It’s hard to figure out exactly which of the many symptoms I have should determine when I got sick but based on the impact of treatment, I’m going to say it was the onset of anxiety and depression. These really ramped up in October 1999.

I was 18 and settling in at college. I had a roommate who was not a good fit. My anxiety and depression seemed to kick off when that roommate suggested at dinner that I had a crush on a dude in our building. I didn’t but I liked talking to him. I thought he was fun. I already had a boyfriend (spoiler alert, 10 years later I married that boyfriend) and I thought that, based on what my roommate said, thinking this kid was fun was basically cheating. (I was wrong. It’s okay to have friends.)

This one conversation launched a spiral of negative self-talk that persisted for months. It was exacerbated by my being at a big university, struggling to make friends, and feeling disconnected from my family even though I was only 12 miles from home.

At the same time, my brother was sick and in the hospital. He was only 5. I don’t remember, but I imagine I felt that going to my parents with my problems felt like adding a burden they didn’t need, in light of my brother being ill

I don’t think I got help until Spring of 2000.

In the following few years I gained a lot of weight, was so sleepy that I would fall asleep in the student union and miss class plus slept through service learning obligations, and started having irregular periods. My primary care doctor sent me to an endocrinologist who ran a lot of thyroid tests but not the one that would lead to my diagnosis 11 years later.

In time, a lot of these symptoms went away, but they recurred with a vengeance the summer after I finished library school in 3011. Again, it started with depression and anxiety - in spite of my being on an antidepressant - and by the time I did a direct-to-consumer test and took the results to my doctor, all I could do was go to work, come home, and sleep, without energy even for laundry or food prep.

Wentz conducted a survey of over 2000 of her readers to investigate what was going on when they got sick. Stress was the most frequent response. I think both of the times I’ve had big flare-ups have been in the face of the stress of a major life transition.

This connection between transitions and flares is why I’m being especially vigilant right now as I continue to live in the liminal space of post-PhD.