Wednesday, January 24, 2018

Learning to remove the masks we wear

“We all wear masks, and the time comes when we cannot remove them without removing some of our own skin.” 
― André Berthiaume

“What we share may be a lot like a traffic accident, but we get one another. We are survivors of each other. We have been shark to one another, but also lifeboat. That counts for something.”
Margaret Atwood

I spend a great deal of my time explaining to people what words like depression and anxiety actually mean.

I fail at this quite often.

In thinking about why this might be, I began showing people this illustrated comic instead to gauge their reactions and see if it increased their understanding of mental health.

It did. It does. In almost every case. 

What the comic so succinctly demonstrates, is that living with a mental health condition is often a question of hide and seek. Of showing one thing to the world and then living a completely different reality to yourself. Sometimes this gets confusing. We try to be good actors, but the issues begin to seep out. Irritability, anger, insomnia, missing work. There are all possible signs that something is not quite right with people, and they are evidence that a person's mental health issues are getting harder and harder to hide. 

No matter how good of an actor they might be.

My professional "bread and butter" has been examining how this works in the life of comedians. In many cases, there is a lot of sadness behind the laughter, and comedy is a way of processing and filtering these emotions. 

But this goes way beyond comedy, and I think is probably as prevalent in the lives of almost anyone who has mental health issues they want to keep "secret." If you break your leg, no one quibbles about taking a day off from work. But "mental health days" are still code for an extra day of vacation. And surely some of us have used them like that. But in reality, they can be just as debilitating. Suicide is the 2nd leading cause of death among people 15 to 29, and much of this is also a result of untreated depression. 

There are a number of reasons we strive to keep these feelings secret. In many cases, we don't want to appear weak or vulnerable or perceived as unable to keep up at work or at home. Perhaps we don't want to be a burden to the people we love. Maybe we've tried to talk about it before and been misunderstood.

And so we wear the masks. And they come in many shapes and sizes. That lady furiously typing away with her headphones on is wearing the "busy" mask so she doesn't have to talk to anyone and risk saying the wrong thing. The guy at work who jokes about his drunken escapades every weekend wears the "clown" mask to deflect others away from his addictions and depression. At perhaps most common is the "I'm fine" mask, where people simply change the subject or avoid talking about issues or problems in their lives.

The problem is the acting eventually gets exhausting. We smile through gritted teeth and laugh through internal tears and give people the "I'm fine" routine in the middle of an internal tornado.

So how do we learn to remove the masks?

Mental health stigma has come a long way in the last 20 years, but it still has a long way to go. Some companies have begun investing in mental health programs for their employees and seen their productivity soar. Even "The Improv" which is one of the most famous comedy clubs in the world now employs mental health professionals. People are starting to get the hang of this.

Although talking to professionals is challenging, I think it's even harder to talk to the people we are closest to sometimes. It means stepping out of our comfort zones and showing people something we may not want them to see. Even in relationships, we create impressions. Perhaps even more so than with strangers. We love our "I'm fines" and "It's okay" and "I don't wanna talk about its." They become such a regular part of our conversations that they become clichés.

I've always loved this quote from Tom Robbins about risk.  He writes, “You risked your life, but what else have you ever risked? Have you risked disapproval? Have you ever risked economic security? Have you ever risked a belief? I see nothing particularly courageous about risking one's life. So you lose it, you go to your hero's heaven and everything is milk and honey 'til the end of time. Right? You get your reward and suffer no earthly consequences. That's not courage. Real courage is risking something that might force you to rethink your thoughts and suffer change and stretch consciousness. Real courage is risking one's clichés.”

So perhaps we need to begin to risk our clichés. To take a chance and talk about things before they fester. To catch ourselves in these "I'm fine" moments and take a chance that maybe, just maybe, someone else has also felt the way we have and can offer some understanding. 

Maybe we're walking right by people that have been there and can help.

In closing, I would like to include a poem from Shel Silverstein. He's known as a children's author. You can believe that if you want. It's a great little poem about the things we share and don't summon the courage to talk about.

“She had blue skin,
And so did he.
He kept it hid
And so did she.
They searched for blue
Their whole life through,
Then passed right by-
And never knew.” 
Shel Silverstein, Every Thing on It

Sunday, January 14, 2018

Blue Monday and the 3 Ghosts of the Holiday Season

For those that don't know, Monday, January 15th is "Blue Monday" this year. What is Blue Monday, you may ask? It's supposed to be the most depressing day of the year. There's even a formula for it calculating the weather, debt level (specifically, the difference between debt and our ability to pay), the amount of time since Christmas, time since failing our new year's resolutions, low motivational levels and the feeling of a need to take charge of the situation. Although the origins of Blue Monday are actually quite dubious, there is some truth that January can be kind of a depressing month. 

As someone quite familiar with Seasonal Affective Disorder as both a patient and a doctor, I know this plays a role. After the anticipation of Christmas there's always a bit of a letdown, and in the US at least, the weather often turns truly dreadful. That certainly is a factor.

But I also think there's something about the holiday season that might contribute a little bit. I came to this idea while watching one of those Hallmark Christmas movies with my mother. I watched for a minute and scoffed at the hackneyed formula playing on people's emotions and sentimentality. An hour later I was sitting with a box of tissues rooting for the grizzled town veterinarian to finally find love with the lonely widow. What can I say? Fruitcake makes me emotional.

The first ghost as per the Dickens' legend is the ghost of Christmas past. This is the ghost of regret. For some, it's another year where they haven't met their goals, found love, improved their financial situation, or whatever. For others, being with family after a long layoff stirs up a number of old feelings of not being good enough and letting people down. Others remain estranged from their families, which can be particularly lonely and painful at Christmas time. 

The 2nd ghost is the ghost of Christmas present. This is the ghost of stress. Many of us worry about how we're going to make it all work financially. Others may worry a great deal about how they look, or where they are in their lives, or how they're going to make it through another year without a catastrophe. For parents, there is that pressure to meet expectations and make the holidays special for their children without also going into financial ruin. I remember my own mother working about three different jobs during the month of December so my brothers and I could beat the shit out of each other with our transformers. A lot of parents make that sacrifice. 

The third ghost is the ghost of Christmas future. This is the ghost of anxiety. Anxiety is a future-oriented fear. The unknown. Things hovering in the future that we haven't resolved and spend a lot of time worrying about. Maybe it's our health, or finding love, or passing a test, or paying our bills. All of us have these worries, and they seem to intensify in the middle of January if the Blue Monday equation is to be believed.

So perhaps the most important question is, how do we keep our heads above water during these tough times? That first week back to work? The first big credit card bill that comes? 

In the Hallmark movies, all of that stuff just kind of works itself out, but real life isn't so simple. Many of us have a plan for the new year to do things differently, and perhaps we've already started to slip a little. As gym owners all over the world can tell you, there is a huge difference between motivation and discipline. Motivation is dreaming of looking great and exercising like crazy for a day trying to get there. Discipline is going to the gym with a hangover a week later on a day you really don't feel like wanting to go. Strive for discipline. 

Beyond the usual "goal" stuff, I think we can also do a little better job managing those ghosts. Maybe it's swallowing our pride and making peace with someone from our past (one of my projects this year). Perhaps it's sending someone a short note telling them we're thinking about them in the new year. Or maybe it's even forgiving ourselves for something that is weighing heavily on our minds.

Although January is a time to unbury ourselves from the month before, perhaps it's also an opportunity to erase the etch-a-sketch and start with a clean palette of self-forgiveness and compassion.

And we can also resolve to do a little better with the people in our lives this year. Listen a little better, pay a little closer attention, stay in touch a little more. Be grateful that we all get another spin around the universe this year. Not everyone does.

Let's use our time as kindly as we can this year.