Photo by Katie Moum on Unsplash

It looked as though I had life figured out. I was working my dream job as a nurse practitioner in primary care. I had completed the treatments for thyroid cancer, finished my DNP degree, and was starting a postdoctoral fellowship. Life was great, and I was excited to build my career. I had no idea the challenges I was about to face.

An unexpected shift in personality.

I have always been a laid-back, quirky person. When I was not working, you could find me sewing and crafting. I am even-tempered and not easily angered. Then my usual calm demeanor began to change; I started getting annoyed and angry about things that normally wouldn’t have bothered me. My thoughts became a loop of negative commentary: “You are not good enough,” “You don’t belong,” “Nobody really likes you,” “Everything would be better without you.”

Slowly, I started feeling physically unwell. I was tired, and not a normal tired; no amount of rest would alleviate the fatigue. It became difficult to drag myself out of bed each morning. My body felt sore and stiff, and every muscle ached. I was constantly freezing, even in the summer heat. I had a nagging, throbbing headache, and my hair was falling out.

My thoughts were foggy, and rational thinking was clouded with depression. I believed I was hiding these feelings, but the people closest to me noticed the changes in my mood and personality. When people tried to help me, I would become defensive or angry.

The university I had attended chose to feature my work in their alumni magazine. I did the interview and smiled for the photos, but I feared what people would think if they really knew what was going on in my mind. The loop of negative thoughts grew louder and harder to ignore: “You are an imposter,” “You are a loser.” That day, I decided it was true that everything would be better without me. I realized these thoughts were not right, and I decided that it was time to face the reality that something was wrong, instead of pretending that I was fine.

A simple adjustment.

After admitting to myself that something was not right and discussing it with my provider, it did not take long to identify the problem. I was not mentally unstable; instead, I was low on thyroid hormone. My previous thyroidectomy and postsurgical testing had caused me to need a medication dose adjustment. I received the correct dose of medication. Adjusting thyroid medication is a slow process and a change in hormone level takes about six to eight weeks. Gradually I noted that the fatigue was gone, and the negative thought loop was replaced with goals and plans for a future that I finally felt capable of pursuing.

I was able to finish the diabetes education project I had started during the fellowship. Finishing the project felt like a victory for both my patients and my own recovery. It allowed me to form new professional partnerships that have enriched my career and grounded my nursing practice in collaboration.

Lingering shame.

As a nurse practitioner, I knew the textbook signs of hypothyroidism: fatigue, hair loss, dry skin, and constipation. Although I never knew the impact that hypothyroidism could have on someone’s mental health. I am forever grateful for the people who supported me during that difficult period. Even though my negative thought loop was silenced, I felt ashamed about my behavior during that time. I feared that I had damaged relationships beyond repair and would always be judged by darkest days.

You never know the challenges others are facing.

As my life started piecing together like the quilts I sew, I realized I also needed to extend the grace to myself that I would offer to others. You never know what challenges others are facing. Those who seem “difficult” may be the ones who need someone to believe in them the most. In some instances there may even be an underlying physiological cause that no one has yet recognized. Through this experience, I have learned it is truly possible to draw strength from the darker seasons of life.

Angela Occidental, DNP, APRN-CNP, FNP-C, is a family nurse practitioner in rural Ohio.