My Inner Journey to Mental Health

Accepting that I have depression was difficult. But my care team, family, medication and talk therapy keep me healthy.

| 5 min read
Rich-DeNagel
Rich DeNagel
Rich-DeNagel-Depressed-og

When I was 26, my life looked great from the outside. I lived in New York City, taught high school, was in a great relationship, had a lot of friends and enjoyed an active social life. I had cystic fibrosis, but how often I did my daily treatments depended on the intensity of my symptoms, and the only reason I ever did them more often was to keep up with my friends. I didn't talk much about CF with my friends. They knew I had a disease with two letters, but could never remember which two. I was embarrassed, ashamed and confused about having CF.

By 28, many things had changed -- mainly my health. I was in and out of the hospital. I had to stop working because I was not taking care of myself. I had broken up with my boyfriend and I spent a lot less time with my friends. My world had been turned upside down. What I didn't realize was that I was depressed.

I didn't know that the symptoms of depression are similar to those of a CF exacerbation -- tiredness, lack of motivation and not taking care of myself are symptoms of each illness, and one can lead to the other. After my second tune up in three months, I was still tired and felt empty and flat. Usually I left the hospital after two weeks of IVs feeling energetic and ready to get back to my life. This time, daily activities were an effort, I had no appetite and watched TV all day. I stopped showering and answering the phone. I did not do my treatments.

I started oral antibiotics, but after two weeks with no improvement, I figured I would have to go back in the hospital. I worried that I was starting the downward slide of CF. Then my doctor asked me if I was depressed and I recoiled. Depression was for morose people who felt sorry for themselves. I assured her I was not depressed, but I worried she might be right.

When my health crashed again, I tried to keep a happy exterior by saying I had kept up with my treatments and chest PT. But my doctor saw through the facade and brought up depression again. Knowing it was the moment of truth, I said, “My health sucks. I am not doing my treatments. I have no motivation to do them. I am having a hard time doing anything.” My doctor said that it sounded like I was experiencing depression, and I finally admitted it. "I guess I am," I said. I wish I could say acknowledging it made me feel better at that moment, but it didn't.

I felt crushed and confused. I did not want another illness. But, admitting I had depression began my journey with mental health.

A psychiatrist prescribed me an antidepressant, and I gradually felt better. I had more energy and started to take care of myself. My ideas of depression began to change, too. I thought depression was being sad, but I wasn't sad. I didn't really feel anything. But I learned that depression is a profound emptiness that robs one of pleasure, energy and emotional connection. Slowly, I began to see depression as an illness.

Treatment for depression has two parts -- medication and talk therapy. The medication was working. Now I had to start talking, including talking about CF. I resisted at first, but slowly opened up. Accepting my CF had been difficult. My feelings ranged from fear to anger to confusion to sadness. I had watched my older sister die from CF. I never talked about it, but mainly I felt guilty. Gradually, I was able to overcome being ashamed of having depression and CF.

Rich-DeNagel-Depressed-square
This is a selfie I took three years ago. A friend suggested I take it to remind myself what I look like when I am depressed.

This is a selfie I took three years ago. A friend suggested I take it to remind myself what I look like when I am depressed.

With treatment, my life changed for the better. Happiness and laughter returned. I started teaching again. Since then, I've had ups and downs with depression and CF. It can be difficult to know if I am depressed or having a CF exacerbation. I have to look at myself. Do I feel empty and alone? Do I have any inflection in my voice or am I monotone? It is not black and white and I need my care team to help me figure it out sometimes.

I now treat my depression as part of my life. I see my CF doctor and my psychiatrist regularly. I know that if I don't treat my depression, I won't take care of myself. I don't love having CF or depression. The good news is that there is treatment, and it starts with not trying to deny either illness. Rather, I talk openly about CF and depression. My life is different from those of my friends. But, I know I am not alone.

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Emotional Wellness
Rich-DeNagel

Rich was diagnosed with cystic fibrosis in 1969 when he was 6 months old. He also had an older sister with CF. Rich is a tough fighter who resides in New York City, and looks forward to many more years fighting CF.

May 2019 -- We were deeply saddened to learn of Rich's passing. Rich opened his heart to the CF community through our blog. He will be missed by many.

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This site contains general information about cystic fibrosis, as well as personal insight from the CF community. Opinions and experiences shared by members of our community, including but not limited to people with CF and their families, belong solely to the blog post author and do not represent those of the Cystic Fibrosis Foundation, unless explicitly stated. In addition, the site is not intended as a substitute for treatment advice from a medical professional. Consult your doctor before making any changes to your treatment.