Would my illness be as serious today if I had gotten treated younger, if I had entered therapy sooner, if I had learned coping strategies earlier?
I wrestle with this question almost every day. Sometimes, I wonder if the panic attacks and depressive episodes I experience now, would be less debilitating if my mental illnesses were identified and treated in my teens. For five years I experienced crushing depression before settling into a structured treatment. We know mental illness affects the psyche, but it also profoundly alters the physical structure of the brain.
Brain changes associated with early-onset major depression have been reported in the hippocampus, amygdala, caudate nucleus, putamen, and frontal cortex, structures that are extensively interconnected. Studies have found reductions in volume of the frontal cortex, with some studies showing specific reductions in subregions of the frontal cortex, including the orbitofrontal cortex. (Yi, 2000)
In a very real sense, I live with brain damage. Not because of an acute injury, but due to persistent isolation, negative self-talk, and a chronic, active stress-response.
For years, I obsessed with why I had depression. What caused it? How did it develop? Why, why, why? Then I had an epiphany. If I figured out the exact cause and reason for the thoughts that developed in my teenage mind; nothing would change in the present.
The future is a hundred thousand threads, but the past is a fabric that can never be rewoven.
Orson Scott Card
I can examine the tapestry of my medical history, but I cannot change anything about it. I can peak at a forgotten corner, but that knowledge will do nothing for me in the present. Consider how you would react if a doctor told you that you contracted the Bubonic plague, and before she got to telling you about how she’ll treat you, she explains exactly how you picked up this disease.
Though that information may be useful in the future, to prevent getting the illness again, it does nothing for you while you are suffering and undergoing treatment.
In research by the Center for Addiction and Mental Health (CAHM):
This study provides the first biological evidence for large brain changes in long-lasting depression, suggesting that it is a different stage of illness that needs different therapeutics - the same perspective taken for early and later stages of Alzheimer's disease.
Had I begun treatment earlier, I may not have had such a wild journey in finding medications and treatments. My symptoms today might be less severe and occur less often. But, that is all speculation.
I must deal with the now, and reinforce my mind to be resilient in the future.