Managing Depression During the Holidays

 

Image: Night Snow at Kambara by Utagawa Hiroshige
Night Snow at Kambara by Utagawa Hiroshige

Right before I got diagnosed with depression, I suffered through the most horrible Christmas ever. On the surface, everything was fine. I spent Christmas Day with my family as usual and a couple of days later my best friend got married in a lovely ceremony and reception. But the moment I was out of sight on my way home from my parents’ house, I burst out crying and cried for hours. And I was only able to endure an hour of the wedding reception before escaping. Thankfully, by the next holiday season my depression was controlled by antidepressants and I truly enjoyed it.

The holidays put a lot of demands on everyone, but are exponentially more difficult for someone with depression. Getting through the usual day to day can be painful, and the holidays add a lot of things to the mix like stress, emotional upheaval and unhealthy (although delicious) food and drink. However, there are a few steps you can take to boost your physical and mental health. Even if the steps don’t boost your mood, they should help to immunize you against some aspects of the holidays that can make your depression worse.

  • Prioritize sleep at the top of your list. Sleep is very important when you’re under stress, and sleep deprivation is not good for people with clinical depression.
  • Drink alcohol in moderation, if at all. Alcohol is a depressant, pure and simple. It might stave off the blues for an hour or so, but will not do you any favors. Its siren song promising temporary oblivion is very tempting, but it’s really the last thing you need.
  • I know this comes as a shocker, but foods high in fat and sugar and not much else are not good for you, and that’s mentally as well as physically. And this is coming from someone who won’t eat vegetables unless they have butter or sauce on them. For one thing, if you’re eating a lot of sugar and fat you’re not eating the good nutrition that can help stave off depression. Second, how irritable do you feel when that sugar high wears off? Not a good look for someone who is clinically depressed to begin with. I know that those holiday foods are yummy and everywhere you turn, but limiting yourself to just sampling those less than healthful foods is a good idea. Have a healthy snack before holiday parties so that you don’t go overboard on appetizers and dessert. And remember, alcohol has a lot of sugar in it.
  • Make some time for yourself. Spending just 15 minutes alone, can be quite rejuvenating, particularly in households where there’s a lot of activity or out-of-town company. Make a cup of tea, go for a walk or find a quiet place to enjoy for a bit. The sounds of silence will be music to your ears.
  • Getting together with family over the holidays can raise a lot of issues. If you’re in therapy, you might want to discuss with your therapist how you should defuse some potential problems. Be honest with family and friends about how you feel. Don’t be afraid of bringing everyone down with your mood; your family and friends may be worried about you, and you will all feel better if there’s an open line of communication.
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Social Anxiety During the Holidays

We spent Halloween at my sister’s house this year. Every year, most of the houses on the block she lives on decorate their garages as one of the locations in the Harry Potter books. The crowd that comes is by now completely insane. You can barely move through the street (which is blocked off). Whenever we go there for Halloween, we help to pass out candy as the crowds move through their garage.

My son, who is almost seven, wanted to help pass out candy. While my interaction was limited to saying, “Hi, cutie,” to some of the tinier Trick-or-Treaters, Lawrence kept up a running commentary. “Wow, great costume.” “Oh look, the good and bad Spidermans together” and, after he was released from the bathroom (he accidentally locked himself in with the quirky antique lock), confiding to visitors that the night had been great except for his “bad bathroom experience.” I’m sure they assumed he had had a bout of diarrhea after eating too much candy or something.

Events like this are why we call him our “little cruise director.” The kid was born with the gift of gab, almost unshakable self-confidence and a need to interact with other people. He gets that from my husband, the ultimate extrovert, not from me. I’m the opposite of both of them in anything to do with interacting with other people. Although I’m articulate in general, I freeze up in certain situations and am perfectly happy with a minimum amount of social interaction.

As you might have guessed, parties and similar social occasions are torture for me. For some reason, my normally healthy self-confidence takes a hit. Everyone seems to be in little cliques and I start getting flashbacks to birthday parties that I was invited to when I was younger. I think in most cases the child’s parents made them invite me because the whole class (at least the girls) was invited or because they were friends with my parents or something. I was painfully shy and somehow ended up being the butt of jokes. I don’t know if my shyness was a result of my depression or a part of it, but either way it meant that most social gatherings were something I endured instead of enjoyed.

Of course, this is the time of the year for parties and gatherings. If you’re like me, you’re anticipating them with the same pleasure that you would a root canal. But there is something you can do to make the experience easier – volunteer to help out.

If your employer’s holiday party (which, in many companies, is essentially mandatory) is usually on your most-dreaded list, volunteer for the party committee. You’ll get to know your co-workers during the meetings and you’ll have something to do during the party. I was on the holiday party committee during my first year at my current job, and was happily ensconced at the crafts table helping people make Christmas ornaments during most of the party.

If you’re at someone’s house for a party, volunteer to come early to help set up, and/or help with cooking and serving during the party. You’ll have won the goodwill of the host/hostess, who you very possibly don’t know that well, you will have something to do instead of sitting in a corner feeling awkward, and you will have some handy conversation openers, “Some cheese-puffs? They’re made with seven different kinds of cheese and they’re yummy.”

If you have the same kind of “wonderful” childhood memories that I do, remember that things are different. Grownups are not as openly cruel as children and less inclined to try to kill the weak or sick member of the herd (don’t ask me why, but that’s what children en masse taunting one child reminds me of). Definitely less Lord of the Flies and more Martha Stewart. During the holidays, most people are enjoying themselves at social functions, and want you to also.

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Bodily-Kinesthetic Intelligence

I’m reading “Green Eggs and Ham” to my son Lawrence before bed. Actually, he’s reading it to me, which is very exciting. He’s doing really well. I only have to help him with about one word out of ten. I read way ahead of my level when I was his age, and it seems that he’s going to be just as good.

The thing I’m noticing, though, is that while he’s reading, he’s wiggling around on the bed, almost falling off sometimes, although his eyes are fixed on the book. Come to think of it, he does this when we’re going over flash cards at the dining table, wiggling around on the chair. He also, which I’ve never seen in another kid, jumps up and down in place when he’s playing a video game, usually when he’s at a part that’s particularly difficult.

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Does my son have ADHD?

Around January this year, my husband and I got the dreaded summons from our son’s kindergarten teacher to meet with her about a problem with Lawrence. It was not a complete surprise – she had told us that she had some concerns. Lawrence was having some mild behavioral problems, in that he was having trouble conforming to the classroom structure.

I knew what she was talking about. I had observed him myself in class, when I took the morning off to help with the Halloween party. He ran everywhere in the room instead of walking. Unlike most of the other children (there were a couple of boys who acted like him), he fidgeted and talked out of turn.

There was some good news. He was that he was doing well academically (and in fact his grades even improved as the school year went on). The only area he was having a problem in was handwriting. He was far behind the other children. Incidentally, my husband and I both had problems with our handwriting in school.

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10 Tips for Staying Sane when Your Partner has Depression

Dolce Far Niente by John Singer Sargent

If you’re involved with someone who has depression, you’ve probably seen quite a few lists (including some that I’ve written) that tell you how to be supportive of your partner. And yes, these are a great idea, as the person who has depression is in hell, plain and simple. However, you have to think about yourself too. Having a partner who’s depressed can be frustrating and lonely. The person you look to for emotional support is, to a great extent, not there anymore.

I’ve been in two relationships with a partner who had depression. In one case, the guy denied he was depressed. The other man admitted he was depressed but refused to get help. I ended up walking away from both relationships. It was apparent that nothing was going to change, and I had to move on. If you are in a better position, with someone who is open to treatment, you may decide to give the situation some time. In the meantime, you have to protect your own mental health. Here are some suggestions to help keep your partner’s depression from becoming your own.

1.  Don’t take your partner’s behavior personally, and don’t take it to heart. If you’re partner’s rejecting you emotionally or sexually, or withdrawing, it’s not due to something you’ve done or not done. Being depressed is almost like being possessed. The depression is the one in the driver’s seat, and when you’re depressed, sad and angry, you tend to lash out at those people who love you. On the other hand, if your partner is saying or doing hurtful things, you have a right to insist that that behavior stop. You don’t need to be a punching bag.

2.  Educate yourself about depression – its causes, the different types, the symptoms, and of course its treatment. If this is the first time that either of you have had to deal with depression up close, this is really important. And it’s up to you, as the person who still has got it together, to do the research.

3.  Be realistic about how much you can help your partner. You cannot cure the depression. You can’t buy something, say something or do something that will make the depression go away. You can be supportive and understanding, which will be greatly appreciated at some point in the future when your partner recovers. But other than getting your partner to a doctor, there’s nothing that you can do to make this go away.

4.  Ask for help from family and friends. If your partner was physically ill, you probably wouldn’t hesitate to ask – and people wouldn’t hesitate to offer. When my husband had shoulder surgery, I got offers of help from family, friends and co-workers. But when your partner’s depressed, it may not occur to others (unless they’ve been in your shoes) that the situation is similar; that you are likely taking on a greater share of the chores and childcare.

5.  You’re your partner’s caregiver, especially if he or she is profoundly depressed. Caregivers need time off. You need to get away from the situation occasionally and do something just for yourself.

6.  Keep in mind that depression is “contagious.” That may sound silly, but it’s very common for family members of someone with depression to develop it themselves. Keep an eye out for any signs of depression in you or other family members, and hotfoot it to a doctor if it becomes apparent that treatment is called for.

7. Find a therapist – for you. Your partner should definitely be in therapy, and you might want to go to couples counseling jointly, but you need someone objective who is also on your side. The therapist can help you develop coping strategies, and also help you determine the answer to the question in the next tip.

8.  Decide what your “line in the sand” is. Are you staying with your partner no matter what? What if your partner refuses to get help? Bear in mind that this decision is for you alone. Using it as a threat or ultimatum with the depressed person (“If you don’t get treatment I’m leaving”) is not necessarily going to do anything.

9.  Take care of yourself physically. You need to eat well, get enough rest and exercise to get rid of stress.

10.  Read one of the books listed below. They contain practical strategies for maintaining your relationship and your sanity when you’re involved with someone who’s depressed.

Books

When Someone You Love is Depressed: How to Help Your Loved One Without Losing Yourself by Laura Epstein Rosen, Ph.D. and Xavier Francisco Amador, Ph.D.
How to Live With a Mentally Ill Person: A Handbook of Day-to-Day Strategies by Christine Adamec
The Burden of Sympathy: How Families Cope with Mental Illness by David Karp

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School or Daycare Avoidance/Refusal Part Two

My son Lawrence started kindergarten this school year. He was in a wonderful preschool the past two years, where he thrived. Of course we were concerned that he would have a little trouble adjusting to starting kindergarten, but while we got the “trouble adjusting” part right, we got the venue wrong. He’s had no trouble adjusting to kindergarten – it’s a problem with where he is the rest of the day that is generating phone calls to my husband and I.

After morning kindergarten, Lawrence goes to daycare, which is located on the school grounds. He eats lunch there and then spends the afternoon. At first he seemed to love it – one time he even scolded my husband for picking him up, as he was going to be a penguin in a play they’d been rehearsing. Then we started getting calls, and hearing that he was getting timeouts. And some of the infractions were relatively serious, at least for Lawrence, such as hitting another child or teacher. And Lawrence has started saying more and more that he doesn’t want to go to daycare, or that he wants us to pick him up early.

It’s a perplexing and frustrating situation for a parent to be in. And let’s be honest, it’s potentially inconvenient. Although daycare obviously isn’t mandatory, as school is, my husband and I both rely on Lawrence being able to go there, or we can’t work. So we started brainstorming with the daycare teachers to find the cause. But for a while we were stumped.

We considered a couple of possibilities. Was he, we asked the daycare teachers, having trouble with other kids? Nothing in particular that they had noticed. Maybe, I thought, the problem is that he isn’t getting a nap in the afternoon anymore, as he did in preschool. His personality changes if he’s sleep deprived. But on further examination, that explanation didn’t seem to make sense. In the past, when he was a little demon due to sleep deprivation, we saw it at home as well as at preschool, and we weren’t having any problems with him.

At this point, although we don’t have a definite answer to what the problem is, we have a pretty good working hypothesis. When my husband went to pick up Lawrence the other day, the daycare teacher told him that Lawrence had again acted out in a very uncharacteristic way. My husband expressed our bewilderment with the situation with the teacher. She said she believed that the problem might be three things. One is the lack of structure in the daycare environment. Lawrence seems to thrive on some amount of structure, which is probably why he’s doing well in kindergarten. But the daycare situation could best be described as “controlled chaos.”

That controlled chaos is the second problem. Lawrence is used to, and apparently needs, a fair amount of peace and quiet, only broken at home by himself. At preschool, the two hour nap provided him, even if he didn’t sleep, with a long period of peace and quiet. There’s none of that at daycare. In fact, there isn’t even anywhere he can go to escape the noise and occasional mayhem. Since I’m very sensitive to continual noise, I can definitely relate to that environment possibly making him cranky.

The other way in which this daycare is not particularly well suited to him is the small amount of attention he receives compared to what he’s used to. The ratio of teachers to children doesn’t favor individual attention. It’s not the teachers’ fault, and they probably suffer in this situation too. But it is definitely not what Lawrence is used to. For the first 3 1/2 years of his life, he was home with me, and obviously received lots of individual attention. Then he was in preschool, where the ratio of teachers to children allowed the teachers to focus on him frequently. Although he’s not needy in terms of getting attention, he seems to need more than he’s getting in daycare, or possibly he just needs to adjust his expectations.

Whew. That story turned out to be a lot longer than I expected. And you might be wondering what the heck this has to do with depression. First, I thought it might be helpful to anyone who is seeing school (or daycare) avoidance in their child and is scratching their head over it. And second, while depression and anxiety can cause school avoidance, not addressing an environment that a child who is not depressed is unhappy in may ultimately lead to their suffering from depression.

I know of what I speak, not as a parent, but as a child. Depression doesn’t run in my family – neither side seems to have a hint of anyone with mental illness. Yet, starting at around seven or eight, I battled undiagnosed depression for twenty years. I was generally happy at home, but I dreaded school.

What changed? Well, for one thing, we moved from a middle class town in New Jersey to a rich, preppy town in Connecticut. Darien, our new home, was like many moneyed towns in that a huge emphasis was placed on sports. You were defined to a great extent by how you performed in sports. I, as you might guess, was not strong in the athletics area. I was a voracious reader, which didn’t lend itself to a lot of extracurricular time spent on sports, and I was (still am) not terribly well coordinated. Also, having Attention Deficit Disorder meant that my attention generally wandered while the Physical Education teacher was explaining how to play a game, which inevitably led to screwing up during the game. You know that kid who was always picked last for the team? Yup, that was me.

Unfortunately, in the 1970s no one, even the medical community, realized that a child could suffer from depression. It was obvious to my parents that I didn’t have many friends, and they told me subsequent to my depression diagnosis that they realized that something was wrong with me, but it never occurred to them that it was depression.

Now, I don’t mean to suggest that every child who is dealing with a less than optimal environment at school or daycare is likely to get clinically depressed. My emotional resilience had suffered some blows before we moved to Darien, both from my parents’ divorce, my stepfather’s deployment to Vietnam and multiple moves before this one.

However, by way of advice, I can tell you that I’m going to keep a careful eye on Lawrence’s situation and watch for any signs that it’s adversely affecting his mental health. If I start seeing some, if we can’t find an alternative form of daycare, I’ll probably have him talk to a therapist who can help him find ways to adjust to the environment. When it comes to depression in children, I believe in preventative care.

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Dysthymia and Depression

Wheat Field with a Lark by Van Gogh

For much of my childhood and young adulthood, I suffered from depression. Although I did have some periods of major depression, the bulk of the time my depression was a type called dysthymia.

Dysthymia is a low-grade form of depression that lasts at least two years, with symptom free periods lasting no longer than two months. Other symptoms, which are similar to those of major depression, can include:

  • Poor appetite or overeating
  • Insomnia or hypersomnia
  • Low energy or fatigue
  • Low self-esteem
  • Poor concentration
  • Feelings of hopelessness
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School Avoidance/School Refusal

Last week my son wanted to play hooky from kindergarten. As I was getting him ready for school, he said, “Mommy, my stomach hurts,” trying to look as pathetic as possible. I had a feeling that the problem wasn’t his stomach, but might have been connected with the fact that my husband was in the hospital recovering from shoulder replacement surgery. Whenever one of us is ill, Lawrence doesn’t like being separated from us. Or perhaps the wish to continue playing “Lego Star Wars” on the Wii.

Unfortunately, the timing was not great. Although I believe in the occasional day of hooky for kids (and for adults), I thought that it was a little too soon in the school year to have one. Also, I couldn’t miss work. When you work in the classroom scheduling department of a large university, the first three weeks are insane. My husband works from home, so normally Lawrence being sick or wanting a day off wouldn’t be an issue, but as he was in the hospital, well, it would be up to my parents. So I had to hurry him along and hope he was just faking (which, fortunately, he was).

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Jump-start your day with exercise (Yes, even if you’re depressed)

Image: Still Life of Vase with Daisies and Poppies by Van Gogh
Still Life of Vase with Daisies and Poppies by Van Gogh

It’s 5:30am and it’s still dark. For some reason I’m actually awake. Granted, my usual waking time is only half an hour later, but to me, voluntarily getting up early is an idea that just doesn’t compute. However, I am deliberately giving up sleep for a good reason. I’m going to jog, using a game on the Wii.

If you’re suffering from depression, you’re probably thinking, “How nice for you.” After all, you can’t even contemplate exercising when you’re depressed. Just getting through the day is an accomplishment. Trust me, I do know how you feel. I went through twenty years of untreated depression. But I also know that some of my best periods during those two decades were the times when I was exercising regularly.

Several studies have suggested that exercise can alleviate depression. A study released recently by a team at Temple University found that it can even help postmenopausal women with stress, anxiety and depression (but not hot flashes, alas). Exercise not only relieves stress, which is believed to contribute to depression, but also gives you some immediate relief due to the endorphins that exercise produces. They’re like nature’s happy pills.

And exercise will help your mood, no matter how severe your depression is or what type of treatment you’re under for it. If your depression is mild, it can be an effective alternative remedy. If your depression is moderate or severe, exercise is a great way to augment an antidepressant or antidepressant/therapy regimen.

But, but…I can hear the excuses coming to your lips now. It’s winter and too dark or cold to walk or jog, you can’t afford gym fees or you don’t know where to find a gym, etc. Or maybe the big one – I don’t have any motivation. Sorry, but I’m going to knock all of those reasons (or excuses) down so you’re going to, at the very least, think of new ones.

If you live where the weather’s inhospitable in the winter, there are plenty of ways to exercise indoors. To do yoga, all you need is a mat and a book or DVD. I use a DVD called A.M. and P.M. Yoga for Beginners. If you’re lucky enough to have a Wii, like us, I can promise you that the jogging, tennis and boxing workouts on the Wii Sports game will burn off plenty of calories, and games like Dance Dance Revolution for the XBox 360 do the same.

Or, if it’s just cold and not raining or sleeting, why not bundle up and go for a walk?

Five ways to motivate yourself

1. Think of the workout as another prescription for your depression. I have no idea why it works, but it does – at least, it did for me on many occasions.

2. Get an exercise buddy. Yes, I can practically hear the groans now. But it’s a tactic that really works. On the day that you really don’t feel like working out, your buddy hopefully will be full of motivation.

3. Keep the payoff in mind. If you find that exercise does lighten the darkness, even for a short time, isn’t that kind of relief worth the effort?

4. Recognize that, when you start thinking of excuses, they are, for the most part, not very impressive. Okay, so it’s raining – are you going to melt? You’re tired? Well, you will feel more energetic after you work out, so get up off the couch. Obviously you should not exercise if you’re injured or truly sick, but don’t let a case of sniffles or a slight headache give you an excuse that you think is plausible – it’s not.

5. Find your favorite way to pass the time if you find the workout boring. If you don’t feel like listening to music, try books on tape. You do tend to walk a little slower, but you may find the workout flying by.

One last thought: Keep your goals realistic. If you haven’t been exercising at all, and decide that you’re now going to work out every day for an hour faithfully, there’s a good chance you’re going to fail. There’s a good chance that someone without depression would fail taking things that way. Start by making small changes in your routine. For instance, I recently started parking my car farther away at work, which adds just a few minutes of walking to my day, but it does help. Maybe you can come up with a similar “baby step” to jump-start your exercise.

Good luck!

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