I was reading about a suicide of a college student recently and when I read his friends description of his behavior it was clear that he had a major depression. I wondered if his friends did not recognize his depression or simply did not know what to do.

Some of the advice for helping a depressed friend goes something like:

• Listen
• Suggest professional help, facilitate an appointment and offer to go with the person.
• Have the person call a suicide hotline  or helpline

Although this is good advice, often with severely depressed persons these interventions are not enough.

If you believe someone is severely depressed what to do and they do not respond to the above ideas what do you do?

1. I suggest calling the police who will make a mental health arrest (if they feel it is warrented) and take the person for psychiatic evaluation. (although this may seem drastic and your friend may be initially be angry with you, this may save his life)
2. Consider an “intevention” using the model of AA. That is when  important people in the person’s life go together to see the friend and clearly and firmly express  their worries about the person who is depressed.  It is  critical to offer hope by clearly stating depression gets better with treatment (this is true) and sharing personal experiences and recovery if you are able. The person usually has a hard time believing depression will ever go away so it is critical to let them know otherwise. Have a plan (referral, visit to Emergency room) ready.

What is Depression?

People use the word depression loosely to mean a number of different moods. We use it when we are down about something going on in our lives, when we are grieving or just sad. I prefer to use the term “clinical depression” to distinguish these moods from the more serious type of depression that may need medication to relieve. Clinical depression is more than the “blues” or sadness. It is not something a person can “just get over” or talk themselves out of. Clinical depression is at least partially based on brain biochemical imbalance (we are still in early stages of understanding this) and often runs in families. Stress and psychological factors also play an important role, although we do not fully understand the causes and factors that result in clinical depression

Common symptoms of depression include:

• Sad or irritable mood
• Loss of interest / energy
• Poor or excessive sleep and appetite
• Difficulty with concentration and memory
• Physical complaints

Medication is often necessary in serious depression and MAY be helpful with less severe types.

Bah Humbug you think, but thats not what you feel. So what can you do to feel better?

Here are 10 Ideas to Help you get Through the Day.

Stay up the night before and work then you can sleep the following day away.

Go to a movie about bad relationships. (How about fatal attraction).

Spend time with a couple who is always bickering. Go sit in divorce court for the day.

Watch / read health reports on Sexually transmitted diseases.

Spend time with a friend bashing the opposite sex.

Think about your worst relationship and all the terrible things that were done to you.

Remember the divorce rate is over 50%

Contemplate that solitude is better then a bad relationship.

Here’s one especially for the women: single women live longer then married ones.

Have a good day whether alone or as a couple!

Happy Holidays

I was being silly here mostly because I was with a friend who has 5 year old twins.  Kids can always put me in the holiday spirit and make the world seem better.  If you are not feeling so jolly its ok,  you are not alone!

Here are two references that  might help you

The first is a professional article that offers scientific evidence for alternative and complementary treatments for depression.

Below you will find my answer to a question about holiday blues.

Hope you find something helpful here.

Question: I often get down during the holidays, why is this, what can I do.

It is not uncommon for people to feel sad during holiday time. This can be a result of not having a “picture perfect” family, unrealistic expectations of what a holiday should be, or memories of holidays gone by (often glorified in the memory).
To avoid this:
1. Do not build up the Holidays in your mind,  keep expectations to a minimum.
2. Keep it simple
3. Start a new and different tradition (go out to eat, go away for the day)
4. Avoid reading all those Holiday Magazines!
5. Avoid shopping, try online or catalogs
6. Only spend time with those you really want to.
7. Get outside, and move!
8. Help someone else.

9. Focus on your spiritual side

Seasonal affect disorder is different than Holiday blues and may need treatment.

Remember to take care of yourself.  You MUST squeeze out a little time each day for yourself!  Find a fabulous book or magazine you love, take a bubble bath, watch a movie,  just be alone for a while.

This is a guest post by Richard Moyle from the Mesothelioma Center at Asbestos.com. Asbestos.com is committed to providing the latest, up-to-date information to our visitors in the hopes of spreading awareness about the dangers of asbestos cancer.

Sarcomatoid mesothelioma is a rare cancer that is caused by exposure to asbestos. This type of cancer has an unusually long latency period and symptoms do not begin to show for at least 25 years after exposure. Because of this, the cancer is typically diagnosed in its later stages and is usually difficult to treat. The typical life expectancy of someone diagnosed with mesothelioma is about one year after diagnosis.

Losing someone to cancer (or any illness for that matter) is one of the most difficult things to cope with and no two people deal with the loss of a loved one the same way. However, there is a general process that most people go through after the death of someone close to them.

British psychiatrist and psychoanalyst John Bowlby has put forth a 4-step process that looks at grief through the eyes of someone who wants to continue living even though their loved one has passed on.  Bowlby explains that the stages of the grieving process can shift and overlap and notes that ALL stages of the grief process may even take place at the same time and that the amount of time spent in each may be influenced by a huge number of factors including age, personality, and the circumstances surrounding the death of the loved one.

The 4-step process is as follows:

• Shock and Numbness – Feelings of unreality and de-personalization (i.e. “This isn’t happening to me.”), people in this stage practice “self-protective” behaviors, which makes them appear stoic but that is just a defense mechanism against pain.
• Yearning and Searching – Also known as “pining”, the bereaved longs to be with the deceased. Some say they see or hear the deceased during this stage. The bereaved speculates how they will get along without their loved one. This is a long stage for many, but some pass through it rather quickly.
• Disorganization and Despair – Mourning sets in. The bereaved may experience deep depression or despair and feelings of bleakness. Some individuals require therapy during this time, especially when anguish hinders everyday activities or results in contemplation of suicide.
• Reorganization – The bereaved “assimilates” their loss. The person who has reached reorganization is now learning how to live life without their loved one. This stage may represent a redefinition of life for many individuals.

There is no set amount of time for each of the first three stages and anyone can get stuck in one for a long amount of time. This is not a problem as long as it does not interfere with things like the person’s job or personal relationships. If that point is reached, it is helpful for a friend to step in and assist the bereaved in seeking professional help.

Are your worries overrunning the good stuff in your life?

Learn life lessons from your cat. Learn to ignore little things and keep them  from taking over your life

Little problems & concerns that often get blown out of proportion:

• Unfair criticism
• Doing the lion’s share of work
• Worry, worry, worry about things you can’t control
• Feeling misunderstood
• Feeling unappreciated
• Unable to change things

Lighten Up

• Surrender to the fact that life isn’t fair
• Don’t make things a big deal of things that aren’t
• Life is a test where failure is impossible.  
• Life’s challenges offer opportunity to grow (really)
• Ask yourself what do I need to learn here?
• Learn to listen to your inner intuitive self
• Make Melodrama  mellow
• Learn to be flexible with change
• Give yourself a break, avoid negative self talk
• Remind yourself of your strengths & successes.
• Distract yourself
• Have a friend help you look realistically at the situation
• As Scarlett Ohara said “tomorrow is another day”

Dear Dr. Duffy,

Sometimes you think you know someone— and you really don’t know them at all.  I thought I knew my sister- I thought her selfishness was harmless-  I had no idea that there was nothing she would not do to get her way or get what she wanted.
My sister Mary and my brother Joe were fighting twenty years ago- it was horrible.  My Father went by to check on my sister- she was screaming about our brother Joe- our Father went home and went to bed and died – right then- it was too much for him! He told our Mother that he could do something with the children when they were little- but now there was nothing- nothing he could do– I was talking to my Mother on the phone when he had the heart attack- he said her name– I was trying to get her to make him go to the hospital- he wouldn’t.
Now 20 years later- here we are again….about 2 yrs ago our Mother discovered breast cancer- had the removal and went on trying to save herself, survive.  I stayed at the hospital with her and our roles sort of changed – I  just did my best to take care of her and knew our days were limited– as we they all are, but there is something about this- it is an unbelievable reality.  The thing that happened was that my siblings did not have the same mind set– my little brother did- Bill  was the baby and they just became closer.  I think I just realized that she was my Mother – the only one I would ever have and I was going to try my best to make the rest of her days as pleasant as possible- spend time with her- I called her every morning and every night— I never was ever jealous of any time any of the others spent with her- actually I was relieved because I really worried about her.

However Mary was still up to her bad behavior. She had married an older man who  had children  she did not care for- my sister was in huge fear that her husband would die and she would have to split their belongings with his adult  children- so my sister talked my brother and law into signing a quit claim on their house.  My sister promised she would always take care of my brother in law- which did not happen- she then starting picking on him and being mean to him.  One night she even called the police to have him removed from the house.  The police said they could not do this- because they were married– so you guessed it- she started divorcing him. She ended up getting most of his money.
 I did witness all of this- and so did our Mother– it was horrible.  Then my sister started in on me- same thing – picking on me- talking bad to me– My sister called and said horrible things to me– on and on– I did not listen to anything she said- by then- I had thought she had just lost it!
Then she started picking on our Mother– yes our Mother – who by now had had cancer my Mother was devastated – so disappointed and angry at my sister— I actually said to my Mother- I will say anything you want me to – to Mary to make her leave you alone— my Mother said,”don’t you dare” my Mother said to tell my sister when she was gone- that my sister was no longer her daughter.
Recently my Mother was so upset- so I grabbed my daughter and we ran to spend the night with her.  When we got there it was 90 degrees in my Mother’s house- she thought the AC was broken- I messed with it- it was just frozen up–got it back on – turned on some fans- tried to calm my Mother- there was no calming her.  Our Mother was sick with the stress from my sister- my sister had been calling our Mother and saying horrible things to her– my sister actually told my Mother she was never going to speak to her again– My Mother told her you will probably get your wish- because I am in stage 4 cancer. Of course pneumonia set in– my Mother went to the hospital- she had lost her will to live…. our Mother died shortly after.

I was with her when she died and I am still sad- I don’t think I will ever really get over this.
Oh but now my sister is trying to steal my part of what I was supposed to inherit— it is awful…..

Thank you for listening,

Sharon
 

Dr Duffy’s Answer

Dear Sharon,

This is all very upsetting. We often have ideas and beliefs (understandably so) about what we want and should have in a family and end up being very disappointed and angry.

Your sister has been behaving badly for many years, this will probably not change. It sounds like both your parents could not give up on her (this is not unusual for parents). You however need to let her go. She will only cause you more grief.

Sounds like you did your best for your parents and it was a good thing your mom had you!

What you probably need to do now is cut off ties with your sister, as letting her abuse you more would just make things worse for you. Let yourself get angry, it is important not to let yourself be in the victim role! I suggest you find a good counselor to talk with to try to come to terms with your feelings and the things that have happened in your family.

You need to let a lawyer deal with the financial end of things and fight for your rights. You then can focus on taking care of yourself personally. You do not deserve to let your pain and anger effect the rest of your life. She shouldn’t have that much power over you!

Wishing you the best.

Dr. Duffy

Response from Sharon

Thank you very much- you are very right.  my sister keeps pulling our chain – I think because it is all she now has left of the family.
we are taking the house to a judge this week to try to force it to sell.  so we can be away from her-
she lies to people – so there is no telling what she is making up—
it is exhausting to have a toxic sister like this- I appreciate you and I know you are right on target!

Thanks again

Sharon

This is one of the worst days of the year if you are wanting a relationship but are without one. Bah Humbug  you think, but thats not what you feel. So what can you do to feel better?

Here are 10 Ideas to Help you get Through the Day.

1. Stay up the night before and work then you can  sleep the following day away.
2. Go to a movie about bad relationships. (How about fatal attraction).
3. Spend time with a couple who is always bickering.
4. Go sit in divorce court for the day.
5. Watch / read health reports on Sexually transmitted diseases.
6. Spend time with a friend bashing the opposite sex.
7. Think about your worst relationship and all the terrible things that were done to you.
8. Remember the divorce rate is over 50%
9. Contemplate that solitude is better then a bad relationship.
10. Here’s one especially for the women: single women live longer then married ones.

Have a good day whether alone or as a couple!

Are you ready to come out of your hibernation or do you have the urge to run back in your home and hide?  Because of the cold winter and what feels like constant bad news about the economy, many of us continue to feel like staying inside and avoiding the whole thing. It’s not so hopeful out there and we are barraged with so many things that can bring us down. Anxiety about money and our economy tops the list. When I say our economy I mean our personal budgets, how to pay rising bills, deal with less income and stretch our dollars. This constant worry about money seems to be there all the time, even when we are thinking about other things. Are you experiencing that feeling in the pit of your stomach (anxiety) whenever the issue of money arises (which is often)?

Well you know what? I say it’s ok to pull inward and comfort yourself for another 6 weeks. Once you know you have done your best to cut expenses and maximize income it’s not only ok but healthy to distract yourself and pull away from constant barrage of bad news and your own worries. Some things cannot be fixed right away and need to be waited out.

So take another 6 weeks to hibernate, comfort yourself and build your inner strength. Spend time at home, listen to music, and watch some of those old movies you have always wanted to see, catch up on your reading. The library is a great place for free afternoon’s entertainment, and there is something so grounding and stable about a library. 

Work online, find some new things to learn, keep your mind occupied with pleasant interesting ideas, and consider enhancing your spiritual growth. Teach yourself relaxation / meditation; there are lots of free or inexpensive resources to help you, (try my relaxation sampler) and this is a great way to calm yourself when your worries start to bloom.

Make some comforting inexpensive food, especially soup; try some bean, potato, vegetable or my personal favorite squash soup. It is so comforting!  Puttering in the kitchen and around the house is always relaxing to me. Do some light cleaning, clean out your closets and get rid of the stuff you don’t need. A trip to a local thrift store will get rid of your extras and maybe find you a great bargain. Consider doing a small project, such as working in wood or some crafts. Hands on is always good to distract you from your worries.  Use your imagination to tap into your left brain (creative side).

Remember worrying never solved anything. Productive thinking and planning of course is necessary at times but it needs to be focused and time limited. Worrying and ruminating is counterproductive, it never helps but in fact gets in the way of realistic planning, and clear productive thinking.  So give yourself a break.

Ambivalence is said to be a common experience of the human condition. I have always believed this but have never felt it as clearly as I do about Kenya.  Talk about a love –hate relationship!

  So much to love: people who always smile and are extremely welcoming and friendly, children that are so engaging and loving, take care of each other, and are resourceful, strong and independent, gorgeous scenery, animals and natural resources.  These are the thing I remember most that will draw me back to Kenya.

On the other hand the things that have caused me so much pain, are: the hunger of so many, especially children, the juxtaposition of the very rich and very poor, pervasive corruption, garbage casually thrown on the road, lack of education, lack of jobs and the hopelessness for so many young adults.

Many Kenyans have difficulty being direct and honest; getting a straight answer can be a frustrating experience. Fibbing or out and out lying to get a few extra shillings can make foreigners very angry.  When this happened to me, I tried to remember that for so many of these people a few shillings can mean the difference between eating or not, and feeding their children. I have been told (and believe) that it is easier to make one dollar in the USA then one shilling in Kenya. One shilling is about a penny. So when I got so tired of people trying to sell me something or quoting prices with a “white tax” added, I remember how desperate they are for that little bit of money. Of course this is not true for all the people selling “”stuff, some are just dishonest, but the majority is desperate for those few shillings extra.

Research has shown those who are pessimistic have a higher risk of dying young.

Those who are more optimistic have better health, and better immune systems. Although pessimism may not be easy to change, you can tone it down with practice. No one expects or wants you to be a Pollyanna, trying to keep a positive attitude does not mean to tell yourself everything will be ok when you know it won’t.

It does not mean you bury your head in the sand! Rather, it is important to try to decrease negative thoughts and unnecessary pessimism. When you find yourself having such thoughts you must say, “stop” and force yourself to recognize other more positive possible outcomes. When I am upset over a situation I often ask myself “what is the worse that can happen here”. Many times you will realize that you can deal with even the worst.

Don’t blame yourself when things go wrong. Pessimists think all bad things will last forever and good ones will be gone soon. Optimists think the opposite. Optimists tend to use active coping skills, such as those discussed above.

When I find myself angry at the world due to contact with some despicable person, I remind myself about all the good people in the world. Stay away from the nay Sayers and those who are too narcissistic to think of anyone else but themselves.

Express your emotional reactions honestly so you can effectively deal with what’s bothering you.

Laugh more: Did you know that children laugh about 400 times a day, but adults only about 25 times. Instead of bristling at life’s annoyances, try to view them as amusing. Look for humor in difficult circumstances. Try to avoid sarcasm, jibes or laughter at others expense. Laughing at yourself (especially your pessimism) is great too. Laughter is truly good medicine. Laughing at yourself is especially good for you!