Soft-spoken Nancy is a client who recently started to come to our clinic because of depression. She looked younger than her stated age with a perfect body shape and attractive face.
“I don’t know what is happnening to me lately,” she began. “Sometimes, I became numb and stuporous. My kids try to get my attention from me, but my mind is elsewhere. I can’t concentrate like I used to. I am so full of worries about bills every month. I don’t know how I’m going to pay them all. It seems that it is better not think about them although it is not easy. I have this disease, ‘the end-of-the-month disease’.” She let out quiet sighs intermittently as she spoke.
“What do you mean by that?” I asked her.
“Well, you know that we have to pay the bills at the end of each month. For me, it is an incredibly anxious time of the month because I am waiting child support money from my ex-husband. He is so unpredictable. I get heartache from worries, ‘What if he doesn’t send the money this month?’ This has been going on for the last five years. So I named my illness, ‘the end-of-the-month disese’. What’s wrong with me? Everyone around me seems to have wonderful husbands and happy marriage.” Tears welled up in her eyes.
Nancy is in her mid-thirties, a single mother who has been struggling to raise two children alone on a limited income. She has been receiving some assistance from the government, which makes her feel quite shameful.
“I didn’t go to sleep until 3 in the morning. So many things I had to finish,” said Nancy, a picture of fatigue.
I asked her about her daily routine and found out her days were packed.
“Early in the morning, I go to exercise and come back before my children go to school,” she said. “I have to exercise every day.” She added that she couldn’t gain any fat around her waist line. If she doesn’t finish one thing she decides to do for the day, she would stay up late until she finishes. Lately, as she feels more depressed, she finds herself less energetic and less capable of completing every item on her list.
Nancy was raised by a mother who was critical and labeled her as a “lazy girl” whenever chores were not done completely. Today, she finds this internalized mother dictating her every task, which has to be accomplished with perfection.
But Nancy’s children don’t follow her directions as she followed her mother’s. She feels constantly on the edge and finds herself increasingly irritated and angered by the mess that her children make. In fact, she ended up scrubbing her son’s shoes until 3 in the morning. She sometimes works frantically during the night — doing the laundry, ironing, vacuuming, and cleaning the kitchen sink, telling herself “no one else will do it for me”.
Nancy also suffers from feeling that she is never good enough as a mother since she got divorced. This notion of “not good enough” forces her to push herself harder. “If I do it perfectly, everything will work out right. I must keep trying” is her attitude. It is a vicious cycle.
Although her ex-husband had left for another woman, Nancy feels she is more responsible for the marital breakup than her husband. She even expressed how glad she was that her marital tension and conflict finally ended. But deep inside, she believed she didn’t do her best and that she failed.
We discussed her tendency to control everything, yet not all things go her way. We also went in depth to talk about her obsessive attitude to look perfect outwardly in sharp, contrasting to her internal dissonance. Although it was not easy to accept the fact, it was crucial for her to understand that perfectionistic expectation was killing her soul.
Even after she recognized the importance of rest and relaxation, Nancy is still struggling to find 10 minutes a day for her inner peace. However, she has not missed her daily physical exercise.
Where we spend our time tells us where our priorities are.

Dr. Beatrice Sool Choi is a registered psychologist at the Richmond Area Multi Services (RAMS) in San Francisco. She can be reached at (415) 668-5955 ex. 39
or RAMS
3626 Balboa Street, San Francisco, CA 94121.