As submitted for publication in Recorder Community Newspapers, March 13, 2008. Published as: View mental health illness with patience, compassion; Climbing out of an emotional pit can be good exercise

As I was thinking about the struggles of some of my patients, I noticed Down Came the Rain on my bookshelf. It is Brooke Shields’ autobiographical account of her struggle with postpartum depression.  In reading her story, I imagined her not only to be caught in an emotional rainstorm, but also stuck in the bottom of what was quickly becoming a muddy pit. I saw how she could have easily remained mired in her depression. She could have succumbed to her self-criticism for not appreciating her good fortune in having a baby. She could have sat, feeling impotent, as the strain in her relationships became too great. But she didn’t. She found a way to take care of herself, talk about her difficulties with others in her life, and make positive changes in her relationships.

Her struggle was specifically with postpartum depression. However, the story of her courage and action is also an example for those with other mental illnesses. Whether you have postpartum depression, another kind of depression, anxiety, bipolar disorder, or, frankly, any mental health problem, you undoubtedly face many similar obstacles.

Others all too often discount emotional problems as a lack of discipline or misplaced values. They are eminently clear about what a person should be doing to get better. If you are clinically depressed, friends say: Just be happy with everything you have. If you have an anxiety disorder, you’ll hear: Just relax already. If you are haunted by an eating disorder, your partner authoritatively says, Stop worrying so much about what you look like. In fact, you probably give yourself the very same messages. Although you all might have good intentions, these messages simplistically mislabel a serious problem; and they are hurtful.

Even worse, people sometimes see those with mental illness as fundamentally flawed. This is especially common when someone is diagnosed with a serious problem that others don’t understand, such as bipolar disorder. In cases like this, people respond with the fear that you are fragile.  They are awkward around you, or perhaps avoid you altogether.

To complicate matters, as the person with the diagnosis, you most likely also view mental illness as a stigma—even those of us who are enlightened are too often in the dark in this respect. The diagnosis itself causes us to question our worth. We question what our “flaw” means for us as an individual. We question everything about our lives. And, with each critical comment or nonverbal message from ourselves and others, we dig our emotional hole a little deeper. Sometimes we dig ourselves down so deep that we barely notice the open sky above.

If you are tired from digging and all you can see are the sides of the hole you are in, please listen carefully… Stop digging! And work to see your illness with more compassion.

Learn about the biological underpinnings of the disease. A simple lesson in the role of neurotransmitters can help you understand why telling a clinically depressed person to just snap out of it, or a clinically anxious person to just relax, makes as much sense as telling a diabetic to just produce more insulin. While we know that there are things they can each do to help themselves (i.e. diet, exercise), “blaming the victim” does nothing to help the person improve. Support and encouragement, however, are another matter; they are essentially throwing someone a rope. Also, just as insulin is sometimes necessary, anti-depressants and anti-anxiety medicine are sometimes needed.

Develop an understanding of the personal, social, and environment contributing factors. None of us live in a vacuum—and even if we did, I have no doubt we’d get depressed from the isolation. So, if you have just given birth and your life is straight out of a country western song (you know, your man just left, you have no money, etcetera), you are understandably at risk for postpartum depression. Who wouldn’t be?!

If you are angry with yourself for being highly anxious when your life is perfect, I’ve got news for you—your life is not perfect. It might be really good, but you face struggles just like the rest of us. And, if you are biologically predisposed to being anxious or the forces in your life have conspired to bring anxiety upon you, then your life is imperfect in this very specific way.

By accepting your particular situation with compassion, you can redirect the energy you use for self-criticism to a better use—finding a way to climb up and out of your emotional pit.

Choose to work cooperatively with a physician or therapist to improve your condition. In the end, you will feel like a physically and emotionally stronger person.

You might need continued medicine or a change in lifestyle, but don’t confuse that with somehow being less than everyone else. Everyone has physical or psychological weaknesses. Your particular one comes with its own struggles, but they don’t make you inferior—only human.

If you have trouble being sympathetic to your situation, find someone in your life who is. Often when we’ve dug our ditch really deep, our hands seem to remain cramped around that shovel even when we’d prefer to let go. Then we need someone’s help. Hopefully, you have a therapist or psychiatrist who is helpful in this regard. You might also find support in a friend, relative, clergy, or someone else who shares your diagnosis. Listen to what these people say. Find what you can agree with in their supportive words.

Once you are out of the hole, or close to it, many of your relationships will also naturally improve. However, you will continue to feel distance, over concern, or confusion from other people. You might need to help these people understand your diagnosis and present situation better (i.e. your illness is under control now). The more comfortable you are with your problem, the more likely they will also become comfortable with it. Then they can be more supportive—even if it’s only by being in your life again without being, as one of my patient’s once put it, “just plain weird.”

I have often found that a crisis in someone’s mental health eventually results in personal growth. It forces people to gain personal insights, develop strengths (i.e. assertiveness), and lead a more balanced life. Although it seems paradoxical, many of the people I have worked with actually became emotionally healthier than they were before their illness. While they were not exactly thankful for their problem, they did appreciate its gifts. I guess you could say that climbing out of an emotional pit is the kind of good exercise that can help you become a stronger person.

The Recorder Newspapers has over 250,000 readers and publishes weekly editions in 19 newspapers, which cover Morris, Somerset, Essex and Hunterdon counties of New Jersey.

Leslie Becker-Phelps, PhD
Basking Ridge, NJ