Are you ever concerned that someone you know, or care about, is depressed? Maybe you’re even worried about yourself. What are the signs that people who judge those things — like therapists or doctors — look for?
Most importantly, what should you look for, and what can you do about it, anyway?
Here’s a quick tour of the symptoms of depression:
- Lack of motivation is more than daydreaming or putting off housework once in a while. Lack of motivation due to mood disturbance is all-encompassing and includes not wanting to do things you usually like to do or not finding pleasure in doing them.
- Sleep disturbance isn’t just the once-in-awhile variety of insomnia nor is it the weekend catch-up sleep most of us seem to need. While we all worry and sometimes we can’t sleep because of it that’s no reason to believe you’re depressed. By the same token, you may oversleeping because you need rest. Sleep disturbance due to depression is not refreshing, not productive and happens more times than not during a distressful period.
- Poor concentration describes difficulty keeping your mind on a task, especially when the task is something that needs attention paid. This includes work, reading, watching television, a hobby, or talking with someone.
- Poor appetite or overeating is remarkable if the behavior is outside the norm. No doubt that, from time to time, we’ve all indulged (too much) in a favorite food; teenage boys are notorious for being bottomless pits. Reasons for not wanting to eat range from having a stomach bug to not liking what’s for dinner to being fussy. If an eating disorder is present, though, that’s cause for concern because of its link to depression.
- Feeling down, depressed or hopeless has no up-side; always pay attention. Feelings such as these are not transient, in-the-moment feelings; hopelessness is in no way comparable to disappointment.
- Never ignore thoughts or verbalization that it would be better to be dead. Talk to a counselor, doctor, or clergy as soon as possible. Don’t second-guess yourself If a plan is in place, and the means to act on suicidal impulses are handy — get to the emergency room right away! Perspective gets lost when people force a permanent solution onto what may be a temporary problem. Getting the right help can literally be a lifesaver.
If you’re concerned about suicide, ask. It’s a misconception that asking “plants a seed”.
Depression is a signal that something’s not right. Is it brain chemistry? Relationship or work problems? Something personal? The biopsychosocial model says that all spheres of who we are — the biological, psychological, and social — all “communicate” with each other.
Like all things that get out of whack, whackiness comes in degrees. Problem-solving the degree gives you information about what to do.
What to know
- Is there significant distress or impairment?
- For how long?
- How often?
- Who notices? And what’s noticed?
- Could it be something else, like substance abuse, medication, or a medical disorder?
Sometimes the only intervention needed is someone to listen; an interested and uninvolved second party can give the much- needed perspective someone needs to get out of a funk. If you feel like you’re in over your head, you probably are. In fact, even professionals call on other professionals when they feel stymied.
There’s no shame in helping someone identify resources that don’t include you.
The pumpkin illustrates there’s not just one face to depression. It’s complex and sometimes not easily spotted. The best we can do is to be non-judgmental, kind, and available to listen to someone who’s having a hard time, depressed or not.
In case of a mental health emergency, call 911 or go to the nearest hospital emergency room.
US Suicide Hotline 1-800-784-2433
Kathe Skinner is a psychotherapist in private practice who works primarily with couples, individually and together. She supports several mental health initiatives, including Project Semicolon, whose message is that your story is not yet over — and encourages obtaining a semicolon tattoo. She lives in Colorado with husband David and their two hooligan cats. Find out more about Kathe @ www.coupleswhotalk.com or www.beingheardnow.com.
© 2015 Being Heard, LLC
Cartoon © Donna Barstow, used with permission
Chuck and Charlene sat on opposite ends of the couch. They hugged the armrests so tight each was almost turned away from the other. Which was really the point because neither Chuck nor Charlene believed their marriage was going to survive. While neither had very much good to say about the other, the couple was willing to try this one last time. At least, they said, for the sake of their kids.
We’re into fantasy when it comes to sex. For most of us, we found head candy in a hidden magazine stash or a suggestive romance novel. Within adults’ lifetimes, though, there’s been an explosion in readily available sexual images.
No wonder couples get into relationship trouble when the expectations built around sexual fantasy get confused with who’s really on the next pillow.
Despite the (sometimes problematic) changes in what’s okay to portray, have we changed enough that sexual images that include disabilities’ realities — like ostomy bags — are fantasy-worthy?
Or is it just gross, which was one person’s reaction to Rachel Friedman‘s photo shoot.
Lots of us believe that people with physical disability are asexual, maybe because the thought of them having sex is a turn off. After all, sexual fantasy is about perfect bodies doing perfectly acceptable things perfectly. Reality’s a bummer. It’s a drudge; it’s hard; it’s not glamorous; it’s too often too tired and too often grumpy. It farts, too.
Reality’s what’s unpleasant to look at; graphic disability’s just part of it.
Kathe Skinner is a Marriage & Family Therapist specializing in couples work, especially with couples whose relationship is impacted by chronic illness/disability. She has been diagnosed with multiple sclerosis for almost 40 years and lives in Colorado Springs with her husband, David, and their hooligan cats. Find out more about her at www.coupleswhotalk.com or at their Couple Communication Workshop site beingheardnow.com.
© 2015 Being Heard, LLC
Super-star athletes are polishing their personas with the advent of the Summer Olympics to be held in Rio de Janeiro in 2016. One of them, Jamaican mega-medal winner Usain Bolt, has the gracefulness of a natural athlete. With his perpetual smile and generally good nature, Bolt is no pushover.
One doesn’t get the impression that Usain Bolt would promote something disagreeable.
Despite his gifts, or maybe because of them, Bolt also demonstrates a remarkably generous spirit, e.g., his 2012 embrace of double-amputee Oscar Pistorius, who competed against Bolt.
At a recent promo event, Bolt paired with Brazilian Paralympic multi-medalist Terezinha Guilhermina as her guide runner. Vision-impaired para-athletes compete under strict guidelines that may include use of sighted guide runners. Guilhermina trains and competes with guide Guilherme Soares de Santana; tethered at the wrist, she runs blindfolded as they match each other in speed and timing.
This high-speed dance is like a successful relationship: Trust is essential. Good communication is quick but subtle, successful only with lots of practice. Even when a compatible partner is found — no easy task in itself — the tasks are twice as difficult, twice as demanding.
If you’ve ever run a playground race with one leg joined to another person’s you begin to understand how tough it is to run as one.
Even so, Bolt expressed concern that Guilhermina would fall over or be unable to run fast enough. Both fears were unfounded.
Like running in synch, when an able-bodied athlete joins with a para-athlete, one shadows the other. Both understand the effort, sacrifice, and ability that has brought them to the medal podium. As in a good marriage, there is mutual admiration and respect; knowledge that the differences are not diminishments.
Now for the preachy part: There are two separate and unequal worlds when it comes to sport. Usain Bolt, personable as he is, sells because of his able-bodied ability, not his smile. Paralympic athletes sell to the larger audience only when paired with Olympic athletes; it doesn’t matter that their talent, drive, focus, and commitment to excellence are the same.
“Blade runner” Arthur Pistorius got more ink because of his fall from grace than from his rise to it.
Societal disequity is an old story and not just one about disability. Overcoming innate human suspicion and dislike of what is different requires conscious and concerted effort. The nudge may come from decades’ worth of disabled vets with their can-do mentality, greater numbers, and the societal bequeathing of a high moral ground.
Personally, I’ll take it any way I can get it: If the result to being paired with an able-bodied celebrity is lasting inclusion and a broader definition of human value, then drop the red flag and let the sports begin.
Kathe Skinner is a Marriage & Family Therapist whose private practice focuses on couples, especially those whose relationship is complicated by invisible or visible disability. Diagnosed with multiple sclerosis for nearly 40 years and understands that athletes go beyond themselves to compete. With two world-class cat nappers, Petey and Lucy, Kathe and husband David live in Colorado where she doesn’t ski.
First published on Disability.gov
For 70 years she put up with his (sometimes volcanic) rumblings. He doted on her with diamonds, and was a poorer father for it.
The youngest of 5 much older siblings, she was babied into being passive and timid. He was a blustering bad boy who loved control; a lifelong natural at most things mechanical. He took seriously his duties as a man, a spouse, and head of the household. He didn’t brook anything that deviated from his definitions of right and wrong, a bigot in many ways. A mother and military wife who could fend for herself and children when she needed to, she preferred being cared for . . . and he liked it that way.
Both were fortunate: for much of their lifetimes, neither was chronically ill or disabled. Unless you count legal blindness, which he didn’t (though most who drove with him did). And even though she developed macular degeneration, a disease of the eye that usually leads to blindness, she could sometimes see the world better than he did.
Several years ago her macular degeneration began to impact both of them. By then, her hearing had deteriorated, too, and her world shrank. Although she rarely admitted fears (not to us, anyway) he expressed his the only way he knew how: he fixed as much as he could. He cut her food, gently guided her through the dimly-lit places they avoided more and more, lent her his arm, and searched out gizmos and gadgets he found in catalogues. He took care of her.
Last year, George left Kate.
True to his role, George had organized everything, including who his wife’s legal caregiver was to be — my husband. Now, almost a year later, Kate no longer plans on joining George in death right away and doesn’t cry for hours each night. Not that she tells us, anyway. As her vision deteriorates Kate, not surprisingly, adapts. David and his sisters do what they can from a distance of a thousand miles, mostly via phone calls and the occasional visit. Immediate support comes from close friends and a kind and caring nursing home staff.
Today, it takes a dozen people to do what George did. Even so, he can never be replaced.
None of us could live well if we spent too much time dwelling on the eventuality of death. But some of us — the visibly or invisibly disabled or chronically ill — need to spend more time thinking about the profound changes a caregiver’s death brings. Like David’s parents, my husband and I are fused by years, experiences, commitment and love. Though I’m the one diagnosed with multiple sclerosis, in truth MS is something we both carry.
As we age and tire, slow and re-prioritize, both of us have to remember that though we plan to go out holding hands as star-crossed lovers, the truth is more mundane . . . and likely. Whoever is left to mourn, cared-for or caregiver, what needs to happen is the same:
1. Plan now. The outcomes might look different, but the grief will be the same.
2. Get your house in order. You don’t have to be a survivalist in order to be prepared with legal, medical, financial, and personal concerns.
3. Create your own family. Gather together people who care, no matter what the will says.
4. Get outside each other. Get perspective from someone trustworthy and caring who’s outside the mix — minister, counselor, or therapist.
5. Express yourself and your needs clearly, often, and appropriately. Consider what to say and who you say it to. Sometimes being blunt can be hurtful; at other times necessary. Some people are better prepared to bring a casserole or help with housekeeping than to see you cry. Try out your voice to a journal, or pay a therapist or counselor . . . they can be skilled and trustworthy allies.
6. Keep in touch with others. It’s unfair (and shortsighted) to place the burden only in one place — like with your son.
7. Have someone to talk to, starting now. Clergy, therapist, physician, friend, partner, family can help you sort out what to say and how to say it. Think of yourself as a nuclear reactor. Keeping it to you guarantees one of two outcomes: shutting down or exploding.
8. Join a group of those experiencing what you are. There’s no substitute for having someone “get it”. Don’t believe me? Try talking to someone who doesn’t.
Kathe Skinner is a Marriage & Family Therapist and Certified Relationship Specialist specializing working with couples, especially those for whom invisible disability is part of the mix. She has been diagnosed with multiple sclerosis for over 35 years. Kathe and her husband David hold Communication Workshops in Colorado Springs and are both Certified Instructors for Interpersonal Communication Systems. Along with their two hooligan cats, Petey and Lucy, they live along Colorado’s Front Range. Find out more about Kathe and David at http://www.beingheardnow.com and read Kathe’s blogs, ilikebeingsickanddisabled.com and couplesbeingheardnow.com.
© 2014, BeingHeard LLC
If nothing else, after 50 years fighting poverty, one thing’s clear: America hasn’t found the right WMD.
Poverty’s still the winner.
Among the most ill-advised social programs developed to counteract the effects of single parenthood on women is one that promoted marriage as an effective weapon. While it’s true that a healthy, stable marriage between two committed people helps in the battle against hopelessness and helplessness, there may be a population not committed to marriage in the first place.
Whoever conceptualized that encouraging the chronically ill-prepared to otherwise marry was delusional at best; a bureaucratic butt-kisser at worst.
What were they thinking?
Not in doubt is that solid relationships can be beacons, gateways to education, employment, mental and physical health. The kicker is that such relationships can’t just be imagined, wished for, or expected without knowing how solid relationship works and passing it on, for at least 5 generations that adopt healthy marital functioning.
Marriage, itself, is a complicated construct that, in the hard sense, pre-exists poverty. Lack of knowledge is a set-up to failure to anything (imagine wiring a house without knowledge of electricity), especially regarding something as profoundly complicated as building a better relationship. Put bluntly, how can anyone expect that partners raised in dysfunctional families would, by dint only of wanting to, create a functional one? That marriage is imbued with such magical powers that, by its very existence, an intricate human condition is untangled? Or that the people who inhabit those relationships remain, generation after generation, committed to their marriages?
Welcome to the Magic Kingdom.
Children learn what they see. Further, children seek more than anything to belong and to be loved. When the cost of having that is withstanding an environment that is counter to family/relationship health — e.g. abusive, withdrawing, uncommitted, adulterous, enabling, permissive, angry, addicted or violent – children often choose unhealthy over healthy. Immature brains learn that this is what marriage and family looks like. Even people who strongly react against their upbringing stand the risk of riding the pendulum to the other extreme, becoming overly compliant, accommodating, permissive, rigid, pious, rule-bound.
The knottiness of relationship is that each of us brings a perspective on these experiences that are often different from our partner’s. Often explosive, this confluence paves the way for increasingly unhealthy negative behaviors for each partner as well as the relationship.
Marital success is promoted when partners participate in learning relationship skills. Partial participation, which seems the rule, doesn’t count; it’s like being “sort of” dead. Besides, when a parent is struggling to provide the basics of life, little, if any, focus is given to the hard work needed to sustain a healthy union during formal couples education, let alone past its end.
Abraham Maslow put it elegantly when describing what needs to be in place before someone can even minimally “become”. The condition of being poor, pregnant and female plays out on a stage of basic needs where relationship improvement is trumped by paying the rent. In the same way, one wonders if self-esteem can be extrinsically motivated in generations raised dysfunctionally.
Poverty in America is generations-old; institutionalized; a mind-set. It would stand to reason that any upward movement on the psychosocioeconomic ladder would also be a lengthy process. A multidimensional process. And a difficult one. As we see development of the New Poor, Americans’ marital behavior will be interesting to track. Will there be a relinquishment of the values that inspire healthy relationship? Will difficulty bind people closer together? And what will happen to the trillions of dollars spent on social welfare programs that, fifty years out, have been unsuccessful in eliminating poverty?
That social success in other countries is not surprising given the unique social structure and size of the United States. While a nation as small as Finland, for example, may be socialistic success in reducing the strife of single parenthood, Finland is not the United States. Not in vastness of size, diversity, political structure, and multiculturalism. Even in the best of situations, marriage is no less multidimensional or difficult; with behavioral and attitudinal improvement also measured in generations.
While I offer no resolution to the multiple dimensions encompassing poverty (my magic wand is broken) better minds than mine have tried and failed.
I do know that a uni-dimensional solution to single mothers’ poverty through marriage insults the problem and ignores the complexity of the fix itself.
For more insights, read Julie Baumgardner’s response to the Council on Contemporary Marriages position on this subject. Ms. Baumgardner is the Chair of the National Association for Relationship and Marriage Education.Kathe Skinner is a Marriage & Family Therapist in private practice in Colorado. Over almost two decades, she has seen low percentages of middle-class couples who have engaged in relationship education continue to apply what they learn. She calls the ones who have, like Adam and Leslie, “Super Stars” and their existence is cause for a smile every day. For almost 30 years, Kathe and her husband, David, have been committed to each other and to their marriage. As Jethro Tull once said, nothing is easy. Read more about their programs for couples at http://www.BeingHeardNow.com. ©2014, Being Heard, LLC