midlife crisis

Depression: What It Is and What to Do about It (Part 2)

Depression: What It Is and What to Do about It (Part II)

This is the second of a two-part series on depression. In this issue, I will describe how depression is treated and prevented. If you or someone close to you suffers from depression, it is important to educate yourself about it and seek treatment from qualified mental health professionals.

There are three basic ways to treat depression: psychotherapy, self-help, and medication. Many people respond best to a combination of two or more methods.

1.    Psychotherapy: Exploring one's beliefs and ways of thinking, and learning new ways of thinking and behaving, with the guidance of a professional.
2.    Self-help: Exploring one's beliefs and ways of thinking on one's own.
3.    Medication: Altering one's brain chemistry by taking antidepressant medication.

A physician may recommend medication when four conditions exist:

1.     The patient's depression is severe.
2.     The patient has suffered at least two previous depressive episodes.
3.     There is a family history of depression.
4.     The patient asks for medication only and refuses psychotherapy.

There are four types of antidepressant medication available today:

�    Tricyclic antidepressants (TCAs)
�    Monoamine oxidase inhibitors (MAOIs)
�    Selective serotonin reuptake inhibitors (SSRIs)
�    Structurally unrelated compounds

The TCAs and MAOIs have been used for decades. The SSRIs (such as Prozac) and structurally unrelated compounds are newer and are being prescribed more and more frequently. They have fewer and less pronounced side effects than the TCAs and MAOIs.

Treatment without Medicine

One of the leading methods for treating depression is cognitive therapy. Cognitive therapists help depressed clients feel better by identifying how faulty ways of thinking are making him or her feel bad. The client analyzes his or her thoughts and beliefs, and learns to substitute more healthy ways of thinking and believing.
Many mental health professionals believe that the ideal treatment of clinical depression is medication in conjunction with psychotherapy.

Prevention of Depression

Depression can often be prevented. It is especially important to take preventive action if you are aware that you have predisposing factors such as those mentioned in the last newsletter.

1.    Identify your risk factors and be aware of where you are vulnerable. Each of us has unique risk factors, such as things we were taught in our families of origin, values we have learned, and the presence or absence of a family history of depression. Anything that has been learned can be unlearned and replaced with something healthier.
2.    Learn to manage stress. You can learn proven techniques for calming and relaxing yourself. Consider taking a stress management class or buying a set of relaxation tapes.
3.    Learn problem-solving skills. Many people who develop depression never learned problem-solving skills. They need to develop the ability to see problems from many viewpoints and to look for a variety of solutions.
4.    Build your life around things you can control. Learn to recognize what you can control and what you can't. Avoid spending much effort on situations that won't pay off for you.
5.    Learn self-acceptance. Instead of rejecting the parts of yourself you don't like, learn to manage them more productively.
6.    Become aware of selective perception. Observe how you generate ideas and opinions about people and events. Remember that these are just your views, not necessarily objective facts.
7.    Focus on the future, not the past. Depressed people tend to be focused on the past. People who set goals and focus on the future tend to be more positive about life.
8.    Develop a sense of purpose. Many depressed people lack a sense of purpose or meaning. This means they have no goals and nothing in the future drawing them forward. To prevent depression, develop your sense of purpose and meaning.
9.    Strengthen your emotional boundaries and set limits. Boundaries define your role in a social situation. They determine how you will or won't behave in a given situation. Having clear, strong boundaries is empowering, while boundary violations make you feel victimized and helpless. Setting limits means having and enforcing rules for the behaviors you expect in a relationship.
10.    Build positive and healthy relationships. Think about what you need from others in relationships. Learn to read people and trust your instincts about which people are good for you.
11.    Avoid isolation. Talk to others about what's going on with you. If you keep your thoughts to yourself, you may be unaware that your thoughts are distorted. If you share them with another person, you can become more objective.


Signs That Professional Therapy Is Needed

1.    Thinking about death or suicide. This is always dangerous and you should see a professional therapist immediately.
2.    When symptoms of depression continue for a long time, you may need professional help. Acute responses to events are normal, but they should not last beyond a reasonable time.
3.    Your ability to function is impaired by your depression. Seek help before your life situation deteriorates to a serious level.
4.    You have become so isolated that you have no one with whom to test reality. Seek someone out to share your thoughts and feelings with.
5.    Depressive symptoms have become severe.
Please call for an initial free consultation. 813-240-3237 We are here to help!

Dealing With Midlife Issues

I would like to help explore the challenges and opportunities that come at midlife. Let’s take the opportunity to look at issues that are specific to the Baby Boomer generation and Generation X. We also have a chance to begin the process of your own midlife assessment with a list of questions presented at the end of this article. I call this assessment the Midlife Checkup.

Benefits of the Midlife Checkup

Taking the time to assess how your life is going at this point can result in benefits such as these:

·    It can help you identify and intensify your inner strengths.

·    You can find your own voice and express it your own way.

·    You can accept your changing physical self.

·    It is an opportunity to forgive those with whom you've been angry.

·    It can help you find ways to reduce stress.

·    You can learn to simplify your life.

·    You can reenergize yourself in preparation for the second half of your life.

Generation X or Gen X 

Generation X is the demographic cohort following the baby boomers and preceding the Millennials. There are no precise dates for when Generation X starts or ends. Demographers and researchers typically use birth years ranging from the early-to-mid 1960s to the early 1980s.

Members of Generation X were children during a time of shifting societal values and as children were sometimes called the "latchkey generation", due to reduced adult supervision as children compared to previous generations, a result of increasing divorce rates and increased maternal participation in the workforce, prior to widespread availability of childcare options outside the home. As adolescents and young adults, they were dubbed the "MTV Generation" (a reference to the music video channel of the same name). In the 1990s they were sometimes characterized as slackers, cynical and disaffected. Some of the cultural influences on Gen X youth were the musical genres of punk music, heavy metal music, grunge and hip hop music, and indie films. In midlife, research describes them as active, happy, and achieving a work–life balance. The cohort has been credited with entrepreneurial tendencies.

As young adults

In the 1990s, media pundits and advertisers struggled to define the cohort, typically portraying them as "unfocused twentysomethings". A MetLife report noted: "media would portray them as the Friends generation: rather self-involved and perhaps aimless...but fun." In France, Gen Xers were sometimes referred to as 'Génération Bof' because of their tendency to use the word 'bof', which translated into English means 'whatever". Gen Xers were often portrayed as apathetic or as "slackers", a stereotype which was initially tied to Richard Linklater's comedic and essentially plotless 1991 film Slacker. After the film was released, "journalists and critics thought they put a finger on what was different about these young adults in that 'they were reluctant to grow up' and 'disdainful of earnest action'."

Stereotypes of Gen X young adults also included that they were "bleak, cynical, and disaffected". Such stereotypes prompted sociological research at Stanford University to study the accuracy of the characterization of Gen X young adults as cynical and disaffected. Using the national General Social Survey, the researchers compared answers to identical survey questions asked of 18–29-year-olds in three different time periods. Additionally, they compared how older adults answered the same survey questions over time. The surveys showed 18–29-year-old Gen Xers did exhibit higher levels of cynicism and disaffection than previous cohorts of 18–29-year-olds surveyed; however, they also found that cynicism and disaffection had increased among all age groups surveyed over time, not just young adults, making this a period effect, not a cohort effect. In other words, adults of all ages were more cynical and disaffected in the 1990s, not just Generation X.

In 1990, Time magazine published an article titled "Living: Proceeding with Caution", which described those in their 20s as aimless and unfocused; however, in 1997, they published an article titled "Generation X Reconsidered", which retracted the previously reported negative stereotypes and reported positive accomplishments, citing Gen Xers' tendency to found technology start-ups and small businesses as well as Gen Xers' ambition, which research showed was higher among Gen X young adults than older generations. As the 1990s and 2000s progressed, Gen X gained a reputation for entrepreneurship. In 1999, The New York Times dubbed them "Generation 1099", describing them as the "once pitied but now envied group of self-employed workers whose income is reported to the Internal Revenue Service not on a W-2 form, but on Form 1099". In 2002, Time magazine published an article titled Gen Xers Aren't Slackers After All, reporting four out of five new businesses were the work of Gen Xers.

In 2001, sociologist Mike Males reported confidence and optimism common among the cohort saying "surveys consistently find 80% to 90% of Gen Xers self-confident and optimistic. In August 2001, Males wrote "these young Americans should finally get the recognition they deserve", praising the cohort and stating that "the permissively raised, universally deplored Generation X is the true 'great generation,' for it has braved a hostile social climate to reverse abysmal trends", describing them as the hardest-working group since the World War II generation, which was dubbed by Tom Brokaw as "The Greatest Generation". He reported Gen Xers' entrepreneurial tendencies helped create the high-tech industry that fueled the 1990s economic recovery.

In the US, Gen Xers were described as the major heroes of the September 11 terrorist attacks by demographer William Strauss. The firefighters and police responding to the attacks were predominantly Generation Xers. Additionally, the leaders of the passenger revolt on United Airlines Flight 93 were predominantly Gen Xers. Demographer Neil Howe reported survey data showed Gen Xers were cohabitating and getting married in increasing numbers following the terrorists attacks, with Gen X survey respondents reporting they no longer wanted to live alone. In October 2001, Seattle Post-Intelligencer wrote of Generation Xers: "now they could be facing the most formative events of their lives and their generation". The Greensboro News & Record reported Gen Xers "felt a surge of patriotism since terrorists struck" reporting many were responding to the crisis of the terrorist attacks by giving blood, working for charities, donating to charities, and by joining the military to fight The War on Terror. The Jury Expert, a publication of The American Society of Trial Consultants, reported: "Gen X members responded to the terrorist attacks with bursts of patriotism and national fervor that surprised even themselves".

In midlife

Google co-founder Sergey Brin, speaking at a Web 2.0conference

Guides regarding managing multiple generations in the workforce describe Gen Xers as: independent, resourceful, self-managing, adaptable, cynical, pragmatic, skeptical of authority, and as seeking a work life balance. In a 2007 article published in the Harvard Business Review, demographers Strauss & Howe wrote of Generation X; "They are already the greatest entrepreneurial generation in U.S. history; their high-tech savvy and marketplace resilience have helped America prosper in the era of globalization.” In the 2008 book, X Saves the World: How Generation X Got the Shaft but Can Still Keep Everything from Sucking, author Jeff Gordinier describes Generation X as a "dark horse demographic" which "doesn't seek the limelight". Gordiner cited examples of Gen Xers' contributions to society such as: Google, Wikipedia, Amazon.com and YouTube, arguing if Boomers had created them, "we'd never hear the end of it". In the book, Gordinier contrasts Gen Xers to Baby Boomers, saying Boomers tend to trumpet their accomplishments more than Gen Xers do, creating what he describes as "elaborate mythologies" around their achievements. Gordiner cites Steve Jobs as an example, while Gen Xers, he argues, are more likely to "just quietly do their thing".

In 2011, survey analysis from the Longitudinal Study of American Youth found Gen Xers to be "balanced, active, and happy" in midlife (between ages of 30 and 50) and as achieving a work-life balance. The Longitudinal Study of Youth is an NIH-NIA funded study by the University of Michigan which has been studying Generation X since 1987. The study asked questions such as "Thinking about all aspects of your life, how happy are you? If zero means that you are very unhappy and 10 means that you are very happy, please rate your happiness." LSA reported that "mean level of happiness was 7.5 and the median (middle score) was 8. Only four percent of Generation X adults indicated a great deal of unhappiness (a score of three or lower). Twenty-nine percent of Generation X adults were very happy with a score of 9 or 10 on the scale."

The Baby Boomers

The Baby Boomer generation is passing midlife (Give or take a few years) right now. This generation includes almost 78 million Americans born between 1946 and 1964.

The Boomers are the largest generation in U.S. history. They have had a major impact on American society as they have passed through every life stage. They are passing through midlife in their own unique way, differently from their parents and differently from Generation X, the group born in the years after 1964.

The first Boomer turned 50 at the beginning of 1996, and the remaining 78 million will observe this anniversary sometime between now and 2014.

Typical Feelings

According to Rocking the Ages authors J. Walker Smith and Ann Clurman (researchers at Yankelovich Partners) and authors like Gail Sheehy, people passing through middle age typically experience the following kinds of feelings.

Great expectations: Most Boomers are beginning to recognize their own limitations. Growing up in the comfortable 1950's, the Boomers learned to expect unlimited growth and endless possibilities. They believed their good luck would never end. Now that they are turning 50, many are shocked to discover that there are limits to life's possibilities.

Regret: As people reach midlife, they must face up to the loss of some of their dreams and regret the mistakes they have made. It is not easy for anyone to face the person one will never be.

Loss: At midlife, everyone has to face the loss of youth, valued by our society. In her book New Passages, author Gail Sheehy calls this experience "The Body Blues" or "The Vanity Crisis."

Meaning: According to Sheehy, the "universal preoccupation" of the middle years is "the search for meaning in whatever we do." As they face the fact that time is limited, the Baby Boomers typically become even more intent on this need to analyze and search for significance.

Change: The midlife years can be a time of radical change for many people. This is the result of endless questioning and evaluation of how one has lived life thus far. Many midlife crises become mid-life meltdowns, says Sheehy, because some people react to feelings of emptiness or disillusionment by destroying everything they have built.

The Boomers developed a value system that is based on a sense of entitlement and which values individuality. Because they hold these values, Boomers respond differently to each life stage than do other generations. You can see these values reflected in scenes like those from television shows from the 1950s and early 60s.

According to Smith and Clurman, four important characteristics of the Baby Boomer value system are:

Self-absorption: The Boomers (once called the "Me" Generation) have the reputation of being more narcissistic than other generations. Because of the times they grew up in, they have always been fascinated with themselves. The indulgence they experienced at home in the 1950s and the world's seemingly limitless possibilities created a fascination with self and a feeling of specialness.

Sense of entitlement: As a generation, the Boomers see themselves as superior to others. They have always assumed that they could have life their way and that the rules were meant for others, but not for them. They feel entitled to rewards and view themselves as winners. They expect success and cannot accept failure.

Need for control: The Boomers need to feel certain and to sense that they are in control of life. They have a difficult time dealing with uncertainty.

Reflection: Baby Boomers have always valued introspection and take pleasure in asking questions.

For most people, life at age 45 or 50 doesn't match the dreams they had at age 20 or 30. When people reach age 45 or 50 and are even slightly disappointed by their achievements and experiences, their feelings are likely to be compounded by these factors of self-absorption, sense of entitlement, and a need for control. But there is also a positive side to this. The tendency to reflect and explore can help one look for new possibilities instead of being stuck with feelings of disappointment.

Keep all of this in mind as you complete the Midlife Checkup. It is a list of 29 unfinished sentences that will help you assess your life to date. The items on this list provide a framework for conducting your own assessment. Please add your own ideas that you think will help you reflect on your life's direction.

The Midlife Checkup

    1.    My most important accomplishments are...

    2.    I am disappointed about...

    3.    I would describe the person I turned out to be as...

    4.    I want to change the following things about my self and my life...

    5.    Things I want to do before I die...

    6.    If I knew I couldn't fail, I would...

    7.    Things I have mastered...

    8.    Things I want to keep...

    9.    I want to keep these relationships...

    10.    I want to let go of these relationships...

    11.    I want to keep these possessions...

    12.    I want to let go of these possessions...

    13.    I want to have these experiences...

    14.    I want to clean up these messes...

    15.    I want to celebrate...

    16.    I don't ever again want to...

    17.    My body is...

    18.    My children are...

    19.    My parents are...

    20.    My spouse is...

    21.    I want to remember...

    22.    I want to forget...

    23.    I must apologize to...

    24.    I must seek an apology from...

    25.    I am most proud of...

    26.    I wish I could forget about...

    27.    I wish I could do over...

    28.    I wish I had never...

    29.    I wish I had...

    30.    Add your own items: