The Importance of Addressing Phase of Life Issues in Depression Treatment
Major life changes can have a deep impact on your emotional wellbeing, including triggering or exacerbating depression. Exploring these phase of life issues is essential to understanding their relationship to depression and contextualizing your experiences. In order to find true recovery from depression in the presence of these issues, treatment must address them head-on and give you the support you need to cope with your changing circumstances.
Robert had never been depressed before. At 65, he was still as active as men half his age, and he was known for his adventurous nature and easy laugh. Then came retirement. “I thought after 30 years of working, retirement would be a welcome change,” he says. But without a routine and the sense of purpose he had gained from his job, Robert gradually fell into depression in the year following his retirement. However, he didn’t readily identify his emotional state as a true mental health disorder for some time. “I thought I was bored. I thought my short fuse was a rational reaction when things went wrong. It took me a long time to recognize that what I was experiencing was depression.”
For Julia, on the other hand, depression wasn’t new. She had struggled with the disorder since her early 20s and had some success with treatment. Many of her symptoms decreased in severity once she started taking antidepressants, and she generally felt that her condition was under control. Then the divorce happened. “I was 35 at that time, and it felt like the floor dropped out from under me,” she remembers. “My depression spiraled and became so severe that it was out of the reach of my normal antidepressant treatment.” For Julia, the stress of the divorce itself and the aftermath triggered her mental illness to grow vastly in intensity and added new layers of suffering that went beyond anything she had previously experienced. “I realized quickly that I needed more than was available to me on an outpatient basis,” she says. “I needed all the help I could get.”
Phase of life issues such as retirement and divorce can have a profound impact on depression, whether it triggers new or existing mental illness. Due to the central role they can play in experiences of depression, it is therefore critical to address these phase of life issues in depression treatment. By exploring how such issues affect depression, you can gain a greater understanding of the effects these events often have on the development of mental illness—and how you can move toward healing.
Exploring Phase of Life Issues
Phase of life issues arise as you enter a new stage of life brought on by either the natural course of aging or specific disruptive events that force you to live in a new way. While some of these stages may be positive turning points, others can be deeply painful, disturbing the way you see yourself and relate to the world around you. When phase of life issues become overwhelming, they can contribute to the development of depression, or significantly exacerbate existing depression. Common phase of life issues include:
Divorce can change your life in both practical and emotional terms. Regardless of whether you or your partner initiated the divorce, the loss of a partner and the reality of living as a divorced person is often profoundly disorienting, causing significant psychological distress. Conflict related to divorce proceedings and child custody issues, loneliness, financial stress, potentially losing friends, redefining yourself as a single person, and coping with the causes of marital breakdown can be overwhelming and push you into a depressive state.
In many ways, divorce is an ending—not only of your current relationship, but of your present identity and your vision for the future. As such, it tends to fuel a grieving process not unlike what is often experienced after losing a loved one. “Most people going through divorce experience some degree of situational depression as part of the normal grieving process over all the losses the end of a marriage brings,” says one divorce coach who specializes in guiding people through the divorce process. “If not dealt with properly, situational depression can linger for much longer than it needs to.” Unfortunately, many people attribute the depression after a divorce to natural grief, failing to recognize that their feelings run deeper and require mental health treatment.
Death of a Spouse
The death of a spouse is one of the most difficult experiences most people will go through. Whether their passing was sudden or expected, finding yourself without your partner can cause profound loneliness, sadness, and even anger as you struggle with your new circumstance. As the National Institute on Aging explains, “When your spouse dies, your world changes. You are in mourning—feeling grief and sorrow at the loss. You may feel numb, shocked, and fearful. You may feel guilty for being the one who is still alive.” These emotional experiences can be accompanied by a host of physical and even cognitive symptoms, including sleep disturbances, loss of appetite, and concentration difficulties, both reflecting and further exacerbating your psychological distress.
While mourning the death of a spouse is an inherently painful process, that mourning may go beyond healthy grief and trigger depression, sometimes expressed as complicated grief. Researchers have found that this is particularly true for older people and women. Unfortunately, many people fail to recognize their symptoms as depression, believing them to be natural reactions to the loss of a partner, thereby missing opportunities to get the help they need to heal. “Spousal loss should spark extra energy in terms of exploring the possibility of major depression,” says Dr. Robert B. Wallace, co-author of a study suggesting that depressive symptoms after the death of a spouse are both common and often durable. “We always need to be looking out for it.”
Retirement is often considered the beginning of the golden years, a time when you finally have the freedom to enjoy the fruits of your labor. For some, however, retirement can be fraught with emotional turmoil for a number of complex and often overlapping reasons, including boredom, financial strain, loss of purpose, and changes to your sense of self. “For a lot of [people] it really is a loss of a sense of identity—something that we get from work,” explains Marnin Heisel, a clinical psychologist and associate professor at the University of Western Ontario. “For a lot of [people], they lose that social network and social connection [that comes with working] … and the meaningful contribution they get out of what they do.”
Indeed, researchers at the Institute of Economic Affairs have found that retirement increases the risk of clinical depression by 40%. Their findings also suggest that people who truly enjoyed their jobs, as well as those who experienced sudden retirement due to job loss, appear to be the most vulnerable. However, depression often doesn’t start immediately upon retirement; many people experience “high levels of satisfaction directly after retirement,” only to see those levels fall over time.
Empty Nest Syndrome
Parenting isn’t always easy; raising another human being to adulthood is a difficult project, placing overwhelming demands on your time and emotional resources. However, for most parents, the work of parenting is also accompanied by deep joy and purpose, and when your child leaves the home to take those first steps toward true independence it can deeply disrupt your psychological well-being and even your most fundamental sense of self. “I was really surprised by how absolutely bereft I felt when [my children] left,” says one woman. “I have always tried to keep my identity as a person as well as my identity as a mother. It wasn’t just that I missed them, it was a feeling that I had moved into a different phase of life. Despite having several part-time jobs and plenty of interests, my primary identity was being a mother.” As one mother writes in a moving article about empty nest syndrome for The Independent, “It’s a horrible, queasy feeling. Other mothers describe the same kind of visceral wrench: a hand goes to the heart as they say they feel bruised, ill, hollow, empty when a child leaves home.”
While it is natural to struggle to some degree with the changes that come with having an empty nest, for some, this struggle can fuel depression. This may be particularly true for women and stay-at-home parents, whose sense of purpose is often deeply tied up in parenting. However, anyone with children can experience depression as the result of empty nest syndrome.
Health is perhaps our most precious resource. Due to the extraordinary impact health issues have in our lives, chronic illness can thus deeply disrupt both our practical abilities and our emotional wellbeing. “You may be facing new limits on what you can do and feel anxious about treatment outcomes and the future,” explains a writer for the National Institute of Mental Health. It may be hard to adapt to a new reality and cope with the changes and ongoing treatment that can come with the diagnosis. Your favorite activities may become harder to do.” Indeed, chronic illness can fundamentally change the possibilities that are open to you, provoke deep anxiety and fear, strip you of a sense of self-determination, and change the way you think about yourself.
While for some, these feelings are temporary, for others they persist and develop into or augment depression. In fact, depression is one of the most common comorbid conditions for people who have a chronic illness, affecting approximately “one-third of people with a serious medical condition.” Additionally, people who have a chronic illness and comorbid depression typically have more severe symptoms of both than those who have just one illness, severely impacting their quality of life and even prognosis. As such, it is imperative to recognize depression as soon as possible in order to potentially decrease symptom severity and improve treatment outcomes.
Addressing Phase of Life Issues in the Treatment of Depression
If you are experiencing depression, seeking professional help is the most important thing you can do in order to find relief from symptoms and create recovery. Today, there are more treatment options available than ever before, opening up new paths to healing and giving you a multitude of opportunities for regaining psychological wellbeing. However, when designing a treatment plan, it is critical for clinicians to take your unique circumstances into account in order to allow you to derive the greatest benefit from the treatment options available. For people whose depression is associated with phase of life issues, this means addressing those issues head-on during the recovery process.
While psychopharmacology is often a critical part of the depression treatment process, addressing phase of life issues must be done through a variety of psychotherapeutic, holistic, and experiential therapies that allow you to deeply explore significant life changes and understand how they affect your experiences of depression. With the guidance of experienced clinicians who understand the relationship between phase of life issues and mental health disorders, you can better recognize the impact of both on your life and the connections between them. This insight can help you develop effective strategies for coping with your complex emotions and disrupting damaging patterns of emotion, thought, and behavior to foster healthier ways of moving forward.
For many, group therapies are particularly helpful for addressing phase of life issues. Painful life changes have a way of isolating you, making you feel separate from the world around you, even when those changes are shared by many others. In therapy groups, you have the chance to connect with people who understand what you are going through, often because they too have experienced the same changes you are facing. In a warm, nonjudgmental environment, you can give voice to your pain, sorrow, and fears while experiencing the support and learning from the wisdom of your peers. This can have a profound impact on the way you see yourself, express yourself, and feel at home in a broader community.
One of the most important things high-quality depression treatment can do is give you the opportunity to redefine yourself. One common thread that runs throughout phase of life issues is the way they can impact your sense of identity. In helping you rediscover your passions, purpose, and joy, mental health treatment can help you not only find acceptance of your new circumstances, but open up new possibilities for finding your place in the world.
Bridges to Recovery offers comprehensive treatment for people struggling with mental health disorders and phase of life issues. Contact us to learn more about our renowned Los Angeles and San Diego-based programs and how we can help you or your loved one start on the path to healing.