This particular event last Saturday was sponsored by the Mayo Clinic and featured some of the foremost experts on the management of depression.  As I listened to one speaker I was convinced everyone should be on medications.  Then the next speaker would have me thinking if we just could get everyone in counseling that would be awesome, followed by a presenter who convinced me self-care was the best approach, and so on and so on. 

As I think about myself currently, I am not suffering from depression, I am satisfied with my life, I am well-educated about the various approaches to managing depression, and in general I describe my overall well-being to be very high.  And yet I remain confused and constantly questioning the “evidence” for managing depression.  As I watched and listened to those in the audience who are depressed, anxious, frustrated, not particularly content, frightened, angry, etc about their experiences with depression I can only imagine how overwhelming this landscape of treatment options and approaches must be.

For example, if you seek care from a Medical doctor (i.e. Psychiatrist or Primary Care Physician) you are likely to get prescribed a medication, if you seek care from a Therapist/Counselor (i.e. Psychologist, Social Worker) you are likely to get told you need to go to counseling on a regular basis, if you seek care from a spiritual advisor you are likely to get told you need to work on your connection with the God you believe in, if you read books or magazines geared toward the physically active you will read that exercise is the answer, if you speak to a nutritionist or dietary expert you will be told you need to be acutely aware of the food you eat, if you seek treatment from a person who practices from an Eastern Perspective you will be told that you need to consider acupuncture, relaxation techniques and diet.  If you call us at Face It we will tell you that you need to consider speaking to others who have successfully addressed depression or attend one of our Peer-based support groups.  I get overwhelmed just reading this.

The point of this list is that there is not a BEST way to treat depression.  All of the approaches above have evidence that they work and all have evidence that they are not so helpful, the problem with this of course is that evidence is rarely discussed and not published.  For some people medication has saved their lives, for others a new exercise regimen has saved their lives, for others their experience with a counselor has saved their lives, for some a new friend who understands and been through depression has saved their lives. 

The point is that you have several options and you need to work with someone who understands this and who will support AND encourage you to create an approach that is balanced and helpful to you!  The problem, as I see it from the professional perspective is that professionals have biases that at times get in the way of their willingness to acknowledge their training and expertise just might not be the answer for you.  This attitude is very damning, especially for those of us who understand the shame and embarrassment so ingrained in our thoughts and moods when we are depressed.

In your journey to overcome your depression, I would recommend it is best to align yourself with a professional who is not only knowledgeable about the various options to treat depression, but who openly and wholeheartedly endorses an approach that is multi-faceted and is designed with your beliefs, needs, and wants as critical components.  And rather than being overwhelmed by the large number of approaches to managing depression, recognize you have options, which is a good thing!

Take Care!
Mark

And then one morning I woke up and it was like my whole world had been turned inside out, spit on, and kicked around.  Everything I described feeling in the paragraph above was now dialed up several notches.  Getting out of bed was a chore, crying like a baby was the norm, not eating, not sleeping, and fantasies about suicide were a constant companion.  Obviously I was in a full on battle with depression.  And yet I didn’t know what was wrong with me…

We get calls here at Face It from guys all the time who ask, “What is wrong with me?”  That is one of the nasty aspects of depression; most of us have no idea what it is, what it feels like, what it looks like, or what it does to us.  And even though for me the struggles I had that led up to a pretty defined onset of depression, many people never have this happen.  Many guys with depression live in chronic funk.  Not happy, not satisfied, sort of angry, not feeling good about who they are…just an ongoing state of “disrepair.”  And then in this scenario so many men come to assume this is how they are suppose to feel. They start to make choices, like working too much, drinking too much, avoiding their feelings, ignoring their families all which lead to more problems.

A critical component of our Mission Statement is Education.  If a guy learns that what he is dealing with is depression, well then he can make a choice to do something about it.  Please help spread the word about what depression is, so when a man is suffering he can begin to understand how to address it.  For more information on signs and symptoms of depression in men click here.  And remember you can always reach out to us here at Face It.  Take care!

Mark 

Other things that I have read and heard about Mr. Seau was that he was a true warrior when it came to playing football.  The guy play injured, the guy played the game at a 100 mph, and his position at linebacker demanded that fear simply not be shown.  Yet somewhere in his soul he was haunted by demons.  If he was suffering from depression, which by all acounts he may have been, than most of you who follow us here at Face It probably have a sense of what he lived with.  On the outside Mr. Seau was as tough as they come and on the inside he was alone with his thoughts of worthlessness, hopelessness, and despair.  If you met him on the street he would probably have shook your hand, offered up a kind smile, and listened to you talk about your memories of him playing football…all the while telling himself that he was a burden and those nearest and dearest to him would be better off if he were dead.  Doesn’t make sense, does it?

Where do we go with these tragedies?  What do we do with them?  Well what I heard today was an effort by many to bring hope and awareness to the issue of male depression in light of a horrific tragedy, like Paul Allen on KFAN.  Junior Seau does not have to die in vain.  Out of Junior Seau’s death we can all agree that enough is enough when it comes to this b.s. that men don’t get depression.  The notion that men don’t get lonely, that men at times are afraid, that men at times are as lost with what to do next with their lives, and that men suffer sadness, loneliness, and yes they even cry.  I just looked at my calendar and it is 2012, not 1958. 

Junior Seau was hurting and I am quite certain that somewhere in his brain he just felt like he couldn’t ask for help.  He probably perceived that he would be ridiculed, mocked, and been turned away by his friends.  Probably not, but that is what depression can do to you.  I heard grown men (football players mind you) crying on the radio today begging for a chance to go back and tell Junior that they were there for him, that they wanted to help him, and that they would do anything to have him alive.  The lesson we have to learn is that when you are struggling and whether that is from depression, loneliness, or the fact that life just feels kind of shitty, there are people who care.  But the bigger lesson is that those of us who are not struggling have got to be tuned into the needs of our friends and loved ones.  You never know what your kind words, your effort to get your buddy out on the golf course, or just your friendship letting him know that it is okay that he is struggling might do for him.  If I have heard once, I have heard it thousands of times…guys with depression feel alone.  We can do something about that and by reaching out you just might prevent another tragic death, like that of Junior Seau.

http://www.youtube.com/watch?v=tAwdeGr19v4

Recently I had a conversation with a couple of executives from a health care company.  We were debating the merit of using peers (e.g. men who have lived with depression) to aid in the treatment of depression.  One of the executives was fairly skeptical about the value of this approach despite clear research supported evidence that peer support is critical.  After the meeting ended I was feeling a bit frustrated (and annoyed to be truthful), so I started poking around in the research a bit deeper.  As a faculty member in the school of medicine and school of social work at the U of MN I know that unless I can produce some study related data, I will often have a hard time making my case.  With that said, it is fairly intuitive that helping others is going to help you feel better about yourself.

As I dug around I found a report titled: “Building Peer Support Programs to Manage Chronic Diseases: Seven Models for Success”  This 2006 report authored by Dr. Michael Heisler overwhelmingly supports the importance of using peers to aid others in their journey with chronic diseases, such as depression.  I came across on paragraph in particular that I think those of you who are battling depression should read very carefully.  It reads;

“There is also growing evidence that providing social support to others may result in health benefits comparable to, or even greater than receiving support.  Individuals who provide social support through volunteering experience less depression, heightened self-esteem and self-efficacy, and improved quality of life”

I know when you are in the midst of feeling depressed the idea of helping others is hard to imagine.  But just like all the other work you must engage in (exercise, counseling, connecting with loved ones, medication, etc) to overcome depression this is yet another tool that can help you.  You don’t have to save the world or volunteer your time every day of the week, but you can send an email to a friend, pick up the phone and call a family member, or offer up a “hello” to a stranger on the street.  These simple behaviors can be critical in your ability to overcome your depression!

So?  I did what we ask men to do everyday single day and that is reach out and talk to someone.  I told myself that I have just as much right to feel vulnerable in the world as the next guy and that it is good to talk these feelings through.  I texted with a friend who pointed out to me that the work of Face It is important.  I had coffee with another friend who reminded me that “Rome wasn’t built in a day.”  And I looked into my heart and head and reminded myself that more often than not I am not in control of the world around me, but with honesty, support, and work I will likely be just fine.  I get how hard it is to admit that you are struggling and this morning when I found myself in tears at a coffee shop I initially felt embarrassed and weak.  But guess what?  I, like all of you guys out there struggling, am only human.   Feeling vulnerable is hard, but by talking to someone about it you realize you are not alone!  Have a good day.

Mark

As we talked the first time it appeared pretty evident to me that John was doing quite a bit to help himself.  He was speaking openly to his wife, he was going through his daily ritual of being mindful, he was exercising, using his therapist, taking his meds, and he reached out to me.  John has a pretty stressful job and with kids who are busy you can quickly recognize that John’s plate is full.  As we talked, John was saying things that made me realize that he was concerned that he was right on the edge of falling back into a deep depression.  I could sense that John was thinking all this work he had done, the good days he had been experiencing for months, and all his progress was about to be lost.  I shared with John that after I started to feel better, which took me about 1-2 years following my hospitalization that I too was always concerned that the return of my depression was imminent.  I mean it scared me to death!

So as John and I talked more he began to gain back his perspective and realize that he was under a lot of stress and he was definitely not feeling the greatest, but he wasn’t going to lose all the momentum he had made.  John just really needed to vent a bit and have someone else assure him that a bad day or even a string of bad days doesn’t equal a return to depression.  So today as John and I talked he told me that just getting together a couple of weeks back was tremendously helpful to him.  What I did for John was try to be a good listner and then help John to see that he was in more control than he was giving himself credit for.  John has worked hard to gain some new coping skills and he is perfect proof of how valuable those skills are when the good days turn a bit darker.  John’s coping skills you might wonder…are using some mindfulness techniques to help him stay in the present and not stress over the things he can’t control, exercising, and in this case reaching out to a friend.  Way to go John!

I know that asking others for help goes against the grain for many of you and I know that the thought of sharing your feelings and emotions with someone probably seems like the last thing you want to do.  But here is the deal, if you wait to “just get over it” or if you tell yourself to “just try harder” without some sort of support and feedback, I suspect you will continue to struggle.  Depression pretty much robs you of your ability to see the world as it really is and often the harder you try to just get over it the worse it gets.  I am not telling you that you have to run out and go on an antidepressant or sign up for counseling, but I am telling you that asking for help and getting an outside perspective is critical.

A couple of things you can do real easily.  First, look around at our website where you can finds all sorts of good information about depression and its treatment.  Second, think of a friend you trust and ask him or her to help you get started.  Third, email us here at Face It (mmeier@faceitfoundation.org or info@faceitfoundation.org) and we can help you with other resources and ideas.  Depression is complicated and the longer you ignore it the more complicated it tends to get.  I know admitting you’re struggling is hard, but living with depression is much harder.  Start 2012 with a push for a better life and start it today!

Mark 

 As 2011 comes to a close, I find myself reflecting back on the last twelve months.  I cannot help but try to put a value on my life.  Money and material things are important but I don’t think that is how we put a value on who we are.  How do we evaluate our lives?

As I think about it, the answer became clear to me.  I think we should judge our life on the number of experiences we have.  Please let me take a minute to explain this new, exciting revelation of mine.

I believe that our lives are made up of experiences.  These experiences happen in all shapes and sizes and we just never know when the next experience will come our way.  In fact I like to think of each experience in my life as a tree in the forest.

As you may know, Mark and I took a cross country trip this summer to raise awareness of depression in men.  That was an amazing experience for both of us.  I see that experience as the trunk of the tree.  As I reflect back on it I realize that a lot of things have come along with that experience, I will call them branches.  There are branches of the new friends I have made because of this experience.  There are branches of support from friends and family that believed in me and what we were trying to accomplish.  There are branches on this tree that I didn’t expect,  that represent how the journey had changed me forever.  There is also a branch on that tree for God, who I know was with me over those three and a half months on the road.  Of course the very first branch that appeared is a real strong and sturdy branch.  It makes me think of my cousin Mark.  It shows me the strength and determination to takes to make a difference in our world.  It is a branch that I know will always be there.  It really is an amazing tree but it is one of so many in my forest.

 I like to look at other peoples trees as well.  I think about my friend Scott that has a new son.  Having his first child was an amazing experience, or trunk of his tree.  From that one experience has grown so many branches.  I bet there is a branch that makes him realize that he could never imagine loving something as much as he loves his son.  There are so many branches of his son’s first steps, his first word and many more.  Over time this tree will grow big and strong right along with him, there will be so many more branches.  Not all the branches are good though.  Scott has had some very tough times with custody battles but they are all still part of that particular tree…not every tree is perfect.  Knowing Scott, this is by far the most special and beautiful tree that will ever stand in his forest.

 I look back at my friend Monica’s forest and see a tree just getting going.  The trunk of this tree isn’t as strong as some but it is still a very special tree.  I know that over time, this tree will grow to be big and strong just like the others.  Remember that a tree can grow by itself but the strongest tree, the best trees need some care.  With her love, compassion and drive this tree has branches starting all over it.  I can see a branch of perseverance and patience.  Another branch of all the support she didn’t know she had.  They too have branches of first smiles, steps and words.  Monica should look back at this tree with pride because this experience has helped make her the very special person that she is today.

Not all experiences are good ones…but don’t give up.  This summer I experienced pain when a friend took his own life.  That experience is another tree in my forest.  That trunk doesn’t look very good at all…until you start moving closer.  If you get right next to that tree and look really close you can see signs of life, just like in the spring when my wife Wendy’s flowers come back to life after a hard winter.  Although they are just starting, I can now see branches are on their way.  I will have a branch that will be the new friendships that have come with Brad’s family.  There is a branch that motivates me to work harder to make sure people know that they are not alone.  There is a branch that shows me just how fragile life is and how we need to reach out to those closest to us.  I see the start of a branch that tells me the God has a plan for all of us.  I am not sure what to expect from that branch but I trust it no matter what.  This tree isn’t a lot just yet, but give it some time.  Give it some sun and some water, I expect hundreds of new branches on this tree very soon and it will be as beautiful as all the others.  Finally, this tree has one very special branch on it. I received a very special ornament from Brad’s mother recently and I will be able to see it hanging on that branch, right in the front, each and every year at Christmas.

So I ask you..How full is your forest?  I bet there is still plenty of room for a few more trees.  Live life to the fullest, look for experiences and remember that no matter how a tree starts out it can still grow up to be something amazing if we just look close enough.

When my time here on earth here has ended, I hope…NO…I WILL look back on a beautiful full forest.

If I had one wish it would be that you spread this story on to everyone you know.  There is someone out there that feels worthless, sad and unimportant.  I want that person to read this story and take a real good look out at their forest and I bet they will see more trees than they ever imagined.  Hopefully they will see some great trees as well as some that on their way to becoming special as well.   Seeing good in our lives can be very difficult at times, reach out and help your friends and family see the trees they have.  You just might help them end 2011 feeling good about themselves.

May each and every one of you have a very Happy and Healthy New Year.

Bill…..