I have a few thoughts... While I haven't had serious issues with depression, I have had some anxiety problems in the past, and have tried to develop ways to handle many of the feelings being discussed, including issues surrounding mortality/death, feeling different, etc.
First of all, there is nothing wrong with identifying the magnitude of the challenges we face. It isn't a sign of weakness to acknowledge that adhering to treatments can be difficult, that we carry heavy burdens at times, and face shorter life expectancies.
I remember being 15 years old and thinking about the possibility of an untimely death. After struggling with that for awhile, and perhaps also in response to other people's reactions to my having CF, many of which weren't the most sensitive, I came to the valuable realization that everyone dies. Getting comfortable with that idea came as I matured, and is a wonderful thing. I know many adults - young and old who live their lives without coming to grips with that, and as a result do not live as fully as I try to. In that sense, I am no different from anyone else - they are equally mortal, and we are the lucky ones who have the chance to come to terms with death early in life, and live what time we have with purpose and intention.
Similarly, in terms of being different... I believe that pretty much everybody faces or will face significant challenges in their lives. In that sense, I am no different from anyone else. I also tell myself that I am fortunate to know what my challenges are, and am fortunate to have the opportunity to manage them as best I can. Not everyone is so fortunate. I also believe living with CF is a skill, and one I have gotten to be pretty good at, and take pride in that. I would rather be who I am, living with CF, than the middle aged person who's world gets rocked by a cancer diagnosis and doesn't know how to deal with it all.
Growing up with CF forced me to make decisions about 1) what was really important to me 2) how hard I was willing to work to maintain my health to do what I wanted to do. I think a lot of adolescents and young adults are really bad at figuring out what their goals are, and how to achieve them. Having healthy, achievable goals that necessitate adherence to my regime is the reason I am reasonably healthy today. I am not forced to stick to a treatment regime, I have things I want to achieve that I care enough about that make it easier for me to accept my treatments as the price of achieving what I want.
Those goals should vary from person to person. They are personal. Someone with lower lung function should still be trying to determine what they want and can reasonably expect to accomplish. It can be anything. Answer the question - what do I want to do this week? This month? This year? Figuring out those answers helps me give meaning to my time on earth, makes me feel like I'm not wasting what time I have, and gives me direction and motivation to keep going. Personally, I put a premium on goals that require me to adhere to treatments... often these are fitness related, but not always... graduating, maintaining a job, etc.
Lastly, and I say this with the realization that I don't have depression, and don't know what that feels like, but I work very hard to maintain a positive mindset, and a high level of self confidence and self-esteem. In clinic I hear a lot about treating depression, but not enough about fostering healthy mental well-being. I believe that positive attitudes don't just happen, but require as much active work to maintain as good lung function. The older I get, the more I accomplish, the easier this has become... I can look back at successes, knowing that even if my life ends tomorrow, I have lived what time I had fully. The fun part is keeping that going.
Chris