December 30, 2009

December 30, 2009
Depression during the Holidays

Welcome to another day in my life. Today is Wednesday and I hope you are having a safe and great week so far.

While I have been lucky enough to make it to another holiday season and almost to another year; I know many people have trouble during the holidays.

Depending on how you slice and dice the numbers, up to 15 million people in the United States will experience major depression each year. Forty million people suffer from some degree of serious anxiety.

I know twenty years ago; the Christmas season was a very depressing one for me. See I had just lost my partner and my god-daughter within months of each other as they lost their battle with AIDS.

Frankly, my family was lucky I made it there at all. It was one of my bad years. I had one of the worst cases of depression of my life. I have also had two others which were also around the holiday season. Now, I have to admit that I actually look forward to the holidays.

One of the most tragic things about living with mental illness is that you often feel like you are the only one. The illness also keeps you silent. You just feel like you can not tell anyone how bad it really is. What is more, when I was in a depressive episode I also felt like I deserved it, that there was something wrong with me, to my very core, and that my friends and family would probably be better off if they did not have to deal with me at all. It sounds melodramatic and self-centered, and in a way it is, but it is also a shame spiral from which it is almost impossible to escape without help.

Whether people are actually more vulnerable to serious depression and anxiety around the holidays is a subject the experts debate. Many say it is, while others point to studies contradicting this commonly held assumption. One thing that can not be denied is that the holidays certainly crank up the emotions on a triple threat: family, money and self image.

Your self image and ego become more vulnerable during the holidays because you’re confronted with acquaintances and family members you rarely see, and who invariably ask, “How have you been,” or “What have you been up to?”

I certainly was not going to tell them that I Had racked up thousands in debt while in a manic episode or spent the last three months barely able to make it to work or leave the house. Actually, giving the usual pat answers was not so difficult. We are called on to do that kind of thing all the time. What was hard was the reminder that I’d been living a tortured, rather than a vibrant life, one that was not necessarily successful by society’s standards.

Money has also always been a challenge, especially around the holidays. I have such a compulsion to buy just the right gift, something that is personal and shows I have taken the other person’s preferences into account. Unfortunately, this usually meant taking a lot of extra time running around and spending money I sometimes did not have. The mounting anxiety about the money I spent and the overwhelming need to procrastinate dealing with the financial realities meant I would crash hard after New Year’s.

As for family, oh boy in so many families there is a heightened expectation to be happy and for everyone to love one another and get along. We are supposed to be immensely grateful for every gift, even when the sweater from your aunt is five sizes too big and still has a clearance sale sticker on it. We’re supposed to overlook long-simmering conflicts or new ones that just cropped up. And for those who have become estranged from or lost close family members, the holidays are a painful reminder of that loss and a sense of deep loneliness.

If you are going through a deep depression, or periods of crippling anxiety or mania if you are bipolar what is a merely stressful time of year for many people can become unbearable. You can not get help if you do not acknowledge the problem, though. You have also got to tell someone, whether it is a health care professional, a family member or a close friend. Preferably the person you tell will be someone you’re fairly sure will be supportive and understanding.

Some people suck it up and trudge through it alone and somehow make it out the other side. I have done that when the bad times were less severe, but I do not recommend it just as I would not recommend toughing it out on your own if you broke your leg. Both strategies can lead to needless suffering and long term scars and complications. The difference is, few people feel shame or guilt about breaking their leg, while mental illness is something we’re never supposed to publicly acknowledge.

Shame and stigma, however, can be a prison we lock ourselves in as well as something that is thrust upon us. For me, initially, depression was something I was relieved to get through and hoped I would never have to talk about again. Then it came back, repeatedly, interspersed with periods of irrepressible enthusiasm and energy. It was not until I was diagnosed with bipolar II, and fully accepted that this was an illness like any other, that I stopped keeping it a shameful secret. Today, most people close to me know about it, and the shame is virtually gone. I also enjoy the holidays more. It took me nearly 20 years to apply to mental health the lessons I had learned about overcoming stigma from people living with HIV/AIDS. As the old ACT UP slogan goes, “Silence = Death.”

For me it is one of the ways I overcome shame, by taking back words that have been thrown at us over the years. It is a personal choice, one that will not work for everyone. For me, however, turning hurt into humor and refusing to let labels define how I feel about myself gives me strength and courage.

Finding the strength necessary to get help for depression, anxiety and bipolar disorder is not always easy, especially with a fractured medical system that treats mental illness differently from almost any other health problem. Help is the way out and up, however.

So this holiday season, give yourself a gift one you may ultimately realize is the best you have ever received. If you have been avoiding seeking help, find it. If you’ve been having trouble accepting that mental illness is not something you cause, but a health problem you experience like any other, spend time in the forums where you can encounter others who have been through what you have. And if shame and stigma about your struggles have kept you silent and alone, think about telling more people what you have gone through. Freedom from shame and stigma is a priceless gift.

Until we meet again; here's wishing you health, hope and happiness.

big bear hug,

Daddy Dab