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.
You Can Learn to Manage Stress
Stress can be debilitating. Excessive or chronic stress can take an unhealthy toll on both your physical and emotional health (see our Oct. 2 post on Learning to Recognize Symptoms of Stress). Many women need a little help figuring out what triggers their stress and why certain situations or people seem to push them over the edge. They may need some guidance from an experienced professional to discover and learn new methods that allow them to effectively manage stress and stay in control. The good news is that with the help and guidance of a psychiatrist experienced in understanding and treating chronic stress, women can live healthier, happier, stress-free lives.
Discovering the source of your stress often involves exploring why you respond to certain situations or people in ways that increase your stress levels. Guided by an experienced psychiatrist, psychotherapy (also called insight-oriented therapy) can help you discover the sources that explain your behavior. Cognitive-behavioral therapy can help you replace negative thoughts and behavior patterns that may be aggravating or even creating stress with healthy, positive thoughts and actions.
Trying to balance the daily demands of home and work life, places considerable strain on today’s professional woman. Recognizing the arduous toll stress can take on professional women, Atlanta psychiatrist and psychotherapist Dr. Tracey Marks has developed a special 4-Step Stress Buster Plan geared to give women the tools they need to cope successfully with the stress in their lives. During a 90-minute initial evaluation, Dr. Marks will talk with you about your current situation and help you develop a personal action plan to reduce your stress levels. As a medical doctor, Dr. Marks can assess and discuss with you any need for medication or additional medical intervention to ensure your good health.
As part of Dr. Marks’ unique 4-Step Stress Buster Plan, you receive the doctor’s valuable notebook How to De-Stress & Achieve Balance. Packed with helpful information and de-stressing exercises, the notebook provides valuable insights and suggestions for future thought and discussion. You also receive access to Dr. Marks’ collection of soothing meditation CDs containing proven relaxation techniques you can practice and use at home.
You are not alone. Dr. Marks can help. Call and make an appointment with Dr. Marks today.
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.
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.
What’s Love Got to Do With It? Everything!
Love is the force that binds us, one to another. A husband’s love for his wife, a mother’s love for her child, the love shared by siblings, the love of lifelong friendships — these are the ties that define us as human beings. Love gives us the courage to persevere in the face of life’s challenges. It gives us the resilience to bounce back from disappointments and comforts us in times of tragedy. Love adds sweetness to life’s successes and allows us to share its joys. What’s love got to do with life? Everything!
So, what happens when love ends? When a spouse or partner dies? Or love crashes on the jagged reef of divorce? The loss of love can have dangerous mental and physical repercussions that exact a toll beyond normal grief. A new study found that the lingering stress caused by the loss of a spouse or partner to death or divorce increased the risk of chronic illness. Men and women who were divorced or widowed were 20% more likely than married people to develop heart disease, diabetes or cancer, according to a recent survey of 8,600 adults from 51 to 61 years old by University of Chicago researchers.
The ending of a long-term relationship, whether from death or divorce, “really destroys financial assets, and it destroys health assets in the same way,” said University of Chicago sociologist Linda Waite, a co-author of the study. Financial strain, loneliness and uncertainty about the future create significant emotional stress. For some, the necessity of moving into more affordable housing or housing that is physically easier to maintain adds additional loss to their grief. Divorcing couples must cope with their children’s feelings of loss as well as their own. The duties once shared by two parents can feel overwhelming when only one parent is shouldering the burden. Combined, these things add to the burden of grief that follows the loss of a loved one, creating a persistent, overwhelming feeling of stress.
Over time, continuous stress erodes both our physical and mental health. Stress from grief or marital strife weakens the immune system, making us more susceptible to chronic disease, depression and anxiety. Strengthening existing relationships and building new relationships can help ease the strain, but some people will need professional psychiatric help to weather the storm and deal with their loss.
Cornerstones of Good Mental Health
Two important cornerstones of good mental health are resiliency and the ability to develop supportive relationships. Even though disappointment, loss and change are normal events in life; they often cause feelings of stress, sadness and anxiety. People who lack good mental health can be overwhelmed by these feelings. Resiliency, the ability to persevere in the face of adversity and bounce back after traumatic or stressful events, is a vital component of good mental health. Resiliency provides the coping mechanisms people rely on to maintain the focus, flexibility and creativity necessary to weather difficult events.
The ability to recognize emotions and express them appropriately is a key component of resiliency. Resiliency allows people to balance negative emotions with positive ones, preventing a slide into depression, anxiety or other mental health issues. Increasing flexibility and providing balance in your life can improve resiliency. The following actions suggested by the American Psychological Association can help you build resiliency:
- Allow yourself to experience strong emotions. However, be aware that strong emotions may need to be avoided if they threaten to interfere with your ability to function.
- Be proactive about addressing problems as they occur, but learn to stop and relax when you need to reenergize.
- Spend time with loved ones and allow their support and encouragement to nurture you.
- Cultivate the ability to rely on others, but learn to rely on yourself, too.
Like resiliency, supportive relationships are important to good mental health. We are social creatures who crave companionship. We draw emotional strength from the support of other people. Developing an ability to forge positive relationships with others may take time and effort, but those connections are vital to our emotional health. Use these tips to help build strong, supportive relationships:
- Turn off the computer or television and socialize with family, friends and neighbors. Facebook and Twitter will never give you the same feeling of comfort or understanding as real, face-to-face human contact. So much of communication is expression and touch; things that are lost in the virtual world. To build supportive relationships, you need to connect with other people personally.
- Shared interests and helping others can forge bonds between people. To meet people who share your interests, join clubs or volunteer. Invite someone you enjoy to continue a conversation over a cup of coffee. It could be the start of a beautiful friendship!
How to Improve Your Emotional Health
Emotional health is as essential to our well-being as physical health. Mentally healthy people are in control of their emotions and behavior. Emotional health allows us to weather the roller coaster ups and downs of life, handle daily challenges and build enduring relationships to create productive, fulfilling lives. When life hits a bump in the road or disaster strikes, emotionally healthy people have the strength to keep moving forward and the resilience to believe that life will get better. While many Americans work at improving their physical health, few realize the equal importance of actively working to improve mental health.
What is mental health? HelpGuide.org defines mental or emotional health as “your overall psychological well-being. It includes the way you feel about yourself, the quality of your relationships, and your ability to manage your feelings and deal with difficulties.”
People who are emotionally healthy share some common characteristics:
- They feel content. Life has meaning and purpose and is filled with satisfying relationships and activities.
- They enjoy life and people, laugh often and know how to have fun. They have created a comfortable balance between work and play, rest and activity, family and work.
- They enjoy learning new things and adapt readily to change.
- They have learned to cope with stress and adversity successfully, and when faced with problems are optimistic that life will improve.
- They have high self-esteem and project self-confidence.
There is a strong connection between mental and physical health. Adequate sleep, regular exercise, proper nutrition, a daily dose of sunlight, limiting alcohol and avoiding cigarettes and other drugs improve physical health while increasing energy and lifting your mood, contributing to positive mental health. Physical exercise releases endorphins that reduce stress and lift mood, helping to combat anxiety and depression. Adequate sleep decreases the risk of depression and increases resilience. Ten to 15 minutes of sunlight a day increases happiness.
It’s as important to nurture your mind and emotional health as it is to take care of your body. Try these strategies for decreasing stress and building positive emotions:
- Feel the world through your five senses.
- Explore your creativity.
- Share your life with a pet.
- Take time for contemplation.
Lack of Sleep Increases Risk of Dying
That sleepless night that makes you grouchy and tired the next day can be a killer — literally. New research shows that getting less than 5 hours of sleep a night increases your risk of death from cardiovascular disease. In a study of 4,600 men and women aged 35 to 55, researchers at University College London and the University of Warwick in the United Kingdom found that women who slept less than 8 hours per night had a higher risk of dying from cardiovascular disease than men. Differences in hormone levels may play a role.
According to data recently published in the journal Sleep, women who slept less than 5 hours per night had significantly higher levels of the inflammatory markers that are indicators for heart disease. Compared to women who were able to achieve a full 8 hours of sleep, risk levels increased dramatically with every hour of sleep lost. Even women who received 7 hours of sleep a night showed much higher levels of risk indicators than those who slept 8 hours.
A growing body of research indicates that sleep is a vital component to good physical and mental health. Chronic insomnia is also known to increase anxiety and contribute to depression, particularly in women. Another study reported in Sleep indicates a relationship between postpartum depression and the lack of sleep common to new mothers. In the Norwegian study, 60% of new mothers reported sleep problems with 16.5% showing symptoms of depression.
Researchers found that postpartum depression not only aggravated insomnia, but that complaints about sleep problems often interfered with the diagnosis of postpartum depression. Researchers found that many women who continued to report sleep problems two months after delivery were suffering from postpartum depression. However, because tiredness and lack of sleep are common complaints of new mothers, those suffering from postpartum depression often remained undiagnosed and untreated.
Researchers emphasized the importance of doctors discussing sleep problems with new mothers. Chronic lack of sleep that affects daytime functioning, results in a general lack of energy or that impacts other aspects of a new mother’s life could indicate postpartum depression. Depression screening is recommended to new mothers who continue to experience chronic insomnia. Treatment by a board certified psychiatrist can help women overcome postpartum depression, find solutions to chronic sleep problems, and enjoy their roles as new mothers.
