Counseling? | Arthritis Information

Share
 

I am very depressed. I am a clinical psychology major in my senior year of college and I have been previously diagnosed with clinical depression and generalized anxiety disorder so I know all the signs.  I know I am depressed, but I also know it is a mild depression compared to what I've had before. I am debating talking to a counselor, but am not sure if I have the time or the money available. I feel so alone in this journey. No one in my family understands how bad I feel and it is another month before I see the RA Dr.

Does anyone see a counselor/psychologist/psychiatrist? Does it help? I've seen one before, but this depression is different, I feel helpless because before there were things I could do to help myself, I can not help myself stop hurting right now and I think that the pain is what is leading to the depression. I am afraid if I go see a counselor, I'll just get more depressed from spending thew money to see them. I just don't know the best route right now.


Well at least come here and let it all out. I am attaching something that maybe helpful to you and others experiencing these same feelings. I posted it once before but we have had a lot of new people since then.

Arthritis and the Cycle of Grief

According to Kübler-Ross, there are five stages of grief we experience after a loss, be it the loss of a friend or the losses associated with a chronic illness:

  1. Denial
  2. Anger
  3. Bargaining
  4. Depression
  5. Acceptance
In the classic pattern of grief, a person would go through each of the stages sequentially, but, as many people have discovered, it doesn't always work that way. You may go through the stages 'out of order,' or even 'revisit' one or another after having passed through it. Not everyone will experience every reaction, nor does everyone experience them in the same order; either way, the emotions they do undergo are perfectly natural, and most may even be helpful.

1.  Denial

Take denial, for instance: 'This can't be happening,' people protest. Some even seek out a doctor who can provide a different diagnosis. If denial gets in the way of accepting the implications of the disease or prompt treatment, it can be a serious problem, but, for most people, denial is simply a psychological buffer against the shock of diagnosis. Israeli psychologist Dr. Shlomo Bresnitz has suggested there are actually seven levels of denial that people may unconsciously employ to relieve the stress or anxiety caused by an experience of loss.

Denial's a normal response to a threatening situation, and the level of denial anyone employs will almost certainly depend on the seriousness of his or her condition. It's easy to dismiss arthritis when it's only a few aches and pains, but not so easy to do when those aches start interfering with your daily activities. Sooner or later, denial just isn't an option any more. At that point, you'll probably start to get angry. 

2.  Anger 

Finding you have a chronic illness for which there's no real explanation and no cure might well make you ask, 'Why me? What have I done to deserve this?' Anger, too, is a normal emotional reaction, and, if it can be expressed, healthy. The most positive way is to get it out in the open; find someone — a friend, family member or professional counsellor — who can help you sort out your feelings, rather than simply dumping angrily (and often without apparent reason) on those close to you. Trying to suppress your anger can lead to other problems, such as channeling your resentment into resistance to treatment.

Try turning the energy of your anger into motivation: Refuse to let arthritis rule your life. Find a way to work it out: Beat the stuffing out of a pillow, or use it to muffle a good, tension-releasing yell. Take a note from big corporations that have 'stress rooms': Buy one of those weighted, inflatable punching dolls for kids, and take out your aggressions on it. Go for a walk, if your arthritis allows it — the exercise will do you good. Try to find ways of releasing your anger, without turning it on those around you. That will happen to the best of us at times, but let your loved ones and friends know it isn't them you're angry at — it's your arthritis. Whatever you do, don't shut them out or turn them off; you need their love and support more than ever.

3.  Bargaining

After anger — or right along with it — may come bargaining, when people say such things as 'If only I don't have to give up golf or gardening or playing the piano... I'll never get angry at anyone ever again.' They may promise the moon in a vague sort of way in return for release from their condition, or seek fleeting solace in comparisons with others ('I'm not as badly off as so-and-so. I should be grateful'). Needless to say, this period usually passes fairly quickly, if only because most people quickly realize the futility of such empty bargaining.

The next stage in the grief cycle isn't so easily overcome. In fact, depression can be overwhelming. It's the most troublesome, recurring, emotional aspect of arthritis, yet it too is an instinctive response to loss and emotional upheaval. In its most basic form, its a kind of withdrawal, a response to drastically changed circumstances, and a time to reorganize inner resources.

4.  Depression

Everyone, healthy or not, feels a little blue at times; there'd be something wrong if they didn't. Those emotional slumps are what psychologists call 'endogenous' depression, inner storms that are usually as temporary as the weather — they might even be 'caused' by the weather, or by waking up 'on the wrong side of the bed.' The other type, 'reactive' depression, is rooted in some definable outside event, such as being diagnosed with arthritis.

'We see a lot of reactive depression,' says Toronto rheumatologist Dr. Rachel Shupak. People with arthritis, she says, 'have a lot to deal with.' But in more than a dozen years of practice, the number of patients Shupak has referred to a psychiatrist for depression is probably fewer than 20. Most patients are able to cope, and most cope remarkably well, she says: 'Anybody who has to deal with the kind of pain and disability that people with severe forms of arthritis have to deal with, well, if they didn't go through some kind of depression, it would be very unusual. I give them a lot of credit that they're able to look within and find the inner strength to deal with it. And most patients do.'

Shupak does her best to prepare her patients for the hard realities of arthritis treatment, right from the shock of the initial diagnosis. She admits that she may even contribute to their depression to some extent in the beginning, simply by being 'very honest' with her patients. Why? Because she doesn't want them to have unrealistic expectations. It's a tough-love approach. She tells rheumatoid arthritis patients, for example, that they have a chronic illness they'll have to deal with for the rest of their lives, but there are medications to control the disease, and that they'll attempt to keep their lives as normal as possible.

At the same time, Shupak tries to paint as reasonable or optimistic a picture as she can. She points out that taking an aggressive approach initially with strong medications is more likely to reverse at least part of the inflammation associated with their condition, and that will get her patient feeling better more quickly and prevent damage later on. 'In essence,' she says, 'we'll be able to give you a better lifestyle down the line'.'

It's still a double whammy. Reeling from the shock of learning you have an incurable illness, you discover you're going to have to take a course of medication that could have serious side effects. Getting depressed over that kind of news is to be expected. Unfortunately, it's the one part of the grief cycle that isn't easily put behind you when you have arthritis, which may impose its effects in an up-and-down course over many years: You grieve every time you discover something else you can't do anymore, says Mary Yee, former president of the B.C. Lupus Association. 'It's an ongoing battle.' Even when the disease seems to be under control, 'it's not constant. You will dip down; you may still get depressed again.'

Most people learn to live with that inconstancy, but if your distress is starting to interfere with your functioning — your ability to get through a normal day — if you're really unhappy and you can't tolerate it or don't want to tolerate it, if you've tried to change things and you can't, then it's time to seek professional help. There are plenty of resources available — among them, your family doctor, rheumatology clinics, The Arthritis Society, social workers, provincial psychiatric associations or any public hospital.

Other emotional changes and signs of clinical depression (depression for which you should seek professional help):

Illness Intrusiveness

Dr. Gerald Devins, an associate professor at the Clarke Institute of Psychiatry in Toronto, describes what he and his associates call 'illness intrusiveness,' the idea that, to the extent an illness interferes with activities and interests, people are more distressed and less happy. Not everyone with arthritis has the energy or determination to respond in an active way to arthritis. More often than not, people do less than they once did; therefore they have less opportunity to experience what Devins calls 'response-contingent positive reinforcement.' In other words, he says, 'they have less opportunity to get the good things in life, because they're doing less.'

Generally speaking, happiness and contentment are the product of a balance between positive and negative experiences. To feel really good, we not only need positive experiences, we need more positives than negatives; simply reducing the negatives isn't enough. One effective treatment for depression and emotional distress involves getting people more involved in valued activities. The problem is, Devins says, 'if you suffer a lot of pain and disability and it hurts like crazy to go bowling, but that's your passion, that's going to compromise your ability to benefit from the treatment. It demands a more creative approach to what you're going to do to still get the zing out of life that everybody needs.'

'What's at the base of depression is that we all need a sense of control over our lives,' says Paul Adam, a social-work educator with The Arthritis Society's B.C. and Yukon division. 'We all need to feel that we know where we're going and that we have some measure of control over that.' People with arthritis have 'a lot of loss in their lives — the loss of a job, self-respect, activities they previously enjoyed and so on. As a result, they experience a sense of purposelessness or lack of meaning, which is certainly a big part of depression.'

To combat such feelings, Adam tries to help people make a transition from their 'old me' to a 'new me': If they can't do the things they used to do, he says, the 'old me' no longer exists; they then have to discover what they can still do, what their 'new me' will look like and what will still give them meaning. It's a difficult transition, but it's one that you have to make. You have to find some sense of your worth, discover that there are other things you can do. For many people, it's an opportunity to realize they have gifts they've never seen or utilized.

The point is, an active response is not only the best way to cope with your arthritis, it's the best tonic for depression. Get out and do something. Go to school if you're academically oriented. If you're people-oriented, get out there with other people. Do volunteer work if you can.

Barbara Brunton, who's in her mid-50s, used to work for The Arthritis Society in Toronto, counselling people over the phone and in support groups. She has 'rupus,' a combination of lupus and rheumatoid arthritis (RA), and she's experienced depression first-hand. More than a decade ago, when she was first diagnosed with RA, Brunton was so sick, her doctor wasn't sure she was going to pull through. She lost 25 lbs. in 12 days and was so weak she couldn't lift a teacup. 'I was very, very frightened,' she says, 'because of course RA is the one form of arthritis that is potentially crippling. So, you always go through the worst scenario — I'm going to be in a wheelchair in no time — pity, pity, that kind of thing.

'I can remember sitting in a chair very much like this one,' she says, swollen knuckles gripping the arms of her chair, 'staring at the rug for five hours at a time. The tears would dribble down, and I'd just sit there. I didn't want to read or watch TV. I didn't turn on the radio. I didn't open the curtains. I was brain-dead.'

Brunton's depression centred on 'an incredible feeling of hopelessness, [which was] in one sense a loss of control, when you lose your ability to feed yourself, get dressed, do all those kinds of things. I had to quit work. I felt so ill I really didn't go beyond that, except to wonder what was going to happen to me. I was devastated.'

Not unnaturally, a lot of people with a chronic illness ask an obvious question: Why me? Brunton wondered if she was being punished: 'I thought, 'Well, you wouldn't get this horrible disease if you hadn't been a bad person.' Many people never get past that point, and there's no answer to the question 'Why me?' That's just the way it is. Yes, it's unfair, but you have to move on, as Brunton and countless others have learned to do.

'I was a very active person,' Brunton says. Her arthritis cost her her job, forced her to retire her bicycle and give up a full roster of recreational sports, pass on gardening — 'all of those things.' But if you can't do what you used to do, she says, 'then you have to ask, 'What can I do?' At some point you have to make that transition. You have to. It's hard, but your option is to stay in depression.' And that, Brunton discovered, is no option at all: 'At one time, I thought my arthritis was huge, and I was small.' It took a long time, and much pain, but now, she says, 'I see it totally reversed.'

In fact, despite the distress and pain and discomfort, Brunton actually thinks her life is better than it was — 'in almost all respects,' she says, 'because I had to prioritize things differently. I had to develop a new set of values. I look at things completely differently now.' Coming to grips with her arthritis has given her a peace and happiness she simply didn't have before the arthritis forced her to re-examine everything she held dear.

You have to make certain changes to your life, says Mary Yee. You have to say to yourself, ''OK, I can't go out and I can't do this all day, but I can do this for an hour.' It's learning to change your attitude and your expectations of yourself, so that you don't sit at home and say you can't do anything. Try to find out what your limits are.'

A friend encouraged Brunton to work with seniors. 'Are you mad?' she responded. 'I can hardly get dressed in the morning.' No, the friend said, 'but you're going to go mad if you don't do something.' So, Brunton dropped into a daycare centre, where she met 'a wonderful gentleman,' a former college dean who had Alzheimer's. 'He never remembered who I was, didn't know his wife. We'd work on crossword puzzles every day, and I'd go home sometimes in tears, because I'd think, 'I did something. I didn't just wallow. I went out and did something'.'

Taking charge of her mental, emotional and spiritual life gave Brunton back a sense of control, and a sense of hope, 'and you can't go anywhere if you don't have hope — about something. Make your arthritis this big,' she says, squeezing a jot of empty space between finger and thumb, 'and you huge. It's hard, no question about it, but it's salvation, too. You need to look for things in life that really have meaning. To me, that's another human being — compassion, love, caring, going beyond appearances. You have to find balance.' It's unhealthy to be too self-absorbed or to forget about yourself, she says: 'It's somewhere in the middle.'

The key to making that change is a tough one: You have to learn to accept your arthritis as an incontrovertible fact. That's the fifth stage of the grief cycle.

5.  Acceptance

Everything — coping with arthritis, learning to set new goals, getting on with life — naturally follows from acceptance. Robin Saunders, who has severe fibromyalgia and has counselled others with the condition, is in his late 40s. 'I will never be well,' he says. 'Ever. That gets a lot of people down, but if you start wondering, 'Where will I be in 10 years?', you're in trouble, real trouble. It sounds corny, but I try to make every day a good day and try to get as much enjoyment out of it as I possibly can.'

Saunders has discovered that, once you've faced and accepted the truth of your situation — that you have a chronic, incurable condition that isn't going to go away — it actually becomes much easier to live with. Acceptance won't happen overnight; it isn't easy learning to accept something as big as a chronic disease, 'but when you start going through it,' Saunders says, 'you start viewing life very differently. I think you do become a better human being, because now you have to face the truth every day.'

Saunders' life is simpler than it was, and he's happier for having faced the truth about things in his life. He's even found that learning acceptance has developed into a skill that carries over into every other part of his life. That, he says, has made him a better person, someone who's learned to value his time and his energy. He doesn't argue angrily anymore, and, if he does get angry, he blows it off quickly, and it's gone. 'I don't get involved in or worry about things over which I have no control,' he says, 'and I used to. I've come to view it very simply: If I can't control it, then worrying about it is a waste of energy, and my energies are a valuable commodity.'

Tis no wonder you are depressed:
 
Full time Administrative Assistant, mom of three Rebekah Haily-6, and twins Hannah Carolyn and Jacob Connor-3, and
Part time college student
 
You are so busy doing so much.......a counselor may help but frankly, some make it worse, be careful with that. Maybe go to your PCP for suggestions....maybe  a spouse ? are you married? maybe your family could be a bit more supportive?
 
Good ol' R&R works wonders, being with those you love. 
 
 
 
 
 
 
 
 
 
I am married but my husband is currently working 20+ hours a day trying to finish his dissertation for his PhD. Last night he came home at 3:45 am and of course I was asleep, he laid down and we get up to go to work at 5:45 am. We both work at the same university, in the same research center, so it is not like we never see each other. He distributes his dissertation to the committee on Monday and defends in a week on June 23, then things will be more normal. My classes this summer are online so it's not too bad. In the fall I have a day class and lab and a night class with a day lab but the labs are 50 minutes once a week so nothing major there. I like to stay busy. I just don't have time to be sick. lol I wish your husband luck on his dissertation. PhD in what? IS he going to be a counselor?
 
THis disease is bad no matter how you look at it. It is progressive and systemic so it is gonna be around for awhile. THe current treatments show promise and new research is being conducted so chances of "feeling better" are good.
 
Just try not to be overwhelmed ( easier said than done) and take each day as it comes, rest, bite your tongue or take it all with a grain of salt to get through.
Thanks,
That info is nice to know I am feeling "normal" feelings about this.
My hubby is getting his PhD in Cognitive Science/NeuroScience his undergrad work is in Computer Engineering.
You have children and a home to take care of as well as working at an outside job and taking classes along with fighting a chronic disease.  My goodness lady, you are super woman as far as I'm concerned.  Give yourself a break and get whatever help you need.  If you feel you are clinically depressed then you know you should be seeing a psychiatriast or psychologist  and that you might need some meds to get you back on target.  If you have to cut back on something else to get the money, just do it.  You are very important.
Ann
you and your husband are both carrying a big load right now..things will be easier once he defends the phd but for you in the meantime you would probably benefit greatly from seeing a counseler.  Most colleges have counseling services that are available yo student at low or no cost.  Is that an option for youWhat about an antidepressant as well?  At least for the short term, to get you thru this rough stage.  Some like cymbalta help with pain too. It would be worth a try, especially if you get 2 benefits from one med!
 
Good luck and remember to find time for yourself.  I have 4 kids and it is hard but I do find a few minutes every day just to be in peace and destress.
 
 
I have tried about 6 different antidepressants and have not found one that works for me. I always have horrid side effects. Since I am only a part time student and a university employee, I do not qualify for the student counseling services. My insurance will pay a portion, but I would still be forking out about a visit for a psychologist/licensed counselor and more for psychiatrist. I may just call and see if I can get an appt. go once and see if it helps any.  Wanttobe:
 
This is GREAT information for anyone who hasn't seen it before!
 
Jennmommi:
 
Life is not fair. Life doesn't always go the way you plan or that it "SHOULD GO"...  I hate to say it but you have too much on your plate. Something has to give. A counselor may help talk through it with you but in the end trying to get through EVERYTHING you have daily on top of this disease probably is way too much. I hope you can find something that you can give up on in order to focus more on yourself. Try to hang in there until you see your doctor. I hope you put yourself on a cancellation list for the dr.'s office just in case you can get in any sooner!
 
Kelly
jenn, yes I see a counselor and it helps me a great deal.  If you are able to do it, give it a try.  In addition to some of the other good suggestions, see if there are any local organizations that offer it free or on a sliding scale.  I've seen ones sponsored by the government (county or state), religious organizations, and charitable organizations in my area.  Also, if you belong to a religious organization, clergy members can sometimes provide counselling, or they may even have a group of lay people who do it.
 
I have tried nearly all the anti-depressants there are (my depression issues started over 20 years ago so I've had plenty of time to try them) and wasn't able to tolerate any of them.  However I take daily SAM-e supplements and that has helped quite a bit.  They aren't cheap, but you can find "buy one/get one" sales at the chain pharmacies all the time.  Also, there is one study that seemed to indicate SAM-e could interfere with mtx (something to know in case you end up taking that med).
 
My last suggestion is a book that I have found very meaningful.  Kitchen Table Wisdom by Rachel Naomi Remen is a collection of true very-short stories (a few pages each...easy to follow even with brain fog) that I would read and then meditate on.  The author is a medical doctor, counselor and chronic illness survivor (Crohn's disease) and her stories are spiritually oriented without being overtly religious.  She also wrote a similar follow-up book called My Grandfather's Blessings.
 
You have so much going on....I hope things will get easier for you soon.
I know I have a lot on my plate, but I have to work (to pay the bills especially now since I have so many Dr bills, I have already paid my deductable 00 plus 0 dollars in copays- lab fees and thats not counting meds and I haven't even seen the RA dr. yet.) I work for the state. My position will not allow benefits if I drop to part time, not to mention my supervisor would not let my position become part time. I just don't do well homebound as a stay at home mom...we'll leave it at that. Some people are not meant to be at home moms, and I am one of them. I was never so miserable in my whole life as I was in the 4 years I was an at home mom. I was almost committed to an institution for suicidal tendencies at that time, and I will not go back to that unhealthy state. I shudder just thinking about it.

As for school I am only going part time and I just started back (This summer is my 4th semester back). I am a senior, so close to finishing, I just can't give it up yet, although Grad school may be put on hold depending on how I feel.

I may be selfish for not giving up work or school, but that is what keeps me sane right now.
I love my family, and I have some help for now (my sister is staying with me for a few weeks) while my hubby busy finishing his PhD. She may end up staying for awhile as she wants to take classes and is taking 2 this summer. She is 19 and never went to school after she graduated high school.

I would rather wait and see what happens once I get on meds before I make a life altering decision concerning school or work.

I'm sorry you are having trouble, but it's wonderful that you recognize the signs and are looking for ways to help you get through this.  Do you belong to a church at all where you could seek counsel?  I've done that once before and I came through with a different perspective that helped me to cope with the situation at the time. 

By the way, I completely understand about having a hard time being an at-home mom.  It is very difficult for some of us, and so natural for others.  I have really struggled with feeling like a bit of a failure for not loving being an at-home mom, so I get what you are talking about. 
 
I hope you find some peace of mind soon.  This board is full of compassionate people who are always willing to offer support.  Use it for interim therapy while you figure out what you want to do.  Hang in there.
 
Dawn
Jennmommi-
 
I totally understand, and I didnt mean to say to make a life altering decision. I know you have to work to bring in the money to support your family, to have insurance in order to see the dr. etc. I've been there, i really have. I have 2 sons , work f/t and even if we could afford for me to stay at home, I wouldn't be able to be a stay at home mom full time either.  I need to get out of the house and atleast work p/t for my own sanity.
 
I think the reason I said that to you is that my family and doctor made it clear to me that I had way too much stress for one to handle by myself and that I had to let something go, or ease up on something in order to focus more on myself, and  take less stress off for my own health... It has helped a lot.  i was on anti depressants for over 10 years too which helped to take the edge off things.
 
That's great that you're so close to finishing school, maybe that will be the break you need? And having your sister there may help as well? You're on the right track it sounds like . Just by being able to be a part of a forum like this one where you can bounce things off people, get advice and share stories, as well as possibly getting some counseling and going the dr. as soon as you can.
 
Take care,
 
Kelly
Dawn,
I am so glad I am not the only woman who feels that way, I love my kids, but I am just not very domestic. I am much nicer to be around when I have a job outside of the home, and feel like I am contributing to the family. I was extremely depressed as an at home mom. :)

I think I know exactly who to call to talk to. I will make an appointment. Unfortunately since I am a Psych major I know all the tricks. lol I think just talking to someone about my fears and anger about being sick will help.

You do have a lot going on and there may come a time that you will have to accept the reality of RA and let something go.   But, since you haven't started on meds yet, you may be right in doing what you can to juggle everything until you're on a treatment plan.   Just be aware that it could take a few months before you see any improvement.  Hopefully your sister can help out and maybe consider having someone come in once/week or every other week to clean your house.  It's an expense, but if it helps in the short term, it's money well spent.   You have a good understanding of your emotional limits, just don't let it take control of you.   I wish you the best in your decisions. 

It sounds like you probably need someone who can simply be a good listener. You might consider looking into a local arthritis support group and maybe find out who they go to if they need counseling.

I'd make an effort to find some anti-depressant that works for you. Maybe not side-effect free, but least problematic. It's hard to manage depression without one.

In the meantime, focus on what you can do and not on what you can't do. There's more than one way to do things and it's perfectly ok to ask for help.   You know, I don't want to throw a wrench in the works here but I have heard counselor and antidepressants here but only one other person observed what I did. And that is jennmommi, you have way too much going on. Something does have to give. It is nice to get an education while working full time but right now your health needs to be the most important thing in your life. And when that gets corrected, then, and only then, should you take on more. Your body is sending you a very clear message that you are doing too much. You have to decide at this point, what is most important, your health or everything else that is too much for you. The decision is yours. You are overextended and now is your chance to try to get on top of your health. I doubt it will happen with all that is going on. You need to take care of you. If you are not healthy, your kids won't have a mom there for them. Right on Lorster!  Good ole common sense!
I take Celexa and it helps me sleep and I feel great during the day.  It has given me a whole new outlook on life. 
Good luck on your journey Jennmommi.  You have been given some excellent advice. 
Huggin Ya!
wanttobeRAFree:  thank you, I also had never seen that before.  A true gem.
 
I have been in therapy for years now.  I started when about four years before diagnosis I was referred to a psychiatrist because I was making up my symptoms to cage for drugs because I am a recovering alcoholic.  I was mad.  I am better now.  It gets different.  Good luck.  Cathy PS (Never liked anti-depressants, didn't work for me at all.  I was in real pain and needed RA DMARDS ASAP, not anti-depressants and not being believed.) 
Jenni--
 
A few thoughts.  I also have to pay a pop for counseling (until 2000 deductible is met).  I went to 3-4 a few months ago.  Plan to go to some more again, in time.  I couldn't afford the biweekly ones they wanted, but even a bit helped.  The counselor I've been seeing is just that--a counselor.  Nothing more.  She is great to talk to.  It is nice to just talk about it.
 
Have you tried Lexapro?  I have hardly any side effects.  I tried Sam-E before, didn't give it a chance, but my counselor wanted me to try that first (and fish oil). 
 
I don't know a lot about your RA, but is there a chance it could get worse if you were at home all the time?  I know mine would be.  I don't know your child care arrangements but that may be a blessing right now. 
 
I would also consider church.  Pastoral counseling is free! :)  Not that you should abuse that, but if you really need someone to talk to (who won't use all the tricks you know :) ) that is also an option.
Jenni - does your workplace have an EAP?  Most will offer 2 or 3 counseling sessions free as part of the program.  Just a thought.I'm a little late on this bandwagon, and you've already gotten very good insights and suggestions.  I just wanted to offer you a "hug" and wish you well.  You're having a difficult time right now.  While you decide to pursue one avenue or the other, remember we're always here to listen and to help when we can.  Good luck to you.Hi, you do have alot on your plate but you are so close to finishing school. I agree with the ones that said to talk to a clergy person. I am fortunate. I have a part time job at the church I attend and my best friend is the rev. I go in on Thursdays and do the bulletin that is handed out on Sundays.  We spend the first hour or so just talking. She listens and I also listen to her. She knows she can talk to me and it won't go any further than my ears. We are good for each other. Do you have a friend or family member you can talk to? If now, I have found this board to be very good therapy. You can vent, cry, complain, or whatever and many people here understand.  You also get lots of different points of view. You can take it or leave it. I wish you well at whatever you decide.
take care

Copyright ArthritisInsight.com