If you are a regular reader of my articles, you already know that I stress that there are three components of overall health status.
*** Physical Health – the body
*** Mental/Emotional Health – the mind and emotional reactions to stressors
*** Spiritual Health – the soul
These three divisions do not exist totally independent of each other. Instead, they merge to form your overall health status.
If you are a regular reader, you also know that I frequently write about spiritual health because some people are not aware of how vital this component is in determining your total level of healthiness. More surprisingly, you may be shocked that I will concede and not insist that spirituality may always be your number one priority at any given time.
Please do not misinterpret this last statement. I totally believe that spirituality must be given daily attention and nurturing to grow consistently in my relationship with my personal Lord and Savior. However, you may have profound physical disease processes or mental illnesses that overshadow the immediate status of your spirituality.
The 1995 graduating class of Midway Nursing was not taught about spiritual health, and there were no questions on my Kentucky RN Board Exam about this matter. It was only after I obtained my RN license that I was exposed to nursing care plans and patient evaulation questions that focused on spiritual needs.
Personally, I find it vital to address my spirituality on a daily basis. This requires knowledge and practice. Much of this knowledge is received by attending prayer group gatherings, Bible studies, and congregate worship services at Consolidated Baptist Church located at 1625 Russell Cave Road here in Lexington. Since I know that I am a saved siner by the shed blood of my personal Lord and Savior Jesus Christ, I am not frightened on a daily basis about my spiritual health – attentive, yes – frightened, no.
I am, however, somewhat frightened periodically about my mental health status. To explain this statement, it is necessary for me to explain my first encouter with depression. At Consolidated Baptist, we refer to this as becoming ‘transparent’ or somewhat ‘baring your soul’ so that your personal life experiences might be of benefit to others.
I had been married for ten years to the father of my three daughters when he decided that marriage was no longer for him. The girls were 1 week old, 3, and 6 when we parted ways. He was a good man and an excellent provider, but he became victim to what many medical personnel experience. His two-partner, large animal veterinary practive grew at such an alarming rate that he seldom received a full night’s sleep and certainly had no respite from his dairy farmer or horse clients who would literally come to our home to retrieve him. Their animals were not pets – they were their financial livelihood.
For the first time in my life, I experienced moderate to severe anxiety. I was young and resilient and survived emotionally intact. Five years later, he died a tragic death, and my children were present in his home during the chaotic arrival and departure of emergency medical personnel.
When my daughters became somewhat more independent, I decided to return to college. Instead of completing my psychology and social work degrees, I decided to pursue a nursing degree. The girls were 10, 14, and 16 when I entered Midway College in 1993 just two months shy of the age of 40. Instead of taking my prerequisite nursing courses first, I was told by the Director of Midway’s Nursing program that I should do the traditional prerequisites concurrently with the nursing classroom and clinical programs. Her reasoning was that if I had survived my adult life intact, I could survive nursing school. Also she focused on the fact that I had a prior GPA of 3.80 at UTM and numerous courses from 1971 through 1974 there that would be honored in Kentucky in 1993. I could not really fathom this, but I accepted her suggestion – mistake #1.
Midway College actually accepted only my English credit hours. I found myself in the dilemma of taking algebra, anatomy class and lab, microbiology class and lab, human growth and development, religion, etc., etc while at the same time attempting to mother a ‘tween’ and two teens who had raging hormones and fought daily over what hair accessories belonged to whom.
The result was physical and emotional exhaustion. I acquired an unrealistic fear of failure the very first semester. (I use the term ‘unrealistic’ because I had a 4.0 GPA the first semester, graduated with a 3.49 GPA, and was one of only 40-something ladies of a class of 90 to actually graduate. The remainder of my classmates did fail their first attempt somewhere along the way). By a week before the first semester’s final exams, I was almost nonfunctional and clinically depressed. Since I had only experienced anxiety, not depression, prior to this, I truly thought that I had a serious physical disease. I could not eat, sleep, or concentrate effectively.
My fellow classmates in the smaller clinical group had no clue as to how to approach me, so they actually observed from a distance. My clinical instructor took me aside and spoke to me as compassionately as anyone ever has. She was not a psychiateric nurse but explained that her sister had recently given birth, had postpartum depression, and thus had to be hospitalized. She added, “She looked just like you do now.”
When a psychiatrist that I knew socially confirmed her opinion professionaly, I immediately burst into tears. I complied, was hospitalized, and diagnosed with Irretractable Major Depressive Disorder, Clinical Type. This meant that my body did not respond chemically to usual antidepressant medication as it should and also that my depression was so deep that hospitalization was required to monitor me.
I was on Christmas break for four weeks, and my physician wanted to have me ready to begin the second semester after the holiday break. He tried me on numerous traditional antidepressant medications that failed to lift the depression. He ordered a consult with a second physician who suggested using a MAOI – a medication of ‘last resort.’ The danger of this medication was that it required strict adherance to a prescribed tyramine-free diet and avoidance of some over-the-counter cold and cough medications. If I failed to adhere to the plan, I could suffer an extreme hypertensive episode in which my blood pressure would rise dangerously. Since I had a history of low, not high, blood pressure I was a good candidate for the medication.
After I graduated and became a psychiatric nurse, I learned that it is common for those who are eventually diagnosed with a mental illness to actually experience their first ‘break’ or episode during a period of formal higher education. Also, the more stressful the field of study, the more likelihood of an initial episode. I observed many admissions to a psychiatric hospital unit for those studying medicine, engineering, physics, etc. in college. I was able to identify that I was more effective as a psychiatric nurse since I had experienced extreme depression my first year at Midway.
I began to research Major Clinical Depressive Disorder and found that those with this disorder usually experience a relapse every 3 to 5 years whether they are on antidepressant medications or not. I found these discouraging words to be accurate. To this day, I am frightened of the next impending depressive episode. One physician diagnosed me with Post Traumatic Stress Disorder (PTSD) as a literal reaction to the truma of recurring severe depression.
Just as with any physical disease, genetics play an important role as a possible contributing factor to mental illnesses. More than one of my relatives have committed suicide, and numerous siblilngs and cousins have taken antidepressant medications.
A residual of my depressive process is that I have experienced guilt concerning problems that my youngest daughter has encountered. She was traumatized by witnessing the death of her father at the age of 5. She also possibly felt more abandoned than her sisters did when I entered nursing school. I do remember that in preparation for my re-entry to school, I literally used gradual desensitization to wean her from my king-sized bed into her own bedroom – from the mattress to a ‘pallet’ beside the bed that was moved outward a few feet each night until she was eventually in the hall, and finally in her own bedroom.
A prior minister at Consolidated Baptist soothed my personal thoughts about myself by explaining my current position in life in response to my attempts to atone prior slights in parenting. In the 23rd Psalm of the Bible, David speaks of his cup ‘running over.’ Minister Baker explained that when you are living your life for Christ and are exposing your adult children to your current spirituality, God will pour into your cup more than it can hold, and the overflow will begin to spill over onto your family. He stated, “Everytime that I look up, you are here in this church.” I had to be. The decomposing body of my deceased father had been found, and my daughter was going through major life upheavals. Minister Baker’s explanation of that passage in the 23rd Psalm really allowed me to learn to ‘let go’ of guilt and grief and move on to a more joyful life.
If I feel spiritually depleted, I will pray more frequently and fervently, read my Bible more, and attend as many church functions as possible. If I feel physically sick, I will make an appointment with my primary care provider. However, if I begin to feel mentally off balance, experience a decrease in energy level, and have overall general body malaise, I almost panic. Thus, I frequently rank mental health as number one on my scale of health concerns. I hope that I explained this adequately without misrepresenting that spirituality or physical health are of less importance than mental health.
How can you numerically rank your three individual components of overall health? You literally list all health problems including your signs and symptoms, interventions that you are using, and how this specific health issue affects your life. When you put it all in writing on paper, you are able to visualize your overall health status and decide which issues are acute and which are chronic – which are annoying and which are dangerous – which are being adequately controlled and which need further attention. Also, be aware that the ranking may change from day-to-day or month-to-month.
Successful businesses utilize financial spread sheets. Successful medical and dental offices have begun the practice of giving patients a printed plan of proposed health care. Successful laypersons can gain more control of their total health by writing a ranked or scaled personal plan of care and by periodically referring to this plan to denote their personal progress.
As I near the close of this article I would like to offer suggestions for local health care entities that both diagnose and treat mental illnesses.
*** Comprehensive Care at 1351 Newtown Pike – phone 859-253-4695
*** Bluegrass Community Health Center at 1306 Versailles Road, Suite 120 – phone 859-259-2635 and 151 N. Eaglecreek Drive, Suite 220 – phone 859-263-2507
*** St. Joseph Behavioral Health System at 869 Corporate Center – phone 859-224-2022
Take control of your overal health and live life more successfully and joyfully. Remember, you get only one earthly body – take care of it!!
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