• Sahar Abdulaziz


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[ Excerpts from the book: But You LOOK Just Fine]

Food for Thought-

The brain is a physical organ like any other in the human body, and like any other organ, it can be susceptible to disease. As a society, we wouldn’t ridicule or berate someone with diabetes, heart disease, or a failing kidney. We wouldn’t dare joke about such disorders. Yet, that is exactly how many individuals with depression, anxiety, and other mental disorders are treated, causing them to become increasingly isolated.

Living behind the mask of a mood or anxiety disorder often allows a person to downplay his symptoms. After all, there are no telltale signs or visible flaws. By discounting his symptoms, or denying the existence of the disorder, the person struggling may delay diagnosis and subsequent treatment. He may fear being judged harshly, especially since there are no outward signs of inner struggles.

The dichotomy of appearing content while feeling awful lies at the heart of this book, and it is why a profile section is featured in the last section of this book. That chapter not only displays informal portraits of men and women who live with mood or anxiety disorders, but also encourages them to discuss and share their vast experiences, emotions, and coping strategies as they struggle to manage their symptoms. More importantly, this final section allows the reader of this book to see for himself that looks can indeed be deceiving.

Learning to live with a mood or anxiety disorder must begin first by educating oneself about the disorder, gradually rearranging priorities, becoming more realistic, and recognizing new limitations, as well as setting new attainable goals and developing new strengths. Accepting oneself as having a mix of strengths and weaknesses becomes a vital life lesson for those who live with chronic mood or anxiety disorders.

Sometimes mood and anxiety disorders seem to materialize from nowhere and then remain a constant companion. A difficult situation may bring on the first episode. After that point, the mood challenge becomes chronic.

People who suddenly face an onslaught of symptoms from a mood or anxiety disorder may feel severed from their past. They are flung like an arrow from a familiar setting into unknown terrain. Feelings of dread, waves of anxiety, bouts of sadness, and peaks of panic can fill every minute of the day. They are the sort of symptoms one wants to shake off like a chill. But symptoms of mood and anxiety disorders, to paraphrase Welsh poet Dylan Thomas, often “do not go gentle into that good night.”

People who live with a depression or anxiety disorder face an overwhelming range of challenges as they wrestle with bad feelings and a negative self-image. They must assign new roles to family members and to themselves. They must learn a new set of rules for their everyday lives―rules that involve simplification, rationing out their energy for the most important daily tasks, and pacing themselves through the ups and downs of their symptoms. They discover that they must refresh and embrace their spirituality in a new way, one that releases the angst they feel towards their condition, even if the lift is temporary. They must somehow learn to accept all of the emotions surrounding their new limitations and challenges. But first they have to learn what those limitations are.

There is a difference between reactive depression (in reaction to a loss, for example) and “endogenous” depression, which is deeper. The latter would include someone who has been mildly depressed his whole life, and tends to interpret things in a negative way. Either form is treatable.

Sometimes depression doesn't get better, despite medications and therapy, or a combination of the two. This is often referred to as treatment-resistant depression. Symptoms such as feeling hopeless, being disinterested in activities, and experiencing sadness persist despite treatment. Sometimes symptoms improve, only to keep coming back. Treatment-resistant depression can range from mild to severe, and generally requires trying a number of approaches to find out if one thing, or a combination of therapies, can be discovered to be effective to quiet the symptoms.

The Impact of Depression on Self and Others

Whether a disabling mood or anxiety disorder hits quite abruptly, or simply crawls leisurely

at a snail’s pace into one’s path slowly and methodically disassembling a person’s existing lifestyle and routine, it is devastating to the person and to those around the person. What was once taken for granted and easily accomplished is now a constant stream of uphill battles and obstacles. Responsibilities in relationships may need to be modified; lifestyles may have to be altered, and moods may fluctuate more frequently. Friends and family members who have been available in the past may slowly pull away. They see the same person before them, but something has altered, and they are not comfortable with the change. Some will stand by the afflicted person; Others may retreat out of fear and misunderstanding. Unfortunately, the latter outcome is common.

Mood and anxiety disorders can have a huge impact on relationships in general, and on family life in particular. Changes in ability to function commonly cause resentment among family members, especially if prolonged. A general sense of helplessness can prevail, leading to more anger and resentment, thereby enforcing a vicious interpersonal cycle of frustration and deeper depression.

There will always be those who are threatened by mental illness or fearful of anyone who is “different” because that difference reinforces their own feelings of helplessness; however, new acquaintances may understand the importance of support and take on crucial and supportive roles. Eventually, a few significant relationships may develop from within support groups, or from people who secretly share some of the same symptoms. Old friendships may shift, and family relationships may become strained, or they may become richer and more defined.

Having to relearn how to live one’s life is not an easy chore, but it is a worthy goal to strive for. What makes it more difficult for others in the case of mood or anxiety disorders is that the person looks just the same as ever. Nothing on the outside has changed. Only the inner world has shifted, and that can be confusing for family members, friends, and co-workers. Others see the same person on the outside, and they cannot fathom why or how things have changed so dramatically on the inside.

Those with easily concealed mood or anxiety disorders must learn to educate family and friends about their disorder. It is not a disease process that can be handled well in isolation. Those who are contending with a mood or anxiety disorder must be given the opportunity and tools to be able to adequately and openly communicate their needs and wants effectively and without feeling guilt or a sense of being a burden. While open and clear communication is difficult, even under the best of circumstances, with depression and anxiety disorders it can become magnified and problematic. Clearly, contending with a mood or anxiety disorder can be a full-time job with numerous responsibilities. No wonder fatigue and depression are part of most mental disorders.

Society is not attuned to the needs of people besieged by easily concealed psychic pain. While many will rush to help someone with an obvious physical challenge, the same good Samaritans may respond negatively when asked to help or provide special accommodations to someone who looks just fine and doesn’t appear to require assistance. Yet a growing segment of the population is dealing with profound limitations and challenges associated with hidden mood or anxiety disorders.

Nobody wants to be alone in sadness, and no one wants to be alone in happiness. It’s important to note that there are more resources today for those with mental disorders than ever before. The Internet offers community support groups and online chat rooms that may focus on a particular disorder or challenge. Support and education for conditions such as depression, phobias, obsessive-compulsive disorder, panic attacks, postpartum depression, post-traumatic stress disorder, and many others is available online day or night.

Additionally there are therapists who specialize in effectively treating many mood and anxiety disorders with newer, non-medicinal techniques, or techniques that are used in conjunction with medications. There are numerous resources on the horizon and much to explore when sorting through the coping tools and treatments for depression and anxiety disorders. Learning how to manage symptoms is crucial, but learning how to adapt to them is equally essential.


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