Cherished Friend,

Today’s topic is not an easy one for me to discuss and it’s very personal. But I feel it’s so important to raise the awareness of depression from grief that I’m more than willing to share my story.

When a loved one dies or you experience a separation beyond your control it’s universally recognized that a process of grief will ensue. But at what point does immense sadness turn into depression? Does the categorization even matter?

According to the CDC, 1 out of 10 adults in the U.S. suffer from depression. The National Institute of Mental Health website lists the following as categories of depression: major depression, persistent depressive disorder, psychotic depression, postpartum depression, seasonal affective disorder and bipolar disorder. You will not find “depression from grief” listed in this category. However, it has been a subject for much debate.

An article in 2012 from Psychology Today states: For years, the American Psychiatric Association has urged doctors not to diagnose major depression in individuals who have recently lost a loved one. In the Diagnostic and Statistical Manual of Mental Disorders (DSMMD), sometimes known as the psychiatrist’s bible for diagnosing mental illness, grief is specifically listed as an exception to the diagnosis of clinical depression. The organization is now considering dropping that exclusion, raising the question: Is grieving ever ‘pathological’?

As recently as 2013, the American Psychiatric Association (APA) did make an exception for depression related to bereavement listed under Diagnostic and Statistical Manual – fifth edition (DSM-5).

Why is recognizing depression from grief as a true disorder important?

If you’re suffering from depression it’s important you have a treatment plan in place. If it isn’t a recognized illness your insurance may not cover the treatment you seek.

Why wasn’t it listed before?

The APA believed there was a difference in depression related to bereavement from major depression, the former was believed to be short-lived and the latter stemming from a mental disorder that may need long-term treatment. They finally recognized that the symptoms are the same and the results can be just as devastating if a person does not seek the help they need.

I know because I was faced with depression in the early stages of my grief.

When my husband Larry died I did most of my heavy grieving while the kids were at school. I didn’t hide my sadness or even tears from them. But I did spare them the sight of their mother curled up like a ball and sobbing. I thought if they saw me in such despair it would’ve frightened them at their young age.

So when the holiday break from school came it meant I was with my children 24/7 for over two weeks, which didn’t allow for me to grieve in the manner I needed to. I did find some time to allow the heavy grief to come out- during my shower or early in the morning before they woke up- but it wasn’t enough of an outlet. Most of the grief I needed to release during this already difficult time stayed pent up inside of me.

To pour salt on the wound my eldest son turned ten a few days after New Year’s Day. It was a milestone birthday and I wished more than ever his dad could’ve been there to celebrate with him.

On my son’s birthday I tried my best to present a happy face, but inside all I could think about was the day he was born and how happy we all were back then. My heart ached even more as I remembered the huge grin plastered on my husband’s face. He was the epitome of a proud papa.

Instead of feeling the joy I did when he was born I started to wallow in misery and the fatigue I felt made me want to throw in the towel. I was tired of grieving, I was tired of being the only parent around to watch my children grow up, I was tired of the burden of taking care of the business…Basically I was TIRED! That began my descent into depression.

For over three weeks I cried from the minute I dropped my children off at school until right before I picked them up. I felt no joy in my life or hope for any to come. It felt as though a heavy black cloud hung over me. I couldn’t make decisions about the business. I had no idea where we would live.

We had sold our house in Illinois the same time Larry received his diagnosis and put all our belongings in storage until we could find a new home in Arizona. Unfortunately Larry died before we could make this change together. So our things remained in storage and the boys and I lived in a temporary home. It was up to me alone to decide if we stayed in Arizona or went back to Chicago.

I couldn’t eat much and my body was beyond exhausted. I felt incapable of moving forward.

Any steps I had taken the previous three months in processing my grief seemed to be wiped away and I was back to square one: the day Larry died.

I was starting to worry that I had sunk to a level I might never recover from. Finally after three weeks of not be able to stop crying ALL DAY I confessed to my grief counselor how I was feeling.

I sat across from her sharing all of this as tears streamed down my face. “What’s wrong with me?” I wailed. Honestly, I was expecting her to say anything expect what came next. She sighed and leaned toward me and spoke softly, “I think it’s time we discuss that you may be suffering from depression…”

What! I wanted to scream, but instead I suddenly stopped crying and stared back at her as though she had to be mistaken. I wasn’t depressed.

I’m the one people came to when they needed someone to talk to. I’m the one who saw the glass as always half full. I’m the one who had to be strong for her children who were depending on her. I didn’t have time to be depressed!

Why would I think it couldn’t happen to me? Of course I knew depression had nothing to do with being strong. I knew- and still know- plenty of strong people who live with depression. How did I miss this? How did I ignore the signs? Simple: it was me who was depressed and isolated in my own world.

My grief counselor and I talked about various avenues and treatments in coping with depression. Since I was still functioning and capable of taking care of my children I expressed that I wanted to take the holistic route and go back to all the wellness techniques I had relied on in the past. Since I had a weekly appointment with her and she would be monitoring me on a regular basis she agreed with my current plan of action. And for me that was key: I had to force myself to take action.

I had stopped myself from making decisions out of fear. Without Larry, I feared I’d make the wrong decisions. I also had to wrestle with fear of moving forward without him. For someone who normally doesn’t make decisions based on fear, I was letting fear rule me. The only fear that was productive in that moment was my fear that if I got worse I wouldn’t be able to take care of my children. And, once again, my children saved me.

How do you know if you’re facing depression? Here are some of the symptoms to be aware of:

• Feelings of helplessness and hopelessness

• Loss of interest in daily activities

• Appetite or weight changes

• Sleep changes

• Anger or irritability

• Loss of energy

• Self-loathing

• Reckless behavior

• Thoughts of suicide

If at any time you feel like you may harm yourself or someone else, seek medical attention immediately!

Here are some steps you can take if you’re suffering from depression related to grief (please note I’m not discussing other forms of depression):

• Seek counseling from a certified and qualified counselor

• Reach out to family and friends, don’t isolate yourself

• Practice stress-reducing techniques

• Eat a nutrient-rich diet (yes, I said it again)

• Eliminate or limit alcohol (it’s a natural depressant)

• Be active, take a walk, practice yoga

• Reach out for help in areas you may be struggling

As I mentioned above I had no hope for my future and I didn’t feel capable of making decisions on my own.

Thankfully I had some people I could count on. After talking with my grief counselor about depression I decided I had to force myself to make some decisions. I reached out to my business partners (who were not aware of my depression) and asked for their guidance in helping me make some decisions regarding my business and a new home for my children and me.

I then decided we would stay in Arizona. After what my kids had been through I didn’t want to take them out of a school they were familiar with and away from the close friends they had made.

I continued to see my grief counselor regularly. This was extremely beneficial for me. As I mentioned in last week’s post, “Living with Anxiety,” I had a standing weekly appointment.

It was during this time that we joined New Song Center for Grieving Children. I can’t recommend enough that you find a quality, professionally organized group therapy program. One of the symptoms of depression is isolation and feeling alone. Attending group therapy with other adults who suffered a major loss helped me to see I wasn’t alone. We provided the support for one another that I still hold dear to my heart today. When you are at the lowest point in your life finding others who understand what you’re going through is priceless.

The depression didn’t go away over-night, but I kept up a steady routine of visiting my grief counselor, practicing stress-reducing techniques and paying attention to what I put into my body.

One of the reasons the American Psychiatric Association doesn’t classify “depression from grief” as a disorder is they felt that as you healed in grief your depression would heal as well and you wouldn’t have to worry about it anymore. Unfortunately, that’s not always the case.

As with my anxiety, I tend to walk a tightrope at times in fighting the depression from coming back, especially every fall. Come September (when Larry was in the hospital) through October 15th, the day he died, I always feel as though a thin veil of darkness hangs over my head. It’s not debilitating, it just weighs on my shoulders kind of like a reminder of the struggles I faced to get where I am today: at peace with my life and myself. Nevertheless, I’m extra cautious in what I do and what I put into my body during this time.

This is why I focus so heavily on wellness practices, specifically affirmations. I know too well how precarious the mind can be and every day I consciously strive to be as healthy as I can be in mind, body and spirit.

And if you are facing depression, I pray you will find your path in healing and find peace in your life.

Pam

PS. During this holiday season be extra kind to yourself. Take time to practice some of the wellness tools I’ve mentioned on other posts.

 

 Good Morning,

The holidays are upon us and I know this time of year can heighten feelings of grief, anger or sadness. So I want to discuss a topic that is very real for many people: anxiety and panic attacks.

 

 

According to the National Institute of Mental Health, anxiety disorders affect about 40 million American adults age 18 years and older (that’s about 18% of the population of the United States) in any given year. Sadly, anxiety disorders now affect one in eight children.

Chances are you, or someone you know, has this disorder.

I’ve known plenty of friends and family members over the years who suffer from anxiety. I’ve listened on numerous occasions and sympathized many times as they described having a panic attack. While I empathized with the pain and fear that accompany anxiety and panic attacks, I never quite understood what it felt like to live with it…Until it happened to me.

In August of 2010 my husband Larry entered the hospital to undergo intense chemotherapy as treatment for acute myeloid leukemia. He couldn’t get a bone marrow transplant until the leukemia was deemed manageable.

One day while he was in the hospital waiting for treatment to begin we received some pretty dire news. When you face a life threatening illness it’s imperative to try and maintain a positive frame of mind in order to keep going each day. But that particular day there was no getting around the issue: if this treatment didn’t work Larry wouldn’t be around to see our kids grow up. I was devastated. But, for Larry’s sake, I became the cheerleader. Outwardly I told him not to listen to what the doctors said because he was going to make it, yet inside I was wrought with fear.

That evening I went home and fell asleep right away completely exhausted from the emotional turmoil of the day. During the middle of the night I was jolted awake by the uncontrollable shaking of my body. Furthermore, I realized my pajamas were soaking wet, my chest felt tight and I couldn’t catch my breath. Trembling, I climbed out of bed. Somehow I knew I had to get out of the wet pajamas. Still shaking, I managed to put on dry pajamas, grab a blanket and wrap it around me. I sunk to the bathroom floor and the tears came pouring out.

Perhaps it was the emotional release of the tears, but pretty quickly my shaking started to subside. Thankfully the tightness in my chest lessened and my breathing started to return to normal. I sat there in shock wondering what the heck just happened to me. Having listened to others as they described their panic attacks I knew I had just experienced my own.

I was stunned. How can this be happening?

Unfortunately Larry passed away less than two months after I experienced my first panic attack. My worst fears were realized. I went through all the motions in a fog after he died. The wake, the funeral, the return home and the return to daily life. Slowly the shock of his death began to subside and the grief came at me full force.

About a month after Larry died I found myself awake in the middle of the night once again. Just like the last time, my body was shaking uncontrollably and my pajamas were drenched with sweat. I had the same tightness in my chest and the same difficulty catching my breath. For the second time I got out of bed to change my pajamas, wrap a blanket around myself and sink to the floor. The only difference was I didn’t have to wonder what happened. I already knew: I had suffered another panic attack.

This time I cried for Larry not being with me. This time I cried because I felt such despair. Is this what my life would be like going forward? Would I just suffer one panic attack after another? Didn’t I have enough to deal with besides adding this to my plate of worries? It didn’t seem fair to me at the time. But then again, NONE of it was fair.

The American Psychological Association believes stressful life events, specifically pertaining to loss and separation, can trigger panic attacks. Please know that I’m not sharing this with you to add fear to an already difficult time in your life. I’m sharing my story with you to help, especially if you’ve already experienced a panic attack.

Not all panic attacks are as severe as the ones I experienced. To date, I’ve never had another severe panic attack like the one I described above. I still suffer from mild anxiety, but I’ve learned to live with it. And so can you.

How can you tell if you’re having a panic attack? Symptoms of a panic attack may include any or all of the following:

• Palpitations, pounding heart, or accelerated heart rate

• Sweating

• Trembling or shaking

• Sensations of shortness of breath or smothering

• Feelings of choking

• Chest pain or discomfort

• Nausea or abdominal distress

• Feeling dizzy, unsteady, light-headed, or faint

• Chills or heat sensations

Here are some tips on how you can cope with an anxiety attack:

• Seek counseling from a licensed and qualified therapist

• Practice breathing exercises, (be sure to read the upcoming Wellness post where I explain breathing techniques)

• Eat a well-balanced nutrient rich diet (in case you’ve noticed, this is a pattern that appears in almost every post!)

• Limit your consumption of alcohol

• Limit your sugar intake, as it will bring down your immune system

• Exercise, do yoga, go for a walk

• Meditate

• Consider past stressful situations and see what tools you’ve used that have worked for you before

• Journal (I will cover this in length at a future date)

• Create and use affirmations

When I woke up the morning after my second panic attack I made a conscious decision: I didn’t want to live in fear of having another panic attack. Fortunately, I had enough tools in my “wellness bag” to give me hope.

Basically, I practiced every single one of the tips mentioned above- just not all at once and not all the same time.

I was already in the care of a licensed and experienced therapist. I was seeing her once every two weeks after I realized how serious Larry’s illness was. After he died I had a standing weekly appointment. It’s been almost a year since I stopped counseling, but I still have her number if I feel the need.

I also attended group therapy at New Song Center for Grieving Children. The children broke into groups based on their age and the adults went into a separate room. Being in a group with others who have experienced a tremendous loss (spouse, child or parent) erased feelings of isolation that can come with grief and contribute to anxiety.

I began to journal again. In fact, I had turned to journaling since college to help me get through rough patches in my life. (By the way, in my case this also took care of “Consider past stressful situations and tools you’ve used that have worked for you.”)

Then I practiced affirmations. Obviously I had no control over the death of my husband and the subsequent anxiety that came with it, but I could influence my thoughts and choose positive steps to heal.

One of the leftovers of that early anxiety that I still have to cope with on a regular basis is difficulty in catching my breath. Getting valley fever certainly didn’t help, so I practice breathing exercises on a regular basis.

Really paying attention to what I put into my body took me a little longer to do. The holidays certainly don’t make this easy. But I can’t emphasize enough the importance of eating nutrient rich foods and limiting alcohol and sugar.

Limiting sugar intake is very important. If you have a child that suffers from anxiety please help your child to read labels and understand the harm it could be causing in the long run.

More and more research is being published that establishes a correlation between sugar intake and anxiety.

According to Psychology Today the Standard American Diet, which is full of sugar and fat, does not necessarily cause anxiety but it does appear to worsen anxiety symptoms and impair the body’s ability to cope with stress.

I am grateful I had wellness tools to practice daily to help me cope with anxiety.

As previously mentioned, I still suffer from mild anxiety. I’m not sure why. Maybe the rubber band of anxiety in my life has been stretched too far, the elasticity has been lost and maybe it won’t ever return to the state it was in before Larry died. But that’s ok. I’ve learned to cope with the mild anxiety attacks that I get from time to time.

I’ve even learned how to recognize the source of my anxiety. Usually it’s brought on when I’m faced with stressful situations that involve my children regarding school or their health. It can also be brought on by life events, such as the death of someone close. And I experience symptoms of anxiety if I don’t eat or sleep well or even drink a little too much in a social setting.

I do my best each day to keep my body and mind healthy. Even so, circumstances outside my control can – and do – trigger my anxiety at times. But each time it happens, I’m confident I can cope with it.

That’s my biggest takeaway: I don’t live in fear of anxiety. If and when it happens, I trust I’ll be ok.

A word of caution: if you experience any of the symptoms listed above and they don’t subside, please seek medical attention immediately. Specifically if you have continued chest pains and difficulty breathing. I’ve been known to head to the ER more than once, just to make sure! Your health is not something to be gambled with.

If you currently suffer from anxiety or panic attacks I pray you find a way to add one or more of the coping techniques mentioned above into your day.

I wish you peace.

Pam

PS. If you live with anxiety and have some positive wellness tools that helps you please leave a comment below for others to see.

 

Hi Dear Friend,

The holidays will be here before you know it and I want you to be as prepared as one can be during this difficult time.

My favorite time of year always started with Halloween and ended on New Year’s Day. I have fond memories from my childhood of decorating the house, watching all the holiday specials on television and celebrating with family. I grew up in a south suburb of Chicago and remember going into the city to Marshall Fields (now Macy’s) and eating lunch by the tall Christmas tree.

I couldn’t wait to carry on some of the same traditions I experienced growing up with my own children. The holiday lights, Santa, and the first snowfall of the year were all more enchanting seeing them through the eyes of my children. Yes, the holiday season was magical to me and my inner child rejoiced each year.

I loved to decorate and, despite what Larry used to tell people, I really didn’t have that many decorations! For me all those details livened up the house and brought the Christmas spirit into our home.

Another favorite of mine was celebrating with family and friends. We usually spent Thanksgiving in Arizona and hosted dinner with friends. Afterward neighbors would come to our house for a potluck dessert. Back in Chicago for Christmas we’d host a buffet dinner at our home for both sides of our family. Then on New Year’s Eve we’d have one big sleep-over so no one had to worry about drinking and driving. Family and friends would come with their kids, sleeping bags and food. We’d spend the evening playing games and enjoying being together. I LOVED this time of year.

That is, until 2010 and I spent my first holiday season without Larry.

Larry died on October 15, 2010. As I mentioned in a previous blog we went to Chicago for the funeral. We came back home to Arizona on October 25, six days before Halloween. At the time my oldest was nine and the twins were seven. Children grieve differently than adults and have the wonderful ability to live in the moment. They caught the buzz from other kids at school and wanted to get costumes. With a heavy heart I took them one day after school to get their Halloween costumes. But I didn’t get one for myself. This would be the first Halloween in years I didn’t dress up.

When one of the twins asked me if I was going to put up the orange and black lights and all the other Halloween decorations my heart sank…, I just didn’t have it in me. All I could say to him was, “Honey, mommy is so tired and we just got back from Chicago, can we skip it this year?” Being the sweetheart that he is, he nodded and started to walk away only to turn around and ask, “But you’ll put up the Christmas lights, right?”

Ugh, Christmas! I couldn’t even face Halloween, how in the world would I make it through the rest of the holiday season?

If you’ve recently experienced a loss or had a major change in your household (perhaps due to separation or divorce) you may already be feeling this way.

I’ll be honest: that first holiday season without Larry was one of the most difficult times I’ve had to face since he passed away. But it was the difficulties from that first year and attending New Song Center for Grieving Children that helped me shape how I wanted to spend future holiday seasons.

And that is my gift to you: to let you know you have a choice in how you spend your Holiday season.

It’s likely there are people around you who care about you and want to help you get through the holidays. As well-meaning as they may be, it’s up to you to decide what you want to do. There’s a lot of stress and uncertainty that accompanies the holiday season when you’re hurting. There even may be guilt associated in feeling you have to carry on traditions. You may wonder if there’s a certain way you’re supposed to behave. You may even be tempted to turn your head and not give the holidays a second thought.

But the truth is, you will need to make some choices and that’s where I’d like to help you.

For those of you who are divorced or separated with children, you will need to reach an agreement in matters where the children are concerned. Most divorce or separation documents already include some sort of “division of holidays” clause; however, verify ahead of time to ensure the other parent understands the arrangements.

I’m sending this out three weeks before Thanksgiving so you’ll have some time to think about what you want to do. Here are some things to ponder:

• Do you want to cook on the holiday or prefer to visit someone else?

• Do you want to decorate your house for the holiday season?

• Do you even want to celebrate or would you rather choose to do something out of the ordinary that day?

• What traditions do you want to keep?

• What NEW traditions would you like to put in place?

Keep in mind that each year your answer to these questions may change as you heal.

If one of your friends or family members is the one that’s hurting, here’s how you can help:

• Be understanding and respectful of the decisions your friend makes in how she wants to celebrate the holiday season.

• Don’t place extra pressure or guilt on your friend at this sensitive time.

•Be specific in how you would like to help. Decorating, shopping, wrapping presents – these simple tasks can feel like a burden when you’re grieving.

And if it’s you who is grieving…How do you honor your dearly departed?

It always gave me a sense of peace to honor Larry throughout the holiday season. These are some of the things we’ve done on every holiday, birthday and any other special occasion:

• The boys and I make our own personal cards for Larry. We draw pictures and write a note to him. Then we share with each other the card we made and what it means to us. (I’ve saved all these cards for my children to give to them when they are older.)

• We light a candle at every holiday meal in honor of Larry.

• We’ve blown up balloons, attached a long string and attached written notes to the string and then let the balloons fly away with our message.

• In lieu of being able to buy Larry a gift I’ve made donations in his honor.

As the family or friend to someone who’s hurting, ask her how she may want to honor her loved one who’s no longer here. Don’t make any assumptions. Your friend may NOT want to do any of these things. Again, be respectful of her feelings. And above all else, do NOT bring a gift for the person who is no longer alive UNLESS you have cleared it with your friend. Your intentions are kind and caring, but during the holiday season feelings are heightened and more intense.

While there is no right or wrong way to celebrate there is one word of caution. DO NOT isolate yourself. If you’ve lost someone or this is a year your children are with the ex, find someone to spend the day with. It’s a fact that depression and anxiety are heightened during this time of the year. You want to take positive steps to heal – isolating yourself is not a positive step.

One last word: make sure to build into your day a little time for yourself no matter how you spend it. If at any moment you find you’re overwhelmed, excuse yourself, grab your coat and take a walk around the block, weather permitting. The fresh air will be soothing.

Remember, voice your needs, and your loved ones will listen.

I pray you’ll find some peace in your heart this Holiday season.

Pam

PS. The Halloween photo is from 2008. Last year I drew the Christmas card shown (Picasso I’m not!) I did dress up this year, check out my Instagram page to see our photos from Halloween this year.