The Stress Doc Letter
Cybernotes from the Online Psychohumorist ™

May 2000, No. 1, Sect. 2

Main Article

The Stress Doc presents systemic/job loss contexts and bio-psychosocial dynamics that both differentiate and interrelate natural grief and mood disorder warning signs. Also, he closes with some inspiring and instructive "F"s for harnessing the pain and passion along with the growth potential of loss and change.

Stressful Contexts for Turning Grief into Depression: Part II

Part I of this series, "Good Grief: Is it Mourning or Is It Depression?" (Stress Doc Newsletter, APR 2000, No. 1, Sect. 2) examined the fine line and conceptual confusions between grief and mood disorder. The essay also outlined the stages of grief. In the past two years, based on my workshops with reorganized and unemployed professionals in career transition, here are seven bio-psychosocial dynamics and role contexts that may help differentiate natural grief from morbid melancholy. While mostly compiled with workshop students in mind -- many of whom are refugees from the volatile engineering and high tech fields -- it’s clear the distinguishing factors deepen and darken an array of loss and grief encounters. This listing also provides depression warning signs; more than just grief clouds are in the picture.

1. Sleeping on the Job. One vulnerable group are high tech employees caught up in the mercurial, "24/7" IT work environment, especially those who literally stay at work around the clock. Not only are these folks exhausted from the hours and demands, but too many truly don’t have a life. Friends and family, relaxation and recreation are forever on the back burner. And when suddenly informed that their contract is over or the project is completed and services are no longer needed…talk about an implosion. Now exposed on the front burner is the beleaguered employee’s burnout process which has been simmering and eroding from within. There’s no spare energy and emotional resources to withstand the termination blow. Not to mention the sense of injustice and outrage: "How can you make me a sacrificial lamb after all I’ve given to the company, after all I’ve sacrificed in my life for you." (As we indicated earlier, burnout is less a sign of failure and more that you have given yourself away.)

Often the most important lesson of this burnout-depression trauma is that, "Life Is Not Fair." Ultimately, we must learn to stand up for our psychological integrity and physical health. If we don't, the risk is predictable: the line between grief and depression can be too readily burnt into oblivion.

2. Breakup of a Marriage. Being confronted with an additional major trauma, for example, both losing a job and the dissolution of a key relationship, will also grease the grief to depression track. For years research has shown that the more change-related stressors experienced in a time-limited period, the greater likelihood of some physical illness or mental disturbance. Not just a layoff or downsizing but even positive changes such as a promotion can heighten stress: higher performance expectations, new authority roles or collegial relations, etc. Too much change, too fast can induce a feeling of being overwhelmed, a feeling of being out of control – "future shock." And if these vulnerable feelings persist, the shaky/quicksand ground can quickly turn from "The Big Muddy" to having you trapped in "The Big Moody."

3. Past Traumatic Loss Experiences. One of the consequences of prolonged or sharply acute stress is a wearing down or the sudden snapping of our psychological defenses. These defenses keep memories of painful events and the concomitant disturbing emotions out of everyday consciousness. When cracks develop in your defensive armor brought on by the stress of loss or separation (such as losing a job or mate) then past associations to previous losses, abandonments, rejections get stirred. Now a judgmental boss in the present starts more consciously reminding you of a former harsh supervisor, or perhaps a critical parent or a devaluing spouse. Especially if these past hurts and humiliations have not been sufficiently and successfully grappled with and grieved emotionally the result, again, is a depression predisposing mourning process.

4. Battered Employee/Spouse Syndrome. Sometimes an employee (or spouse) who has been subjected to a pattern of verbal and emotional trauma (not to mention physical abuse) does not know how to set limits and fight back, or does not believe that leaving the abusive scene is an option. This person is definitely vulnerable to helplessness, worthlessness and passivity. In the work setting, when management does not believe they can force out an employee, or they don’t want to directly fire the person for fear of legal consequences…an insidious game may ensue. The targeted individual may be subjected to subtle forms of hostility by management or by a management surrogate. Perhaps management tolerates or ignores the baiting of the employee by colleagues. Even when the harassment seemingly isn't blatant it can be a legal issue if management should have known about the harassment and interceded. However, taking companies to court still can be another "holy grail" quest. Any of the above scenarios can break down an individual’s will, spirit and health.

And when an embattled employee hangs on trying to fight the system without sufficient financial and legal resources, the result, too often, is a greater deterioration of his or her physical and mental states. Once the proverbial backbreaking straw event occurs through trumped up dismissal, outsourcing or from the employee finally giving up the fight the endgame is predictable. Grief is overwhelmed by "battle fatigue" or the individual collapses in a heap of depression.

5. Illusion of Security and Age Anxiety. In a rapidly changing, paradigmatic shifting economy – from the industrial to the informational/high technical – all folks but, ironically, many early computer trained or science degreed professionals may find themselves frighteningly out of date. Having created a seemingly secure position, for example, evolving mainframe expertise, once laid off these professionals suddenly feel like they’ve been dropped off on the moon. Compared to when they were last doing job exploration, the current IT field, gravity and atmosphere is so profoundly different. It literally is a shock. First there are the unanswered telephone calls and resumes mysteriously lost in the job listings black hole. Then there’s the constant refrain: "You need to upgrade your skills and certifications."

Of course, this scenario is a bit less daunting than the one for a basically middle aged computer virgin; just the thought of becoming computer literate can throw such an individual in a phobic or panic state. And, not surprisingly, age is a significant job/career factor even for those not technophobic. Frequently, a number of old timers in the computer field or (or post-40 year old newbies to IT) bemoan age discrimination in what’s increasingly perceived as a Gen X run world. Once again, when psychological, educational and socioeconomic forces are conspiring against you (or are perceived as such) the boundary line quickly dissolves between grief and depression.

6. Multiply Downsized. A particularly at-risk individual is the member of the increasingly large horde known as the "Multiply Downsized." This creature is fen found in the engineering, aerospace and rapid startup-rapid fold IT industries, as well as in an array of government agencies. After awhile it appears this employee’s main mission is as a statistical artifact in a restructuring process. Of course, some folks who have survived several layoffs or downsizings develop a thick skin – "been there, done that." Their transitional radar is finely honed and now the battle veterans know to jump ship before it crashes into the restructuring iceberg.

However, the almost universally vulnerable employee is the one who has left a hometown, sold the house, said good-bye to family and friends, moved alone or with family to a new section of the country for a "great opportunity"…and within six months the promised land/position has disappeared once again in the disorganizational black hole. This hole is more than unsettling; it's particularly dark and bleak. In fact, the person may not have fully grieved a previous downsizing (whether as organizational outcast or survivor) and may have been on the edge of depression before the latest transitional trigger.

7. Addictive Patterns and Depressive Propensities. Finally, two other susceptible classes of individuals for pathological grief are people who: a) routinely use addictive behavior – drinking, drugging, smoking, eating, cybersexing or "romantasy" obsessing," gambling, etc. – to avoid or numb painful emotions and difficult problems. This medical illness and/or escapist defense mechanism not only can be inherently toxic (for example, when abusing substances) but it impedes the chance for developing and shaping cognitive-affective muscles. Psychosocial maturation is retarded by a pattern of avoiding analytic, emotional and interpersonal problem-solving.

Invariably, an addiction process which may have blocked out existing depressive signs and bottled-up rage, or numbed low self-esteem, etc., is no longer able to shut out or deny the "no exit" separation trauma. You have to deal somehow with the loss crisis. (I suppose a deadly overdose is a tragic exception.) Psychological defenses and addictive escapes, as well as the grief process itself, are overwhelmed. Massive depression, psychiatric breakdown or withdrawal may quickly ensue, and

b) people with a genetic/family predisposition to clinical depression who are not receiving proper medical/psychiatric treatment. These folks tend to be acutely sensitive to loss, emptiness and abandonment, to shame, humiliation and rejection. A history of having difficulty directing and sustaining energy and attention, seemingly a lifetime of self-doubt, feeling like an impostor, procrastinating, not completing projects or meeting goals, running from commitments, etc., all obviously shed light on the aforementioned sensitivity and vulnerability. Again, the boundary between grief and depression most likely has rarely been demarcated.

So for significant numbers there’s a progression from grief to depression and, finally, with enough adversity and unending stress, the possibility of further descent into overt clinical depression. Obviously, when there is a genetic predisposition, the contributing factor to a mood disorder is not just external or environmental. However, it’s also true that chronic stress, untreated burnout or a prolonged and morbid grief process can either: a) bring out a latent genetic predisposition to depression or b) can adversely impact the workings of our biochemical and hormonal systems so that even as adults, without clear family history, a clinical depressive disorder can gradually build then "suddenly" emerge full blown.

Clearly, a multi-pronged bio-psychosocial intervention is necessary for confronting major loss, for tackling comprehensively situational or clinical depression. The intervention goal is to help the wounded individual gain the emotional stamina to embrace and evolve through the natural grief process. Some combination of individual grief counseling, support group, couple counseling or family therapy, medication, exercise, relaxation or meditation, diet, assertiveness training and career counseling or retraining may well be needed. My personal recovery motto is not for the faint of heart:

For the phoenix to rise from the ashes
One must know the pain
To transform the fire to burning desire!

Finally, a closing strategy for confronting loss and grief as well as situational and/or clinical depression. And the source of the inspiration shifts from the poetic to the alphabetic. By understanding the dynamics of distress, burnout, grief and depression and by applying "Practice Safe Stress" tools and techniques every day you will, for once, be proud to have earned an "F"...actually, six of them. May you successfully engage the path of "The Six 'F's of Loss and Change":

1. Shaking or breaking up life's puzzle; letting go of a familiar past, 2. Confronting and channeling the anxiety of an unpredictable future, 3. Grappling with a loss of identity and integrity, with a loss of self-esteem and pride...with a loss of face, 4. Exploring and generating new resources -- environmental, informational and psychological -- for evolving a new focus, 5. Seeking and being open to feedback, both challenging and affirming, such as a variety of TLC -- "tough loving care" and "tender loving criticism" -- throughout the grief and rejuvenation process, and 6. Trusting in higher power faith, from a belief in a transcendental power to the synergy and confidence instilled by participating in a vital support group or counseling/coaching relationship.

And next newsletter, a treatise on how these "Six 'F's" can help you grow from grief and...Practice Safe Stress!

Reader's "Higher Power of Humor" Section

[Ed. Note: Here are reader emails on "Cosmo Magic to Cyclothymic: Highs, Lows & States of Flow" and "Good Grief: Is It Mourning or Is It Depression? -- Part I" from the APR 2000, No. 1. The insightful and heartfelt quality speaks for themselves. Write on, dear readers!]

Subj: Bravo!

Mark, I just finished reading the latest installment of your stress-filled ponderings, aka newsletter. Very enjoyable and thought provoking. I sense a lot of heart and soul . . . blood, sweat and tears behind your words.

I will probably be reviewing the matrix quite a bit in the coming weeks or months. Hopefully, to allow myself to become more aware and conscious of "what makes me tick." I applaud your efforts to not only stare the beast in the eye but to turn that experience around and share it with the masses.

I sometimes wish there were a healing balm that could be applied to the corporate minefield that would allow for a restoration of an employee's ability to trust their employer as well as the employer's ability to find and nurture the inexhaustible talents of their workers. Perhaps it is corporate America that has thrust this nation into a throw away society rather than the fast food or manufacturing sectors.

I continue to anticipate the release of your long awaited book and if they mess up the deadline let me know, I would not mind being a case study for rage turned outward. LOL

Continue to enjoy the ride,

Brenda

Subj: About that newsletter

Mark: Well, your article on grief sure is timely. Tony leaves either Monday or Tuesday for the move to Seattle. He's getting his family packed up now as we speak (or read as the case may be). Sometimes I'm o.k. and others I just start to cry. Sob would be more honest. I mean, this man was part of my everyday life for eight years, in my life for nine. We would speak two or three times a day. We wrote my first book together. He taught me how to write. And most importantly, I suppose, I learned how to love. And I learned how love has so many variations on its theme.

I tell myself that while this chapter in my life is closing, another chapter begins. There is, after all, a continuation to my life. The book has not exactly ended. Yet, the loss of a primary person is so very powerful. To lose someone is feeling as though a very part of you has been torn away. Telling yourself someone else will come along is akin to telling a parent who loses a child that you can, indeed, have another. There is no consoling here. It's a healing process. And while this person isn't dead, the move represents the close of an era. How sad, how gut-wrenching, how relieving, how cleansing.

P.S. The writer of this letter (a colleague and personal friend) is taking applications. Requirements are: one male, grounded, available emotionally, physically and maritally; sense of humor, age compatible, self-sufficient, reliable, feminist, supportive, good sense of humor, kind, compassionate, sexual, and oh yeah, a democrat wouldn't be bad either. If interested, email me (stressdoc@aol.com) and I will forward it along.

Subj: Mark, Mark, Mark. . .

You are causing me hours and hours of intensive thought while I am supposed to be working. . .this is stress!

I need to say these things to you while I am thinking them. . .

Have you read the latest Psych Today about the new branch of Psychology forming from what was called Humanistic Psych blended with Flow theory science?

At Coastal we developed a very cool new genre of safety training videos called "Real Real Life's" that blend humor with training and a little slap stick comedy. . .you would LOVE them. They also repeat a mantra of AWARENESS, ATTITUDE and ACTION. . .that if nothing else comes across that does!

And that brings me to ZEN and our limitations when it comes to diagnosis and what we do to stop those cycles that have us all in and out of spiraling negative thinking and depression. . .I am so much more AWARE of my own internal voices at this point than I was 5 years ago, then AWARE that I can choose to reframe, to focus on what it is I want, who I want to be. I was gifted with lovely little "mother wisdoms" that passed on a paradigm of "personal change is impossible" like "A zebra doesn't change his stripes"--and my meditation practice and reading and practicing tell me otherwise. . .surprise, surprise.

When I make "those calls" and fail to get the response I want within an hour or so -- some people start obsessing BEFORE you do--if I can stop and hear those voices running through my head, name them--oh, look there goes fear, there goes the line that I'm not worthy, yup, there's that familiar, you've been abandoned -- then I'm on my way down the path to reframing.

Of course, beyond the awareness/naming and then the reframing. . .I have to do two more things: First, sit on my hands and practice patience until I can rework with my own fears and doubts AND then be willing to call back and ask questions, exposing my vulnerability, furthering the goal of replacing those fears and doubts. Information IS power. . .I am always relieved when the REAL reasons replace my own made up reasons--even if they are similar, there is a relief I feel from coming out of my own head and having reality affirmed one way or "the" other:) In any event, the "balance" you speak of is the magic key, isn't it? The peacefulness?

Okay, I've actually done some work in-between putting this together:) I hope you find some peacefulness in your "down" time, and don't manifest chaos to avoid the many fears. . .

By the way, what is the diagnosis for extremely low self-confidence. . .that's the one I need to design a matrix for! It's the skin I'm shedding, currently. AND, what is the diagnosis for anxiety I experience when sitting next to my 15 year old who is behind the wheel of my Mazda Navajo with her newly obtained learner's permit? That's a biggy these days too. Of course her answer to that is. . .Mom, just let me stay with Dad for a few months, will you:)

Later, Robyn

I was "surplused" in fall of 1996. The Monday after being let I go I immediately went to work finding a new job. After about 60 days of unemployment I found several new jobs. But that did not diminish the pain. I still truly feel that I wrestle with the shame and anger at being fired.

Sometimes I just have to let go of it. It is the book of Job. Sometimes you just have to honor God for the sake that God is God. That is, sometimes you just have to live with what happens. I know that I can never hurt the corporation as they hurt my own ego and pride. But as you say, at some point you have to see that there is some positive that comes out of it all.

Richard

Mark, You are good -- I'm going to be out of touch for 2 months -- and I don't know how long messages store--but I hope I don't miss your solutions. I'm an alcoholic with 20 years sobriety so drugs are out of the question for me. I've watched too many people end it by script drugs. But I'm really into solutions and -- Mark you are good.

G-d Bless Bettie

Subj: My Way

Mark, My most valuable lesson in life is that to progress I must take the abilities given and work with them, regardless of how tiny they seem, they are still my abilities and I can do it my way, not like the general public, but I can bring progress to my life and others just by using the tools I have. (And keep on keeping on until we obtain our goals.) Perseverance. I'll tell you my sad crybaby story when I get back. Certainly the Buddhist have the answer when they chant, "Turn poison into medicine."

G-d Bless and the Good Forces be with you. Will read you later. Bettie

P.S. Of course you can publish anything I say (Doesn't everyone want that?) :)

Hi Mark. I was reading your newsletter and I had to laugh, not at you but with you. In reading your info on "addicted to mood swinging," I felt like you were climbing inside my head and reading my mind, right down to that perfect girl fantasy, although for me it's the perfect guy who's going to make my life a fairy tale existence. In my normal life I don't really believe that, but for what ever reason, some guy triggers that response in me and I go completely into another mindset. If feels great and then quickly feels horrible. It's the obsessiveness I identify with. God I hate it when that happens and I swear that I will never do that again, but somehow it seems to have to run a cycle which usually ends up in hurt feelings for me big time. But the truth is I am never really presenting the real me any way and if I attracted someone when I was in that frame of mind, when that "high" feeling wore off, I probably wouldn't like him anyway. I hate feeling out of control like I get. I am not sure if "addicted to mood swinging" is a medical term or your term, but it aptly describes how I get. Some have called it ADHD. My present doctor calls it Bipolar II. But to me the cycle you describe is the same no matter what you call it, although for me it usually ends in rather severe depression, which feels almost self-induced by my need for the thrill. Anyway, it is always refreshing to hear a person who can fess up to what really goes on in his head and is not ashamed. There aren't many like you, as most people bury all that stuff so deep, even they aren't aware of what they do to their own lives, or the people around them. Take it easy. Really enjoyed the article! Linda

Hi Mark. As I reread your article, there were so many things of what you said that I too experienced. What really rung a bell with me was when I do get to feeling better when they get my medications right, I too can feel true compassion for others instead of irritation. And the thing about feeling humble, that's there too. It's a feeling like, OK I get it now, and it feels peaceful and good. But what I am starting to see is that these meds need to be readjusted more often than I would have thought. I thought that once they were right, than you were good indefinitely, but that sure hasn't been the case with me. I don't seem to consciously realize that it is my meds not working, I just sort of get into these mood swings where I feel totally out of control. I don't like the way I act at those times. I look at myself and have to ask who are you. Then the meds get adjusted and I am back to who I wanted to be and in control of my emotions and moods. Yes, if you feel it could help someone else to use my letter anonymously, then go ahead and do so. Take it easy. Linda -

Subj: Superb Article!

Good Grief: Part I Is It Mourning or Is It Depression?

Mark,You really did a great job on this! I've been living the process you describe for the last couple of years, and your description and analysis is dead on-target.

I really enjoy Camus and the line you quoted was a great help to me during this difficult period.

My use of a "whole corner of the possible" is not well understood by many of my friends and family members -- but is has been positive and lifesaving for me. I like myself better now -- and feel much more fulfilled in my work than I did as a driven business manager. When I first lost my job, I could not imagine my life without it! Now, I could never go back..........

"Once we have accepted the fact of loss we understand that the loved one [or loved position] obstructed a whole corner of the possible, pure now as a sky washed by rain."

I'm glad that things turned out well for your father in his career crisis years ago. You had mentioned that he was ill. How are things going with that?

Again, great job. Take good care...

My best, Tula

Wow-eee, what a time for me to get this letter, my father passed just 4 short months ago and the family is having a heavy over load about how he passed. its a long story but you can trust that i am frwding this to my mom and sister. how true are the emotions of feeling sorry and feeling your sorrow, my sister is having this problem which is added by her guilty feeling too, that she didn't go see my dad in nov. and he passed on jan 5,2000,,, thank you thank you for all your efforts to keep us sane in an insane world!!!!!!! in case you haven't been told lately, and I've only read the first of the 3 newsletter you just sent me, your doing a splendid job and i look frwd to more of your letters.

woooohoooo i just gotta read the next 2 letters from you,,,your new friend,,,cary

you have just been kissed, xoxoxoxoxoxoxox

Seek the Higher Power of Humor: May the Farce Be with You!

 Mark Gorkin, LICSW, known as "The Stress Doc" (TM), is the Internet's and America Online's "Online Psychohumorist" (TM). An experienced psychotherapist, "The Doc" is a nationally recognized speaker, and training and OD consultant specializing in Stress, Anger Management, Reorganizational Change, Team Building and HUMOR! His writings are syndicated by iSyndicate.co m and appear in a wide variety of online and offline forums and publications, including iVillage/allHealth, AOL/Online Psych and Business Know How, Mental Health Net, HRHub.com, Financial Services Journal Online, Paradigm Magazine an d Counseling Today. The Doc also leads his national "Shrink Rap and Group Chat" for AOL/Digital City and WebMD.com. Check out his USA Today Online "Hotsite" Website -- www.stressdoc.com . For info on his workshops or for his free newsletter, email stressdoc@aol.com or call 202-232-8662. Spring 2000, look for Practice Safe Stress with the Stress Doc, published by AdviceZo ne.com.

(c) Mark Gorkin 2000 Shrink Rap™ Productions