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.

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.

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.

“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.

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.