Intimacy

My guess is that the title of this blog post got your attention, but maybe not in a good way.  If you are like me, you assume that when you hear the word intimacy it has to do with sex.  Depending on how you feel about sex or how you feel about talking about it, it may be an unsettling thing to read.  However, I want to try to expand our definition of intimacy and how it can apply to us in our close relationships.

Until I read the book “Stretched Too Thin” by Jessica N. Turner, I only thought of intimacy in very narrow terms.  But, did you know there are many types of intimacy?  Jessica’s book described several of them, which I will list here: sexual intimacy, emotional intimacy, intellectual intimacy, aesthetic intimacy, creative intimacy, recreational intimacy, work intimacy, crisis intimacy, conflict intimacy, commitment intimacy, spiritual intimacy, communication intimacy, and moral intimacy.  I will leave you to her book for descriptions of these types of intimacy, and my guess is there are more out there too.  Regardless, I think it is great to expand our ideas of what intimacy means.  In hindsight, it almost seems obvious.  No matter what you do or what happens in life, you can find ways to connect with a partner.

If you are struggling with depression and have a significant other, or if you have a significant other with depression, what does this expanded definition of intimacy reveal to you?  Does to help to know that there might still be some ways you can stay connected despite the depression?  Does this give you hope?  Or, does it change anything?  If it does change anything, what is that?  Overall, this list may give you ways to reframe your experiences as you go through a depression.

Goal Setting

Although I don’t find it a particularly fun process, goal setting is done in a lot of places by a lot of people.  I am guessing many of you have heard of SMART goals, where each letter of the acronym stands for Specific, Measurable, Achievable, Realistic, and Time-Bound.  Old news, right?  Luckily, I stumbled upon a different type of goals, and I want to share this information with you today.

Have you ever heard of SMARTER goals?  This system was developed by an individual named Michael Hyatt.  Here is what each letter stands for:

Specific

Measurable

Actionable

Risky

Time-keyed

Exciting

Relevant

This system already sounds more fun, right?  Not only does this framework get to the important pieces that you can’t get away from – honestly, goals do have to be specific, measurable, and time bound, but I really like what gets changed or added.  Goals should be actionable – meaning a goal should get you to do something.  Risky means taking a chance to see how it will go.  My assumption is this has to do with taking good risks, not questionable ones that may be harmful to you or others.  Goals should also be exciting, and this is the key piece I like.  If they are not exciting, it makes goals harder to work on or even develop.  Then, goals should reflect your values and apply to what you want in life.

When thinking about goals related to recovery from depression or caregiving goals, I think this is a great system to consider.  The exciting part may be challenging, but it is worth trying to consider.  However, the relevant part can be very helpful in determining what is most important to recovery and caring for yourself and others.  Overall, I hope this system gives everyone a larger framework for understanding and developing goals.

Keeping Up with the News

In a post from a long time ago I wrote about the news and my thoughts on it.  Today, I want to revisit that topic again and talk about its effects on depression and mental health.

To recap my previous post, I am not a big fan of the news.  It tends to be incredibly negative, and while it may help me keep up on world events, most of the time I try to get the essentials and leave the rest.  Sometimes that makes me ignorant to some important things that are happening in the world, but I would rather risk that than feel angry and sad all of the time because of what I see or hear in relation to the news.

Related to depression and mental health, I think the news has a negative effect too.  In fact, looking in retrospect, my dad used to watch the news most of the time he had the TV on, and I can’t help but wonder how that might have led to his depression.  While I am not outright blaming the news for his illness, I suspect it was yet another factor that led to it.

If you are depressed or someone touched by a depression, the news is not a friend.  While there are some good reasons to know what is happening in the world sometimes, I would say it is best to avoid as much of the news as possible.  And, there are sources of positive news out there, and I applaud the effort to have it, but it pales in comparison to the negativity we currently see.  One of my dreams is to see a world where the news talks about positive stories at least as much as they talk about negative ones.  It would be even better if the positive stories outweighed the negative ones.  In the meantime, I stay away from the negativity as much as I can.

Standing Up and Speaking Out

Yesterday I attended an event about advocacy, and it included a very informative group of speakers and attendees.  Today, I want to share some of the highlights I took away from the event.  I feel that they can apply to advocating for many issues, especially mental health.  Here they are in a list form:

1.What if we didn’t retrofit our work to an existing system, but rather created a new one?

2.Anger about injustices and action can lead to power.

3.You may want to run for office not to win (although that would be great!), but to spread the word about issues that are important to you.

4.Think twice about saying you are not interested in politics.  Your landlord, your mortgage lender, your insurance carrier, the people who run the businesses you shop at, and many others that affect your life are interested in politics, so you should want to have a say in matters that affect you.

5.You may not be interested in politics or advocacy until you become a parent, and then having children may change that dramatically.

6.Intergenerational conversations are important in politics and advocacy – we need to include the voices of the young, old, and middle-aged.

7.In advocacy, you need to use your brain and your voice.

Now, these are somewhat random, but I think they are all helpful or interesting.  When it comes to advocating for mental health, I think they are all also very applicable, and they will be useful for me as I work to continue my dive into advocacy work.

How about you?  Do you agree with my list?  If not, which parts do you disagree with?  This is by no means a definitive or comprehensive list, but I thought these were nuggets worth sharing.  I hope you will enjoy thinking about them too.

Birthday

As I write this entry, I have just celebrated another birthday.  This year is not particularly special, but people are always so nice about recognizing that it is a special day in my life.  Perhaps the fact that it is not particularly special is a good thing, and I want to share why I am thinking that way.

When someone is facing a major illness, a birthday can be a very big deal.  Here, birthdays mean survival.  They mean hope and faith and love and life.  If I remember correctly, the American Cancer Society had a big ad campaign on TV about donations and support leading to more birthdays for cancer sufferers.  The intent here is wonderful, and everyone should have as many birthdays as possible despite what conditions they may have.  Of course, sadly, we know that many people do die from cancer, and that birthdays are cut short.  We also know that cancer is an important health issue to address.

But, I wonder – what about a “more birthdays” campaign for mental illness?  We know a lot about mental illness here:  it tends to strike a lot of people when they are young, and people with mental illness tend to die earlier than others.  And, as I know, death can be an unfortunate outcome of depression or other mental disorders.  In many ways, mental illness is a lot like cancer, but I have yet to see a “more birthdays” campaign for mental illness.  Perhaps we should work on making that happen.

But, back to my birthday.  I feel incredibly fortunate because my birthday is not a big deal – I am not trying to fight cancer or mental illness or any other serious disease.  My birthday is just like any other day, and I wish that all birthdays could be like mine.

The Mind Body Connection

When it comes to the mind and the body, I think a lot of us think about them as two separate things.    It’s possible to partially blame it on some long standing historical perspectives.  As a result, we believe that one does not influence the other.  However, many people have started to talk about how the mind can affect the body, and those ideas seem to be gaining more acceptance and are receiving more attention.  But, what about the body affecting the mind?  Is that even possible?  What does that look like?

In my general quest for knowledge I have heard about interesting research that the body can indeed affect the mind.  One example involves using Botox.  Botox has been used cosmetically for many years as a way to smooth lines and wrinkles on the face.  However, it has been found that people who have had Botox for frown lines have also shown improvements in mood.  There is an argument that a person may feel better because they think they look better, but there seems to be more to it.  Another example comes from exercise, where it has been shown that it can improve mood as well.

So, Botox and exercise for depression?  Of course, these are only a few examples from a larger world of possibilities, but there is growing evidence that the body can and does affect the mind.  Using this idea as a framework, my hope is that this will give us even more possible treatment options for depression.  So, if possible, why not consider Botox?  Why not consider exercise?  Overall, I like the idea that the mind and body work together and should not be treated separately.  Once we think about everything as being connected, I believe we can find even more ways to treat the whole individual.

Mistakes

Today’s theme for me has shaped up to be about mistakes.  I thought I had caught a big one at work, but after investigating I found out that all was well, which I am glad is the case.  Then, it seems like I have heard other talks or songs about mistakes today, and it has me thinking about them in general.  In my mind, to make mistakes is to be human.  It is just a part of life.  However, I wonder how our perception of mistakes might lead to things like depression.

Is it possible that someone thinks they have made a large number of small mistakes or one big mistake and then that has led to depression?  It seems entirely possible to me.  In general, I think we all have a great capacity to internalize a lot of mistakes, even though there was likely many other factors that played a part.  I think a lot of us put a lot of pressure on ourselves to be good all of the time, and when we do stumble, we take it very personally.  So, my call here is to really take a harder look at our mistakes and see if we can lessen the severity of how we internalize them.

Now, as a disclaimer, there are some mistakes (intentional murder, intentional violent crimes) that are pretty awful, and I am not including those in this post.  However, for the rest, a key point is that mistakes are likely the result of a behavior.  So, the mistake is from something you did, not an extension of who you are as a person.  If this is true, then internalizing the mistake is not great.  You dislike the behavior, not you as a person.  My hope is that you start to look at mistakes in this way and separate them from who you are.  You may need to make amends or apologize for some mistakes, but overall, I hope people can understand that how we feel about our mistakes can lead us down a path to depression.  But, there are healthier ways to cope with our mistakes.

Social Determinants of Health

Lately, I have heard a lot about “social determinants of health”, but I have vaguely glanced over the idea.  Today, I want to explore this more in-depth and give you an overview.

Although you can find a discussion about this topic in lots of places, the information I am presenting here comes from the website healthypeople.gov and the Healthy People 2020 program.  They define social determinants of health as “conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.”  Some examples of social determinants include access to educational opportunities, access to job opportunities, quality of education, transportation options, public safety, social support, exposure to crime, access to mass media, and culture.  Healthy People 2020’s approach to social determinants of health is focusing on five key areas: economic stability, education, social and community context, health and health care, and neighborhood and built environment.

I am happy to see that many organizations, including the U.S. government, is really starting to address these factors, because I think they absolutely have a role in our overall health.  We need to start looking at not only the entire person, but the larger context in which the person lives their life.  I am looking forward to what we find out and how we can address the problems that are identified (problems that I suspect a lot of us already have an idea about).  Specifically, when looking at this and depression, I think we might find even more potential factors that lead to depression.

How about you?  Have you heard about social determinants of health before?  Do you think these are important to our health?  I hope you agree that this is another great way to look at a bigger picture of our health.

Depression and Substance Use Disorders

We all understand that depression does not exist in a vacuum.  Sometimes, it may be the only diagnosis a person has, but there is still a lot of factors that come with that diagnosis.  Many times, however, there are other things going on.  Some people might also have high blood pressure or diabetes.  Maybe they have a different physical disability.  Today, I want to talk about a particular combination – depression and substance use disorders.

In basic terms, a substance use disorder involves using a drug that has not been prescribed for an intended purpose.  Some drugs, like heroin and meth, are illegal across the board.  Some others, like opioids or benzodiazepines, are legal but must be prescribed for a specific purpose.  Those suffering from depression (and other mental illnesses) also have a strong chance of having a substance use disorder.  A lot of times this is not discussed, but it is starting to get more attention.  In the past, depression and substance use disorders have been treated in different places, and that has caused a lot of frustration, because treatment for one can help with treatment for the other.  Sometimes it is hard to determine what came first.  Was the person depressed, and then started to self-medicate with a drug?  Or, was the person self-medicating and then got depressed?

Regardless of how it happens, the important thing is to recognize that these things can happen at the same time.  As always, it is super important to remember to treat the entire person, not just the most obvious problem.  We need to demand that treatment for depression and treatment of a substance use disorder can be done at the same place and at the same time.  We need to understand that substance use disorders are common in mental illness.  Lastly, we also need to understand that like mental illness, substance use disorders are NOT a sign of bad behavior or choices, but is also a real group of illnesses.

Happy ALL of the Time?

While I can’t speak about the rest of the world, here in the United States it seems like we are obsessed with “being happy”.  We want to be happy, and we want those that we care about to be happy too.  What exactly does “being happy” mean?  I think you can find many different answers for a definition, but part of that definition seems to include the idea that we should be happy all of the time.  Today, I want to share that I think being happy all of the time is not realistic, nor is it healthy.

In the recent history of my life, I have been bothered by the idea that I am not happy all of the time.  Why shouldn’t I be happy I ask myself – I really do have it all in most respects.  But, try as I might, I get sad or angry or mad, and it happens more than once a week.  Then, when I haven’t “been happy”, I have felt bad about not being all sunshiny all of the time!  And so the downward spiral goes.  However, I am starting to recover from this.

It’s time to get real.  Being happy all of the time is not ideal.  We are all humans, and we all have a wide array of feelings.  As long as we are not hurting others or ourselves, it is ok to feel what we feel and roll with it.  We all need to lose the pressure to be happy all of the time, because life is simply not built that way.  So, give yourself the permission to feel what you need to, and be happy when it makes sense to you.

If you are dealing with depression in any way, no doubt the pressure to “be happy” is way larger than what the rest of us face.  But, the same goes for you as well.  You will be happy when you can.  It can take time to get into recovery and feel some joy again, and that is ok.  No one should pressure you to just “be happy and get over it”.  Let’s all give ourselves a break, and let’s just feel the variety of emotions that humans were meant to feel.