Anxiety

Depression and Connection, Part 2

In the last blog I wrote about depression, I promised more information on the relationship between connection and depression. Some of my clients have described depression as being like a black hole, or like a heavy and suffocating blanket. Others have described feeling as if the world is muffled or distant. Many go through their day with a smile on their face that they wear for the benefit of others; you may have seen that commercial for depression medication where the woman holds up a smiley face mask but behind the mask, she is clearly unhappy and disengaged. The imagery of these descriptions conveys a sort of darkness and loneliness. People who are depressed often feel alone. And they often do an amazing job of posing as a happy person. They struggle to believe that others could or would want to understand the depth of their pain, or that anyone would want to be around them if they knew the truth. Often, people with depression may feel they are “too much” and do not want to burden loved ones. As a result,  they turn inward and isolate, pushing away those that care the most. Putting on a smiling face and isolating oneself for the benefit of others is a huge problem in dealing with depression because it doesn’t work. Just to emphasize … isolation and pretending do not work!!! Those strategies don’t work because they serve only to deepen the depression. Isolation’s counterpart, connection, is what is needed. Often when one thinks of the word connection, the image of an in interpersonal relationship comes to mind. Connection to people is absolutely a main component of one’s well-being. Healthy, nurturing, and reciprocal relationships with others, such partners, friends, and family members have been shown to improve people’s quality of life and health. Good relationships make the ups and downs of life bearable because we have others with which to share both the joys and sorrows of life. Humans are not meant to walk alone. We thrive and accomplish more when we are in meaningful relationships.There are other kinds of connections that are important as well, such as doing meaningful work. Do you remember a time when you were so excited about a book you read, or inspired by someone’s story? Or that time when you knew what you wanted to do and couldn’t wait to get started? Or when you found yourself in a place that moved you so much, that you knew you needed more of that in you life? That is connection! It is connection to people, and it is also connection to that which helps you to know your place in the world and allows you to contribute something meaningful, something that gives you a sense of purpose and contributes to your broader understanding of life. Earlier, I said that pretending to be okay and distancing oneself from others only exacerbates depression. It reinforces ideas of being alone and unwanted. The reality is we need to be with others, especially when we feel at our lowest and most vulnerable. The support we receive from others, personally and professionally, is essential to recovering from depression. There are people who want to help. It may not be the first person you ask, or even the second and third, but there is someone in your life who will say, “yes, I want to be there for you”. So, no matter how murky the depression waters seem, or how deep the black hole seems to be, ask for help. Do the opposite of what you feel in those moments. Go to where the people are.  

Inside The World Of Infertility (Part I)

April 21st begins Infertility Awareness Week. For some of us, 1 in 8 to be exact, this reminder is more than a week long. It’s a daily, monthly, yearly, and lifetime struggle of awareness that our bodies aren’t doing what we need it to do. Few things are more heartbreaking and devastating to a family’s dream than getting a call from the doctor telling you that you and your spouse are unable to have a baby without IVF (In Vitro Fertilization). It’s a deep pain that hits the core and while, over time we manage, the wound never goes away. There are constant reminders, insensitive comments, and endless personal questions that come with infertility. Not to mention the financial investment, the physical and emotional pain, and the stress of timing the injections, blood work, pills, and implantation to the minute. It literally is a direct science!I remember the phone call like it was yesterday. My husband and I were celebrating our one-year anniversary in Dakota Beach. We had been gifted with a condo and were thoroughly enjoying the nice breeze and view of the ocean from our room when my doctor called me.  He said, “Melissa, your tests came back along with your husband’s. I hate these phone calls. I’m sorry to say that you won’t be able to conceive without the help of IVF. And even with IVF, the numbers don’t look good.” Instantly I stopped thinking and breathing. My mind was going a million miles a minute and shut down all at the same time. I apologized and asked him to repeat what he just said. He simplified and said, “These test results are showing us why you’re not getting pregnant.” He then gave me a name of an IVF specialist and encouraged me to call right away.Infertility does not discriminate. It happens to anyone regardless of race, gender, sexuality, religion, and SES. It even happens to therapists! Infertility can’t be wished away. It’s a grief and a pain like no other. And although everyone who struggles with infertility has their own story, feelings, and emotions surrounding events that only happen to them, there’s a special bond between those who share an IVF and/or infertility story.So, what do you do if you or a loved one has just learned you have infertility or continue to struggle with your empty womb or the waiting?

  • Listen to your physician. If they are not supportive and empathetic, find one who is. You need a good compassionate doctor who will walk with you in this journey.
  • Be kind to yourself. Take time to grieve. You have suffered a traumatic loss. Surround yourself with nonjudgmental and non-fixer people. You need to be able to express your feelings and be validated—not judged or fixed. Infertility is not a problem that can be solved. Some people believe that if IVF works and you get pregnant and have a baby—poof, you’re fixed! All is well. This is not the case. Yes, it is a happy and amazing miracle. But there are so many emotions,feelings, and hidden pains that need addressing.
  • Remember you are NOT broken. Just because there’s a part that may be labelled ‘dysfunctional’ does not mean you or your personhood is.
  • Find a therapist who will help you with coping skills to alleviate your suffering. Not take away the pain, but help in lessening it, help you in your grief, work through unmet expectations, and help manage anxiety if you are going through the IVF process. Don’t suffer in silence. Reach out for help.

Connection and Depression, Part 1

Serotonin is a neurotransmitter and hormone that is involved in the functioning of multiple organ systems in the body. Commonly, it is known as the happy chemical. There is a strong correlation between low levels of serotonin and depression. This is a simple enough explanation and if that is in fact the case, then medication should do the trick. And indeed, medication can help ease the most severe symptoms of depression such as fatigue, decreased concentration and focus, sadness, feeling as if one is in a fog, and general apathy. Notice that I used the word “ease” when explaining how anti-depressant medication can address symptoms of depression. I use this word because anti-depressants are not a cure-all and because depression is a complicated condition. We know that serotonin is implicated in depression, but it is a chicken or the egg argument. Does depression happen because of an insufficient amount of serotonin, or is the production of serotonin impacted by depression?This is an important question because it tells us that managing depression requires a multi-modal approach. Think about it. If you are someone reading this blog right now that has suffered from depression, whether it is infrequent or chronic, what things made it bearable? Was it the great feeling you got from exercise? Or a lovely lunch with a dear friend? A successful presentation at work? Or being selected for a prized opportunity at school? And maybe it was as simple as a walk or eating your favorite ice cream. These events create pleasure,contentment, or a sense of accomplishment which in turn boosts our mood. And those momentary feelings are just that, momentary, when you have depression. Why is that? There are a couple of explanations. One being that people who are depressed are often extrinsically motivated. One who is extrinsically motivated seeks affirmation and approval from the outside world. Success and happiness are determined by the approval of others whether that is in the form of  praise, admiration, or the number of followers/likes/retweets on social media. On the other hand, a person who is intrinsically motivated experiences satisfaction with knowing they have done a good job or are a good person without lots of validation from the outside world.By itself, there is nothing wrong with being extrinsically motivated. Nor is it necessarily sufficient to only be intrinsically motivated. The reality is we need both. We need to know our worth without excessive amounts of validation, and yet it sure is nice when someone notices when we have done a good job. In my opinion, it all comes down to connection. Real, meaningful, life giving connection to others and to a life with purpose. People are healthiest when they know they matter and that what they do matters. People are healthiest when they enjoy relationships where they can be themselves in all of their multifaceted and complex wonderfulness. Do you have people in your life that help you to know you matter and are you engaged in activities or work that give you a sense of purpose? If the answer is no, and you are feeling depressed or anxious, perhaps it is time to re-evaluate and seek new experiences and relationships. Psychotherapy is a great place to begin that exploration and uncover what might be holding you back. More to come on the relationship between connection, depression, and anxiety.