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Mid-Life Crisis, Depression or Both?

Mid-Life Crisis, Depression or Both?
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After the death of Robin Williams and the knowledge that his depression let to suicide, Fiftyisthenewfifty felt it would be fitting to republish this article in hopes it would be helpful.  If you feel depressed, seek help.

BY KATHLEEN HEINS

The stereotype of a married man going through mid-life crisis usually involves the purchase of a snazzy sports car. In women, it may mean some experimentation with Botox. In reality, a mid-life crisis can mark a period of significant depression for both. Let’s face it; you’re not as young as you used to be. Case in point: You used to think that aging gracefully was the plan but now you think that a bit of filler might not be entirely off base. It’s kind of like when you said you’d deliver “au naturel” but ended up shrieking for the epidural! It’s at this period in life that the phrase “Youth is wasted on the young” really hits home: You may be retired or at least thinking about it, caring for aging parents (or mourning the loss of them) or addressing health issues. You may also be experiencing the stress associated with children heading for college, struggling to find their way in the world (and paying their own bills!) or even returning to the nest. All of which is, to say the least, overwhelming.  Is it any surprise that you may find yourself singing the blues?

Men Experience Depression Differently

While both men and women get depressed, men are far less likely to seek help. Their experience with depression is also different than it is in women. According to the National Institute on Mental Health (NIH), men are more likely to experience irritability, anger, reckless behavior and physical pain than overt sadness when depressed. They’re also more likely to turn to alcohol or drugs as a form of self-medication. No surprise that men are also less likely to acknowledge that they are struggling and need help.  Often they are not even aware that what they are experiencing is depression.

Although women are diagnosed with depression more often (most likely because they are more willing to seek help) and more likely to make attempts to end their lives, men die from suicide four times as often as women. Several books that address depression from the male perspective include: “I Don’t Want to Talk About It: Overcoming the Secret Legacy of Male Depression” by Terrence Real and “Darkness Visible” by William Styron (both available on Amazon).

While men get angry, women with depression are more likely to report feelings of sadness and anxiety. Menopausal symptoms which result in problems sleeping, hot flashes, night sweats and fatigue can also affect well-being. Signs of depression in both males and females include a change in eating patterns (eating more or less), sleeping too much or too little and a change in energy level. According to the NIH, depression is caused by a family history of depression, the effects of hormones that control mood and emotions on brain chemistry, and stress. Typically all three are involved.  In both men and women there is typically more than reason they are not feeling up to par. “Depression is caused by an interplay of factors, which may range from psychology, to genetics, stressful life events, drug abuse, and medical illnesses,” says Itai Danovitch, MD, MBA, chair of the Department of Psychiatry at Cedars-Sinai Medical Center in Los Angeles, CA. “Depression that develops after the age of 50 is sometimes called ‘Late Life Depression’, and is more likely to be caused by major stressors, like the loss of a loved one or a serious medical problem,” he adds.

Treatment Works

It’s important to recognize that treatment for depression is typically highly effective. A Stanford University study showed that a combination of talk therapy and medication works best for more than a mild case of depression (as opposed to either approach alone). Medications, such as antidepressants, can also make a huge impact but can take several weeks to work. While there may be some initial side effects such as headache or nausea most lessen over time. For some, however, antidepressants may cause suicidal thoughts or attempts. Others may become agitated when they first start taking an anti-depressant which may be a sign of undiagnosed bipolar disorder. It’s important to talk to your doctor about any side effects you might have during this time. If you are prescribed a medication, and you find it’s working, adherence is crucial as going on and off a medication can reduce its effectiveness.

Don’t let the stigma of mental illness keep you from seeking therapy. Ask your family doctor for recommendations or check out your insurance provider’s web site for a list of psychiatrists and therapists near you. Typically, the psychiatrist will be the one to prescribe and manage your medication and the therapist will be the one you talk with to process your thoughts and feelings. Keep in mind that if you are living with depression it’s better to act sooner than later. Research shows that the sooner you seek treatment, the quicker you can get relief and the less time needed for treatment. Not sure if you have enough coverage? The Mental Health Parity and Addiction Equity Act of 2008 requires group health plans and health insurance issuers to offer the same level of care offered for all medical surgical benefits including no annual limits. If you don’t have insurance some of the agencies listed at the end of this article can help. Keep in mind you may have to try a few therapists before you find the one that works for you.

Bringing out the Best in You

Getting enough sleep and regulating your sleep schedule so that you go to bed and get up at the same time each day will go a long way toward feeling good as will getting at least 30 minutes of exercise most days of the week. Eating a good diet can also help. Men can particularly benefit from doing some form of group exercise such as a circuit-training program where they have the opportunity to also socialize; something women find easier to do. Reach out to others; isolation can make your depression worse!

Bad Mood Busters

What to do if you find yourself in a funk? “For short term alleviation distraction works,” states Patrick Burke, PhD, a clinical professor of psychiatry at the University of Arizona in Tucson and author of Mood: The Key to Understanding Ourselves and Others. “This could be anything from dancing, listening to music, taking a walk, playing bridge and physical activities of all kinds,” he adds. Take a look at local programs at libraries, community centers and in the events section of your newspaper. Try something new such as art classes, white water rafting, or a cooking class. Volunteer! Studies show that feeling a sense of purposefulness is an important component of mental health (see volunteermatch.org for local opportunities).

Kathy Eckart, Director of Crisis Intervention Services for Mental Health America in Greenville County, SC, recommends exploring what speaks to you. “I think that would be individual for each person; what are their interests, what makes intrigues them, what satisfies them, what do they just plain like to do.” Check out encore.org for some resources for reinventing yourself and meetup.com to find others who share your interests.

Burke says that although there are quick fixes for changing mood, sustained change will take more work because it involves not only relieving bad moods but making a positive mood more of a habit. “This means people need to carefully examine the situations they find themselves in, the roles they play in the situations and find what is meaningful.”  In positive psychotherapy one works to not only reduce negative symptoms such as sadness but build on positive emotions. For example, try writing down three good things that happen during the day and why or finding the good in a given person or situation instead of focusing on shortcomings. One form of therapy, known as cognitive behavioral therapy or CBT, teaches new ways of thinking and how to change behaviors that contribute to one’s depression.

It’s important, says Danovitch, to recognize that while it’s normal to have periods of sadness, being depressed is not a normal part of getting older. “There are excellent treatments for depression, including very effective therapies and medications but these interventions can only be effective if the individual seeks help,” he states. “I would encourage that individual to get high quality care by seeking references, ensuring they understand the treatment plan and getting a second opinion if they are not improving.”

Mentalhealthamerica.net and NAMI.org (National Alliance on Mental Illness) are great sources of assistance and information and can provide leads for free or reduced cost individual or group therapy. If you (or someone you know) are at risk for suicide, call 911 for emergency services, go to the nearest hospital emergency room or call the National Suicide Prevention Lifeline at 1-800-273-TALK (for help). Veterans can also call send a text to 838255, or access a confidential online Live Veterans Chat at veteranscrisisline.net.

Kathleen Heins specializes in health and well-being. Her work has appeared in Better Homes and Gardens, Good Housekeeping, Ladies’ Home Journal, Reader’s Digest, Runner’s World and USA Weekend, among other publications. 

 

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