1990: I begin to show signs of major depressive disorder. I was fifteen.
1995: I’m certain I have major depressive disorder, and like an utter moron, did nothing about it. If you learn nothing else from my saga, try this: don’t do that.
About 2000: I develop adult-onset chronic iron deficiency anemia. In one of life’s cruelties, the symptoms exactly mimic MDD. Am I tired? Yes. Damn depressive disorder. Am I easily fatigued? Yes. Damn depressive disorder.
2000–2025: My anemia gradually worsens until my normal daily hemoglobin level is so low I have to massively curtail physical activities. I continue to blame MDD, of which I’m in an especially bad spot. (As a psychiatrist told me, “your brain was chronically starved of oxygen: were you expecting your MDD to get better?”)
2025: I develop a spontaneous hernia and don’t notice it… but my upper intestinal tract sure does. I develop an internal bleed. I lose even more hemoglobin that way. Further, iron deficiency anemia can — in severe cases — affect blood clotting (hemostasis), so it’s quite possible this bleeder bled for … a really long time.
Memorial Day, 2025: I present to the emergency department with a blood hemoglobin of 4.8 grams per deciliter (below 6.5 is generally considered “inconsistent with life”), a spontaneous hernia, and a massive blockage in my upper intestine composed of fecal matter, bile, and coagulated blood.
Surgical intervention was necessary, as was massive amounts of transfused blood.
Prognosis: recovering from long term oxygen deprivation is hard. When your blood O2 is at levels “incompatible with life”, to use the gloriously anodyne phrase I heard in the hospital, you begin to accumulate damage throughout your entire body at once. I’m fortunate to have dodged brain or cardiac damage, but my body is still weak as a kitten. I have a lot of rehab ahead of me.
The MDD is noticeably improving as my hemoglobin levels rise.
There you go. That’s all of the story I’m making public.
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