What do a 45-year-old professor, several well-educated parents, a retired psychotherapist, a concerned husband, and a college student all have in common? These are people suffering–or intimately connected to someone suffering–from clinical depression who didn’t know it.

How, in this day and age, with so much information available, is it possible that depression can still go undiagnosed and therefore untreated? Perhaps this is part of the reason why the blog “Depression Part Two” on Hyperbole and a Half  just went viral (besides how extraordinarily creative it is). Here are some reasons why smart people can miss the signs of depression:
1. Depression can creep up on you.
Not all depression is so severe that you can’t stop crying or get out of bed. For many people, the feelings of sadness manifest as a growing disinterest in life’s activities. What used to be fun or interesting seems unimportant or shallow. You don’t feel like going to your friend’s birthday party so you make up an excuse. You feel bored by the books or TV shows that used to appeal to you. You don’t notice how, little by little, you are pulling back from others, spending more time alone, locked in your room.
2. Depression seems to be a logical response to life’s challenges.
Since depression often worsens or can be triggered by loss or stress, you figure that you are responding appropriately to what is indeed a painful time in your life. You may have broken up with a boyfriend, had difficulties at work, done poorly on a school assignment, or moved away from a supportive environment. When you don’t snap out of it, even when your life circumstances appear to get better, you don’t realize that your negative mood state has persisted for months or even years. 
3. Some depression manifests as extraordinary irritability rather than sadness.
One of the most commonly misunderstood or overlooked manifestations of depression is hypersensitivity or irritability. People around you tell you that you are constantly cranky. You seem …

“The point of marriage is not to create a quick commonality by tearing down all boundaries; on the contrary, a good marriage is one in which each partner appoints the other to be the guardian of his solitude, and thus they show each other the greatest possible trust. A merging of two people is an impossibility, and where it seems to exist, it is a hemming-in, a mutual consent that robs one party or both parties of their fullest freedom and development.”                                                                                            -Rainier Maria Rilke, poet

One of the ongoing polarities in any relationship–whether between marriage partners, parents and children, or friends–is the balancing act of closeness and distance. This is the ongoing dance of intimacy, and the key is to learn to move towards and to move away without seeing either polarity as right or wrong, good or bad. To forge the bonds of relationship takes time together but also takes time apart lest the bonds begin to feel too tight or binding.

In my last blog about the tug-of-war in relationships, I described the predictable stages of closeness and distance as the bond of intimacy develops over time, working towards the goal of mutual interdependence. What happens when a family goes through times of increased stress due to loss, trauma, illness or rapid change?

Stress and the Tug of War

When anxiety goes up in a family or relationship due to times of rapid change, each of us has a preference for one side of the polarity. When stressed, young children cling more to one or both parents, whereas adolescents often do the opposite and pull away, locking themselves into their bedroom and refusing to talk. What do you do? What does your partner do? Is it more painful for you to be more distant from loved ones or do you feel …

“Humor is mankind’s greatest blessing.”     -Mark Twain

Every year, at this time of year, tensions mount. The arrival of the gift-giving holidays like Christmas and Hanukkah (“What should I get my mother-in-law?”) accompanied by impending vacations from school (“What will we do with the kids all cooped up in the bad weather?”) collide with the week-long visits of friends and relatives (“Will my divorced parents fight in front of the kids? What will we do with everyone? How can we feed a group with two vegetarians, a die-hard carnivore, and six fussy kids?”). These questions and others like them threaten to put most of us over the proverbial edge.

What can you do to prevent the slippery slope of irritability and overwhelm? How do healthy families manage? Although the complete answer to these questions could fill an entire book, the swiftest solution is to find the humor wherever possible. As William James, the father of modern psychology, so aptly said over a hundred years ago: ”We don’t laugh because we’re happy, we are happy because we laugh.”

What Kids Can Teach Grown-ups     

Did you know that the average kindergartner laughs 300 times a day–in vivid contrast to adults who average only 17 laughs a day? They also indulge in generous amounts of spontaneous play. Now that is something to stop and think about. I don’t know about you, but I’m going to start counting my giggles and see if I can get back into the hundreds. Clearly, most of us grown-ups are taking life far too seriously for our own good. The more stresses that build up, the more essential that we find something, anything, to laugh about.

Laughter Cures What Ails Us

Not only will our laughter make the holidays go more merrily, but we will be less likely to catch the latest virus. Although we have known instinctively for millennia that laughter, like crying, can be a powerful antidote to pain and suffering, the scientific world is catching up. According to the American Association for Therapeutic Humor, laughter may …

“Man cannot discover new oceans unless he has the courage to lose sight of the shore.” -Andre Gide

What do things like asking loved ones for advice, reading stacks of self-help books, taking classes, searching for a good therapist, or hours of web-searching all have in common? You probably guessed it. There is something the seeker wishes to change. As a family therapist, I am called on for help with many different types of problems but all with the same goal–making changes to find greater happiness, deeper love, greater success in life, or fewer failures in love or work.

Change is a great teacher, although certainly unpredictable–sometimes harsh, sometimes exciting, often frightening or overwhelming. What makes change so difficult? Why is it so hard to sustain? What is it about change that the very idea of it can put fear into the hearts of otherwise courageous folk?

Given that change is an inevitable part of life, it makes sense that each of us figure out how to increase our capacity to rebound or spring back from change and loss, a concept now called resiliency by social science researchers. Although some aspects of resiliency are inborn, other aspects can be learned and practiced.

Just as individuals go through stages of growth and development from infancy to adulthood, so does the family move through the various cycles of life, including sickness, death and other losses. At each stage, and especially in crises, the relationships of each member to others in the family need to adapt and change.

The demands of babies and toddlers are vastly different than when kids reach school age. At first dependent upon adults for their very survival, children seek for more and more independence as they grow and mature. All of our relationships–between child and parent, brother and sister, partner or mate, adult and aging parents–must keep being redesigned to meet rapidly changing circumstances if they are to remain helpful and healthy.

“Any change, even a change for the better, is always accompanied by drawbacks and discomforts.”  -Arnold Bennett      …

“You gain strength, courage and confidence by every experience in which you really stop to look fear in the face. You must do the thing you think you cannot do.”                             -Eleanor Roosevelt

We know from the previous blog that a certain amount of anxiety is a necessary part of life, but what do we do when fear begins to rule someone’s life? And especially if that someone is our child?

Short of getting professional help or using medication, what tools can help build more strength and resiliency to face common fears and phobias? What’s the best way to help our children move forward in a world that will always have dangers?

“Men fear death as children fear to go in the dark; and as that natural fear in children is increased by tales, so is the other.”  –Francis Bacon

Young and old, child or adult, fear is one of our companions in life, and we should be glad that it is. Our brains are hard-wired to notice signs of danger and to alert us to take protective action. A certain amount of anxiety can actually enhance our performance in stressful situations. Certain fears go hand in hand with childhood. Others don’t.

Key #1: Know what is normal given your child’s age.

There are a lot of fears that are part of the normal process of child development. Most come and eventually go away on their own as kids get older. For example, babies startle at loud noises and are afraid of large unfamiliar objects. At around six months, your formerly easy-going baby will suddenly be afraid of strangers–which can unfortunately include grandparents if they don’t see them much. Stranger anxiety often peaks, then will seem to disappear, only to reappear again and again over the course of the next year.

Separation anxiety is another normal developmental milestone that can appear suddenly at around eight months. It is a good sign that your baby is smart enough to realize that his or her survival depends on you, which is why the baby screams like crazy when you try to leave them with a babysitter. Although stressful for parents, babies naturally move through this stage by having the painful experience–and the reassurance of you and other caregiving adults–of how you come and go and come back again. Practice and repetition is how we learn to confront our fears.

Preschool kids, aged 3 to 6, are typically afraid of the dark and often worry about monsters, ghosts or wild animals. They hear noises in the night and want to sleep near or with their parents to feel safe and protected from these imaginary beasts.

As kids get older, they typically develop more realistic fears such as anxiety about being sick or injured, or the …

“Forgiving does not erase the bitter past.  A healed memory is not a deleted memory.  Instead, forgiving what we cannot forget creates a new way to remember.  We change  the memory of our past into a hope for our future.” –Lewis Smede

We’ve all been hurt by others–some in small, but painful betrayals and others in ways almost too horrible to imagine. I’ve listened to stories from victims of physical and sexual violence, from children who were bullied and tormented by peers, from adults whose partners cheated on them, from families torn apart by drug and alcohol abuse. Should we forgive people even when they’re unwilling to acknowledge their wrongdoings, let alone take responsibility for them? And if so, why?

Yes. The reason that forgiveness is important is because it actually helps the victim recover and get on with life. In the past ten years, the focus on this topic has grown enormously. The research has been teaching us what the benefits are to an individual’s physical, emotional and psychological health. In 2010, an entire issue of the Journal of Mental Health Counseling was devoted to forgiveness in therapy, summarizing the findings of over 1000 published psychological research articles on the topic.

There are clear mental health benefits that come with the ability to pardon those who have hurt us. Perhaps most notably, the research shows that an improved ability to forgive results in decreased depression and anxiety.

Those who are able to forgive also have a greater likelihood of experiencing significant posttraumatic growth. This means being able to get on with your life after the crisis has passed.

We also know that forgiving helps people shed their negative affect about whatever happened whether it be fear, anger, hurt, or all of the above. In turn, the subsequent decrease in obsessing about the crime or betrayal facilitates better sleep. Don’t we all know how difficult it is to participate happily in life when our sleep is chronically poor…

Speaking of sleep and physical health, other researchers have …

We hope that you are one of the lucky parents whose kids can’t wait to go back to school. Unfortunately, millions of kids have a hard time going back–for many different reasons.

Some are starting kindergarten and just plain scared of the unknown. Others (over 6.5 million kids in America) are heading off to a new school where they lack friends or familiarity.

Even larger numbers already know what they don’t like about school. They’ve been there, done that. They have to get up early, sit in classrooms and do what the teacher tells them to do all day long–including homework when they get out.

Although we all agree that getting a good education is essential, that doesn’t mean that many kids don’t hate the loss of freedom that goes with it.

To make things worse, public schools in America have been profoundly impacted by both the troubled economy and by the mandates of the No Child Left Behind legislation. Many schools doubled their math and reading instruction but, in order to do so, eliminated music and arts education, the very classes that many kids looked forward to the most.

“As you simplify your life, the laws of the universe will be simpler; solitude will not be solitude, poverty will not be poverty, nor weakness weakness.” -Henry David Thoreau

NEWSFLASH!: The United States gets the gold! We have become the nation with the highest level of anxiety in the world. According to a recent study by the World Health Organization, 31 percent of Americans are likely to suffer from an anxiety problem at some point during their lifetime. The silver medal goes to Columbia with a lifetime risk of 25.3 percent, and the bronze to New Zealand with 24.6 percent. “The United States has transformed into the planet’s undisputed worry champion,” writes Taylor Clark, author of “Nerve: Poise Under Pressure, Serenity Under Stress, and the Brave New Science of Fear and Cool.”

Articles have been written by psychologists, politicians, pundits and other bloggers trying to explain the reasons for this downside of American mental health. I’m more interested in what we can do about it. We will undoubtedly need to tackle this problem from many different angles. This is only one.

Since prior generations of Americans did not reportedly suffer from such epic levels of fear and worry, is there something to be learned from our familial history? If you are one of the worried masses, could it be time to simplify your life?