battled anxiety and depression for many years and attempted suicide. These co-existing truths underscore her assertions that what people see on the surface about others may not reflect their mental health reality, and that mental health struggles are not choices, but are medical conditions that can be managed with a combination of medication and talk therapy.

"People can sometimes make it seem like being depressed is a choice," said Goeman, an IT senior systems analyst in Information Technology. "If I could choose to not be depressed, I would choose it. If I could choose to not take medication every day, I would choose that. It was not my choice to have depression and anxiety, but that was the card I was dealt, and I am doing my best to live with it."

Medication pathway is one of trial and error

For Goeman, feelings of isolation and being different from her peers started in high school, but it wasn't until she sought treatment for sleep issues in college that she was diagnosed with anxiety and depression, as well as insomnia. These diagnoses put her on a rollercoaster ride to find the right medications to treat her conditions.

She shared that her first medication experience in college made her "very sensitive and over the edge," and after a fight with a friend, she took an entire bottle of Trazodone, was taken by ambulance to the hospital, had her stomach pumped and was placed on an involuntary psychiatric hold until her parents could get to her.

From then until now, Goeman explained that she went from taking no medication, to a lot of medication, to less medication (which didn't work), and then another medication (which did work) and, most recently, an increased dosage of that medication, only taking a break when she was pregnant with her son. "I probably will never take medication for insomnia again," she added, "but I also know that it doesn't work for me to not take my other medication because I have mood swings and it's very difficult without it. You have to be consistent."

Medication and therapy work together

Goeman believes that pairing medication with therapy makes a big difference, stating that although her medication certainly helped her, it was the therapy – which she defines as self-care – that really allowed her to move forward. "I have a great support system. My husband is awesome, but I believe in therapy, because sometimes you are having feelings that people in your life don't quite understand," she said.

"When you tell a therapist something, he or she will listen and say, ‘Here's another perspective.' You are more open to hearing that from a third party who can validate what you are feeling without you having to put a filter on it," Goeman noted. "You may have thoughts that people could think are incredibly weird, but a therapist knows what is normal for you, and why you think or feel a certain way. It may be something that's totally odd to other people, but therapy helps you work through it."

She also uses other self-care techniques, such as taking 10 to 15 minutes of silence by herself during the day, and always having something on the books to look forward to. "I struggle with living the same day over and over again," she said, which at times is challenging because her young son needs a routine. She enjoys making plans to switch that schedule up, such as going out to dinner with friends or watching a movie.

Fighting the stigma

When Goeman hears friends or colleagues say that depression is a choice or isn't real, she speaks up to report that she takes medication for depression every single day. "Just because you can't see that someone's brain has different chemicals, that does not mean it's not real. Some days I am extremely happy and others I just want to stay in bed and take a beat to feel sad," she said.

Goeman reports that her supervisors at Mayo Clinic largely have supported her by being flexible so she can seek therapy and attend doctor's appointments when needed. She advised those with mental health issues to carve out their own path and "be their own advocate" when navigating what they need. "Pay attention to yourself, because you are the only person who truly understands how you feel, and seek help when needed because you are not alone."

Although Goeman doesn't typically share her story with others, she is sharing it now "because I don't care what people think anymore. In the beginning I was very quiet about it because I was concerned that people would think that if I had anxiety and depression I would be unable to function, but I've had a great career at Mayo these past 10 years."

Look for signs to help others

Goeman says her own experience also has allowed her to recognize signs of depression or anxiety in others, such as self-isolating or cancelling plans. "I offer to go on a walk with someone or just call them on the phone," she said. "We all should pay attention when something seems off" with a friend or colleague, according to Goeman. "Someone else can help you get up, keep moving and get help."

Bottom line, she said, her mental health conditions "are like any other medical conditions." If you have depression, "you should not be ashamed of it. Some people may say you have depression because you're weak, but I don't think I'm weak. I feel like I am stronger because of it."

Share Your Story
Throughout the coming months, we will be sharing a series of employee and learner stories to break down the stigma around mental illness within our organization. Colleagues who are interested in sharing their stories can do so here. You can share your story however you feel most comfortable, anonymously or not.

Resources

Lend an EAR.  A five-minute trainingmoduleto learn how to better support each other in the workplace.

Crisis Resources:

The National Suicide Prevention Lifeline -  988

The Veterans Crisis Line and Military Crisis Line – 988 (Press 1)

Crisis Text Line – Text HELLO to 741741

Additional Resources:

Mental Health and Well-Being Website:  https://mentalhealthandwellbeing.mayo.edu/

Mayo Clinic Learner Resources:  http://intranet.mayo.edu/charlie/student-services/well-being/emotional/ 

Employee Assistance Program

RST: 507-266-3330 or http://intranet.mayo.edu/charlie/employee-assistance-rst/ 

AZ, FLA, MCHS, remote:  Vital Work Life: 1-800-383-1908 or www.VITALWorkLife.com

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In order to bring your best self to work or school each day, it is pertinent that you nurture your mental health. Let’s foster a culture at Mayo Clinic that encourages transparency and accountability with each other. We cannot consistently put the needs of the patient first if we do not address our own needs in these ways and support our colleagues to do the same. It’s ok to not be ok.