Recovering from Tragedy Is a Process
When you are caught in the throes of tragedy, your emotions feel out-of-control. But there is an order to how we process the chaos that accompanies traumatic loss, whether it is the death of a loved one, a failed romantic relationship, job loss, a difficult medical diagnosis or any of the challenges we face as we move through life. Understanding the process we go through as we work through a traumatic experience can help us cope. There is comfort in understanding that our feelings and responses are normal.
When we suffer a tragedy, we grieve for what is lost. Death, divorce, job loss, relocation, illness — all involve significant change and loss. In order to accept the change and move forward, it is necessary to recognize and mourn what is lost, whether it is friendship, love, familiarity, ability, status, financial stability, etc. Psychiatrists have identified distinct five stages of grief that accompany loss. While these are most often applied to mourning the death of a loved one, we go through the same stages as we learn to accept and heal from any tragic loss.
- Denial and isolation. At first, we may deny feelings of loss or try to minimize the importance of the event. People may withdraw from family and friends through emotional discomfort or embarrassment.
- Anger. Anger can be directed outward or inward if the person feels her actions contributed to the tragedy. Feelings of “why me” are also common.
- Bargaining. No one wants to accept traumatic loss. We may try to bargain with God, promising “I will do this if you remove this burden from my life.” Or be tempted to plead with an employer if we are laid off. Bargaining attempts to stave off the inevitable.
- Depression. As anger fades, numbness may overwhelm us. Pervasive sadness blocks feeling. We may feel hopeless. You may need the guidance of an experienced psychiatrist to help you move forward.
- Acceptance. As we work through loss, we learn to accept the new reality.
For more information on How to Recover from Tragedy, listen to Dr. Marks’ October 14 podcast.
Depression Is a Treatable Disease
Life is a roller coaster, full of ups and downs. But if you start to feel like you’re always “down” or you start to have trouble just getting through the day, you may be depressed. More than 17 million people in the U.S. experience an episode of depression each year, twice as many women as men. Fewer than two-thirds of depression sufferers receive the medical help they need, yet in most cases proper treatment can alleviate symptoms of the disease.
Yes, depression is a disease. Depression is caused by an imbalance of chemicals in the brain. It is a whole body illness that affects you physically, mentally and emotionally. Depression is not a matter of trying harder, thinking happy thoughts, a sign of weakness or lack of will. People suffering from depression cannot just “pull themselves together.” Depression is a medical disease just like diabetes or heart disease. Without treatment, depression can last for months, even years. Some people have an isolated episode of depression triggered by a traumatic event like job loss, financial difficulties or the death of someone close to them. Chronic stress or anxiety can result in depression. Some people have periodic episodes of depression throughout their lives; for others, the disease is chronic.
The symptoms of depression are unique to each person. Depression causes changes in thinking, feeling, behavior and physical health. The severity of symptoms differs with each individual. Symptoms of depression may include:
- Persistent feelings of sadness, emptiness, hopelessness or helplessness
- Loss of interest in normally enjoyed activities
- Irritability, restlessness, excessive crying
- Sleeping too much or too little, trouble getting out of bed in the morning
- Loss of appetite and weight loss or overeating and weight gain
- Fatigue, exhaustion, decreased energy.
- Difficulty concentrating or making decisions, memory lapses
- Thoughts of death or suicide
Although antidepressants help alleviate depression symptoms for many people, not everyone who is diagnosed with depression requires medication. The most effective treatment for depression is generally a combination of psychodynamic therapy, cognitive-behavioral therapy and medication management administered and coordinated by an experienced psychiatrist.
If you or someone you know suffers from depression, don’t lose hope. Depression can be treated. With the support and guidance of a caring psychiatrist like Dr. Tracey Marks, you can rediscover joy in your life.
Learning to Recognize Symptoms of Stress
The nagging headache starts at the office. You feel tired. You’re having trouble concentrating. Your productivity starts to suffer, and you begin to wonder if you’re coming down with the flu. By the time you get home you’re ready to tuck yourself into bed. The chills and fever never materialize but your symptoms don’t go away.
While persistent headaches, fatigue, frequent forgetfulness and decreased productivity can be signs of illness, stress is often the culprit. Stress can affect your body physically, can impair thoughts and emotions, and can impact behavior.
- Physically, excessive or long-term stress can cause headache, back pain, chest pain, high blood pressure, erratic heart beat, stomach and intestinal problems, and sleep problems. Persistent stress can decrease your immunity to disease and cause heart disease.
- Emotionally, persistent stress can cause anxiety, restlessness, excessive worry, irritability, sadness, anger, feelings of insecurity, inability to concentrate and forgetfulness. Left untreated, stress can lead to serious depression.
- Behavior changes associated with constant stress include overeating or undereating, problems managing and controlling anger, drug or alcohol abuse, increased smoking, social withdrawal, crying spells and relationship conflicts.
If you are experiencing any of these symptoms of excessive or chronic stress, it is important to seek medical help. Naturally, a trip to your primary care physician to rule out and address any physical illness that may be responsible for your symptoms is in order. However, if chronic stress is the source of your symptoms, you will have to go beyond your primary care physician to cure what ails you.
Chronic stress can be treated and overcome and you can learn to live a happier, more balanced, relatively stress-free life. With the help and guidance of a psychiatrist experienced in stress management, you can learn to recognize your personal stressors and how they impact your life and health. Through cognitive-behavioral therapy, an experienced psychiatrist can help you learn to recognize and control your reaction to stress. With expert guidance, you can learn new techniques for responding to stressful situations and people. You don’t have to let control your life. With help, you can learn to control stress and regain control of your life.
Stability, Not Marriage, Key to Kids’ Happiness
A new study by an Ohio State University researcher found that it is the stability of the parent and the home, not marital status, that determines whether divorced children will thrive and be happy. The study found that children who grow up with a single mother are as likely to succeed academically and socially as those who grow up in traditional married-couple homes if the parent is emotionally stable and the home environment is stable. Published in the book Marriage and Family: Perspectives and Complexities, the study bolsters support for single-parents, gay couples, children being raised by grandparents or relatives, and other non-traditional families.
“Kids like to know what to expect,” Claire Kamp Dush, OSU assistant professor of human development and family science and study author, told The Columbus Dispatch. She explained that creating family stability means maintaining the status quo. Study data indicate that single mothers who do not move in with a new partner or remarry create the most stable home environments for their children. When home life was stable, Kamp Dush found no difference in levels of academic achievement, cognitive stimulation, emotional support or behavioral problems between children from single-parent and traditional married-couple homes.
Some researchers see a connection between stability and financial resources. Many other studies have found differences between children’s welfare and happiness in single-parent and married-couple homes. Many of those differences are rooted in financial circumstances and quality of education. When poverty enters into the equation, it can tip the balance against stable home life.
Single mothers worried about finances are more likely to suffer anxiety, depression and other emotional problems that can significantly impair the stability of home life. According to the U.S. Census Bureau, 50% of children born to single mothers live below the poverty level. Statistics posted by The Heritage Foundation indicate that 35% of divorced mothers who receive child support and 42% of those who don’t live below the poverty line.
If you are struggling with single parenthood, a qualified psychiatrist like Dr. Tracey Marks can help you deal with the anger, anxiety, grief or depression you may be experiencing so that you can provide a stable home for your children.
Depression During Pregnancy May Warrant Medication
Ground-breaking new guidelines issued by two national physician groups state that while talk therapy alone is considered the best treatment for pregnant women who suffer from depression, in severe cases use of medication is warranted despite potential risk to the developing fetus. Nearly one in four U.S. women experience episodes of depression during pregnancy, 13% of whom are prescribed antidepressant medications. Until now, doctors have lacked coherent professional guidelines to guide pregnant patients in weighing the risks of various treatment procedures for depression during pregnancy.
Based on a study of medical practices between 1999 and 2003, the new guidelines, which were jointly issued by the American Psychiatric Association and the American College of Obstetricians and Gynecologists, stress that talk therapy alone remains the preferred treatment for pregnant women suffering from depression. However, the guidelines go further, stating that in cases of recurrent depression or suicidal inclinations, prescription of antidepressant medication to augment talk therapy should be considered.
The guidelines point out that the danger of limiting treatment for severe depression and under-treating the mother may in certain cases outweigh the risk of subjecting the developing fetus to antidepressant drugs. Babies exposed to antidepressant drugs in the womb can be born prematurely or with low birth weights. Some antidepressants given in late pregnancy can cause more serious, potentially life-threatening problems during the first two weeks of life. The new guidelines, however, recognize the greater risk of poor nutrition and prenatal care that often results from untreated depression and the increased risk to both mother and fetus from possible suicide.
Physicians praised the new guidelines for clearly encouraging obstetricians to screen pregnant patients for signs of depression and for clarifying the role of psychiatrists in caring for pregnant women suffering from depression. “This is a very exciting time in obstetrics and psychiatry, a golden opportunity for us to really make a difference in the lives of women and their children,” UCLA psychiatrist Vivien Burt told the Los Angeles Times.
Physicians from both specialties expect the new guidelines to result in better medical are for women and their unborn children during pregnancy, with obs screening patients for depression and referring those who exhibit symptoms to psychiatrists for treatment.
Depression Can Be Treated Successfully
In a CBS public service announcement, veteran 60 Minutes newsman Mike Wallace tells us to have hope if we are depressed. He reminds us that there is nothing to be ashamed of. Depression is a medical illness, not a failure of personal strength. Depression can be treated and you can go on to live a normal, happy life. “You can beat it as I did,” Wallace tells us.
Mike Wallace speaks from personal experience. Traumatic events in his professional life were wearing him down. He was unable to sleep or eat normally, placing a further drag on his mind and body. Gradually he sank into depression. “I was copeless; not just hopeless, but copeless,” he said in an interview posted on the Academy of Achievement, a museum of living history. Click here to read the entire interview and Wallace’s personal account of his battle with depression.
Wallace’s experience is not unique. A traumatic personal experience or loss — job loss, death, abuse, financial hardship, major injury, social isolation — can trigger depression in even seemingly strong, healthy and successful individuals. Depression can affect anyone; the illness recognizes no social-economic boundaries. Children and teens are as susceptible to depression as adults.
Successful treatment for depression is best directed by an experienced, highly skilled psychiatrist. Treatment is determined by the unique needs of each individual but generally includes a combination of cognitive-behavioral therapy, psychodynamic therapy and medication.
- Cognitive-behavioral therapy helps individuals replace non-productive habits of thought and behavior with productive, satisfying ways of acting and thinking.
- Psychodynamic therapy, or insight-oriented therapy, helps discover the cause behind our behaviors so we can be freed from irrational fears, habits or beliefs.
- Medication may be administered to normalize chemical changes in the brain linked to depression.
In his interview Wallace points out the crucial value of psychotherapy in concert with pharmaceutical therapy. He notes that he continues to see his psychiatrist every six months “for a lube job” to help maintain his mental equilibrium.
For some people depression is a solitary experience triggered by trauma; for others, it is a chronic, recurring condition that requires continual monitoring just like heart disease, diabetes or any chronic illness. Depression can be successfully treated and controlled with the assistance and guidance of a qualified psychiatrist. If you are depressed, contact Dr. Tracey Marks. There is hope.
How to Tell When Sadness Becomes Depression
It’s hard not to feel depressed these days. We’re still digging ourselves out of the economic rubble, more soldiers are needed in Afghanistan and fires are raging across California. Then there’s the normal mayhem that parades across our TV screens on the local news every night. Unless these events intrude into our personal lives, however, they affect most of us only superficially. It’s when traumatic experiences become part of our personal daily experience that the risk of depression increases.
Unfortunately, the scope of today’s problems is so great that an unusually large number of people are coping with personal disasters like job loss, layoffs, home foreclosure, debt, illness, marital discord and other difficult life challenges. As time passes and these problems continue to eat away at us without solution, anxiety and grief for our losses intensifies. Feelings of helplessness and hopelessness can overwhelm us. We blame ourselves and may even consider death or suicide. This is the risk and danger of depression.
The National Institute of Mental Health estimates that 14.8 million adults experience a major depressive disorder, and an additional 3.3 million Americans suffer from mild or chronic depression. Since 1996, the number of Americans taking antidepressant drugs has increased by 100%. Many people who suffer from depression do not recognize that they have the illness and do not realize that they can recover with psychotherapy treatment directed by an experienced psychiatrist.
Depressed people feel overwhelmed by a life over which they feel they’ve lost control. They are exhausted by the struggle to solve problems for which they see no solution. They stop participating in their usual activities. They lose interest in activities that used to give them pleasure. They begin to withdraw from family and friends. When sadness or despair last more than two weeks or begin to interfere with the normal activities of daily living — working, eating, sleeping, family responsibilities — consider it a cry for help. Someone who is depressed may not recognize their need for help; and many are relieved when a family member, friend or co-worker steps in to offer assistance.
Depression can be treated successfully with competent care directed by an experienced psychiatrist. On Friday we’ll discuss successful treatments for depression. Click here to watch Dr. Tracy Marks’ helpful podcast on Depression and Anxiety Coping Strategies.
Fighting the Out-of-Work Blues
The starting bell in the employment race has always rung in the fall. September has traditionally been the best time to look for a new job. Children start a new school year, freeing parents from daytime childcare duties. Collegiates return to college campuses, leaving stores hunting for replacements. Corporations assess staffing needs as they ramp up new marketing programs. Whether looking for full- or part-time work, most job seekers found success during fall recruitment drives. But that was before the recession and double-digit unemployment.
Today, job searches are taking months instead of weeks. Layoffs have made competition fierce, forcing more and better qualified applicants into the job pool. As job searches lengthen and savings dwindle, anxiety and feelings of desperation set in. Some people frustrated with their inability to find a job that will support them or their family give up and sink into depression.
But the burden is felt not just by job seekers. When layoffs occur, those left on the job often suffer survivor guilt. Those still employed are forced to take on greater work loads, work longer hours and assume greater responsibility, further increasing stress and anxiety. For some, the stress becomes too great. According to the U.S. Labor Department, 251 people committed suicide on the job last year, an increase of 28% over the previous year and the highest number since reporting began.
Losing your job doesn’t have to be a career death knell or plunge you into a pit of despair. Traumatic experiences can be a catalyst for positive change. Psychiatric counseling that focuses on cognitive-behavioral therapy can help you find the silver lining in a layoff or difficult job search. Losing a job can be the impetus you need to abandon a career you don’t enjoy, start a business or go back to school. It can be an opportunity to explore new interests, discover what is most important to you and reinvent yourself in a new career. If you are struggling with a job layoff or searching for a new direction in your life, or if you are feeling depressed and anxious about your job, cognitive-behavioral therapy under the direction of an experienced psychiatrist like Dr. Tracey Marks can provide the support and skills you need to meet life’s challenges successfully.
