Soulful Healing

I have found myself having a lot of conversations about depression lately.  From clients to friends to colleagues, sadness and disappointment have many people in their grasp these days.  I imagine that local, national, and global events are major contributing factors.  Whether you call recent U.S. economic challenges the Great Recession or the 2^nd Great Depression (hmmm, there’s that word again), unemployment & stagnant wages & cuts to services to our most vulnerable are crippling the nation.  Then there’s the Haiti earthquake, the BP Oil Spill, the Japan earthquake, tsunami, and nuclear crisis, and the various wars the U.S. is participating in.  Lots of reasons to be bummed, especially if you watch mainstream news on a regular basis.

Sadness is a normal human emotion and while it may not be pleasant to feel, it is an essential part of our experience.  I think it is important to be sad about the above laundry list of alarming events…  Sadness — like all our other emotions — can be a messenger, if we let it.  Sadness alerts us that something important, significant, meaningful is happening.  Whether sad at the end of a fun experience or about living far from family or about the loss of a job or loved one, sadness is part of our collective story.  In addition, one cannot be happy all the time.  In fact, we call it mania when someone’s mood is excessively positive for too long.  Think about the cycles of nature…  There is birth, growth, death.  Plants require both sunshine and rain to grow, so how can we expect only sunshine in our own lives?  As the book of Ecclesiastes notes, “To everything there is a season and a time to every purpose under heaven.”

While personal challenges and socio-political factors have a huge impact on a person’s mood, there is a significant difference between general sadness and clinical depression.  True clinical depression is deeply painful (both emotionally & physically) and makes it difficult for a person to function normally.  The disorder takes over a person’s thoughts, turning them almost exclusively to the negative (or at least making it really hard to think anything positive).  There is huge body of research on what is happening in the brain on a neurochemical level in a depressed person, but that’s beyond my purpose here in this article.  I’ll focus instead of the different types of depression, their symptoms, and some resources for more information. 

There are different types of depression, but when most people use the word they are probably referring to Major Depressive Disorder.  From the Diagnostic & Statistical Manual of Mental Disorders, the symptoms of Major Depressive Disorder include:

• Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feeling sad or empty) or observation made by others (e.g., appears tearful).  Children and adolescents may present with irritable mood.
• Markedly diminished interest or pleasure in all, or almost all, activities most of the day
• Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite.
• Insomnia or hypersomnia
• Psychomotor agitation or retardation
• Fatigue or loss of energy
• Feelings of worthlessness or excessive or inappropriate guilt
• Diminished ability to think or concentrate, or indecisiveness
• Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

As you read through this list, you may have found yourself thinking, “I’ve felt that way before!”  It’s true, many of us have had these signs or symptoms at one point or another for a short time.  It is important to note that a person with true major depression will have at least five of these symptoms and experience them nearly every day for at least two weeks.   In addition, the above symptoms must be significantly impairing a person’s daily functioning.  This means that the person’s behaviors are causing them to have significant difficulties at work (e.g., can’t complete important tasks), school (e.g., sudden drop in grades), or in personal relationships (e.g., emotional withdrawal from or frequent arguments with one’s partner).

Another form of depression is called Dysthymic Disorder (from Greek, quite literally “bad mood”).  This is more of a low-grade depression that lasts for an extended period of time.  Two or more of the following symptoms must be present for at least two years in adults and one year in children (with no more than two months being symptom-free).

• Poor appetite or overeating
• Insomnia or hypersomnia
• Low energy or fatigue
• Low self-esteem
• Poor concentration or difficulty making decisions
• Feelings of hopelessness

Due to the training & experience required to properly diagnose a depressive disorder, I encourage you to refrain from diagnosing yourself based on the information presented here.  If you suspect that you or a loved one are experiencing depressive symptoms, please consult with a qualified mental health professional.  You can also take this online Depression Screening Test to help you determine whether your feelings & behaviors match up with depressive symptoms.  Psych Central hosts this screening test and has an amazing collection of resources on depression and its treatment.

In my next post, I’ll be exploring various treatments for depression, with an emphasis on how mindfulness, meditation, and movement can be used in depression recovery.  Be well and stay tuned!

“Sticks & stones may break my bones, but words can never hurt me.”  This familiar children’s taunt may be a nice way to dismiss a bully, but you and I both know that it’s not altogether true.  In fact, I often think that social, emotional, and spiritual wounds are far more painful than anything a stick or stone can do.  In addition, there are often severe emotional wounds that come from living through violent experiences.  I see this as especially true for those who are living in areas that are currently at war.  While there are many people in many countries and communities living with violence of some type, I’d like to focus today on U.S. soldiers returning from active deployment.  Many of our soldiers are coming home with lots of thoughts, feelings, and actions that the rest of us civilians might have a hard time understanding.  Witnessing violence and death (an inherent part of war) has serious effects on the human mind.  In a military setting, one is essentially re-socialized to incorporate these experiences into one’s worldview to build up the capacity to cope, but those strategies don’t work so well when the soldier returns to her/his regular life.

What is Trauma?
For our purposes here, the term “trauma” refers to the serious physical or psychological harm of Self or someone else, whether actual or threatened.  The seriousness of the event is usually observed in the person’s  response of fear or terror.  Per the DSM-IV-TR, the diagnostic manual therapists use to categorize mental health diagnoses, the common emotional and behavioral reactions to trauma include:

• Re-experiencing the trauma
  • Flashbacks:  Feeling as though the trauma is happening again
  • Nightmares
  • Feeling very distressed when reminded of the trauma
• Avoiding reminders of the trauma or feeling numb
  • Avoiding people  or places that might trigger painful memories
  • Forgetfulness related to the event
  • Feeling detached from others
  • Difficulty experiencing a full range of emotions
  • Not wanting to talk about the event
• Increased arousal
  • Difficulty falling asleep or staying asleep
  • Feeling irritable, grumpy, or angry
  • Increased sensitivity to sound & movement – such as feeling jumpy or on edge
  • Difficulty concentrating

Trauma Responses as Helpful
These types of feelings and behaviors might serve a person well in a dangerous environment.  That might sound strange at first, but stay with me…  Feeling detached could be useful because a soldier, for example, needs to distance himself from what’s happening or he can’t do his job.  Difficulty sleeping is helpful when the enemy might attack during the night and a soldier needs to be fully awake & alert with little notice.  Developing an increased sensitivity to sound & movement is useful when a soldier needs to carefully observe everything going on around her in order to stay alive.  It is also not difficult to understand how irritability and anger develop under constant exposure to injury and death, especially since military units often function with the closeness of a family.

From Helpful to Unhelpful
So we see that certain trauma responses are useful in environments where danger is actively, and perhaps relentlessly, present.  But these challenges with sleeping, concentrating, irritability, and increased sensitivity are not useful when a person leaves that dangerous situation.  Nightmares and flashbacks cause the nervous system to be on high alert, which can lead to irritability and difficulty communicating.  Lack of sleep is physically exhausting and if insomnia is severe enough, it can  eventually lead to odd perceptual experiences and hallucinations.  Feeling numb and detached can lead to social isolation and failure to reach out for help when it is most needed.  Difficulty concentrating makes it hard to get work done and perhaps hard to hold on to a job.  Difficulty maintaining a job can create tension in one’s close relationships, leading to more social isolation, and self-blame.  Quite the vicious downward spiral.

Helping our Soldiers
If you or a loved one is struggling with the above feelings and behaviors, the good news is that there is help.  Taking that first step of asking for help can be really difficult and yet it the first step that is so important in the healing process.  It can also be such a relief to lay down the burden you’ve been carrying.  Here are some great resources for healing from the struggles of war and military conflict:

Give An Hour — Providing veterans of Iraq & Afghanistan, and their families, with free mental health assistance 
Heal My PTSD — A wonderful compilation of information and resources about Post-Traumatic Stress Disorder 
National Alliance on Mental Illness (NAMI) –Providing support, education, advocacy, and research on mental illness.  Broswe around the site or click the “Find Your Local NAMI” to search for a chapter near you.   
NAMI’s Veterans Resource Center — A variety of resources compiled by NAMI to support troops, veterans, and their families.

Stay mindful and be well!

Over the past few weeks, my motivation to write has been low.  First, there was Thanksgiving.  I had a wonderful time celebrating with my family & friends.  One of the side effects of feasting, though, is a sleepy lethargy!  So I gave myself permission to just enjoy the relaxation that I don’t usually make time for.   Then in the week after Thanksgiving, one of my friends passed away.  She was about a month younger than me and her death was entirely unexpected and shocking.  I think I spent that first week feeling numb and in complete denial.  As the most basic defense mechanism, denial comes in very handy.  Information that our minds cannot process is blocked out because to take in that information might require a complete reorganization of thoughts, feelings, and information that we currently have.  If you think organizing your desk is challenging, try reorganizing your mind!  About a week after I got the news, I was able to really feel the sadness my defenses had blocked out.

Dealing with this sadness got me to thinking about how the holidays are not always “happy”.  With smiles on our faces, we encourage one another to have “Happy Holidays!”  And while Halloween through Christmas is easily my favorite time of year, it carries with it reminders of both past joys and past sorrows.  Then, there are the current joys and sorrows.  I was reminded of this recently while watching the movie Parenthood, where one of the characters gives an apt description of life as a rollercoaster, noting that she prefers the rollercoaster to the merry-go-round.  Whether we like it or not, life is rollercoaster… a sometimes intense series of ups and downs and all-arounds, with (hopefully) moments of rest in between.  I don’t know about you, but I am looking back on a year that zoomed by in true rollercoaster fashion.  There were a whole lot of amazing times and a whole lot of hard times.  There were times when I thought I couldn’t be happier.  There were times when I couldn’t imagine how I would get through the day.  Here I am…  sad, content, worried, joyful, eager…  all of the feelings that make up this life.  But most of all, I feel lucky to just be sitting here writing about it.

Still, at this time of year, we can sometimes feel pressured to be happy.  As if, when we are not happy, we are somehow upsetting the natural order.  Sometimes, we might even actively become angry with each other because someone wants to honestly express their discomfort or discontent.  When we are the accusers, it’s usually a sign that we are denying, ignoring, or avoiding our own difficult feelings.  It’s far simpler to blame others, versus doing the hard work of looking inward and coming to terms with the stuff we’ve been ignoring.  While denial and avoidance are great forms of self-protection in the short-term, they don’t tend to serve us well in the long haul.  What we deny or avoid comes back to haunt us in strange ways.  Just because we choose not to be conscious of something does not mean it just goes away.  It can come to settle in the subconscious, from which we act out our fears & desires without conscious awareness.  Have you ever been completely shocked by an observation that someone else has made of you, only to later realize they were right?  It’s rarely pretty, but try saying hello to the junk buried in your subconscious with gentleness and curiosity.  Remember that self-blame only creates stagnation and keeps us repeating the patterns we don’t like.

If you are one of the people for whom the holidays are not so happy (or are perhaps a mix of happy & sad & other stuff), know that you are not alone.  I also hope that, as you experience the wide range of human emotion during this holiday time, you can honestly share that with someone who is willing to listen.  Whether you are grieving a recent loss or a more distant one, many people are feeling exactly the same.  Maybe it’s time to reach out for a little social contact, maybe it’s time to stay home and rest, or maybe you need a smidge of both.  Only you can figure that out for your Self.  Denying your Self the right to feel what you feel can have all kinds of negative effects.  So pick your favorite self-care strategy or engage in some self-reflection to get you back to your Soul center.  It’s right there waiting patiently for you to return.  While we struggle with our losses, let us also call to mind the people still here to walk through this life with us.  Whatever your Soul is handling right now, I’m wishing you the  grace to let yourself heal and let others in your life know what you need.  Be well!