midlifedude

Man at midlife making second half matter

Archive for the category “mental health”

Intersection of Beginning and Ending

For the second straight day, I couldn’t get my mother on the phone and got no reply to my messages. The last time I called from work and left a message, I got a sick feeling. I knew something was wrong.

I called my wife Amy and told her to meet me at my mother’s apartment building, where we had struggled to move her a year earlier during a period of my mother’s physical health decline and struggle with a mental health disorder. At midlife, roles had reversed and we had become my mother’s caretakers and support system.

When we got no response to our knock on the door, dread came over me. We entered and found her dead on the bathroom floor, cause of death unknown. Though she had been experiencing health problems, they were more the nagging kind than life-threatening—until they were even more than that, suddenly.

It was a tragic start to a political campaign. Only five days earlier, I had registered in dontknockfront-cover_6283732Maryland’s capital of Annapolis as a Democratic candidate for state delegate. I had never told my mother I was considering running—our relationship had been strained during her time of unpredictable and volatile mental health, exacerbated by her stubborn nature and rebellious streak. I didn’t want to mention a political run until I was fully committed to entering the race and felt she was on firmer ground. I had planned to let her know I was in the race the next time I saw her. I never got that opportunity. I felt terrible I had never shared the news.

The profile story on my candidacy in the Baltimore Sun with an October 8, 2013 dateline coincidentally hit the newsstands the same day that Amy and I found my mother dead. That day, I was going to proudly present the article to my mother, my biggest supporter, as I broke the news to her about my candidacy.

I wrote about my mother’s political influence on me and the impact of her death on my nascent campaign in Don’t Knock, He’s Dead: A Longshot Candidate Gets Schooled in the Unseemly Underbelly of American Campaign Politics:

I credit my mother Sandra Sachs, a diehard liberal Democrat from Boston who had a fascination with the Massachusetts Kennedy clan, a devotion to other charismatic pols and a penchant for volunteering for campaigns, for getting me interested in politics…

The Sun article provided me a nice opening salvo. Now I just had to back it up with real action. That is, as soon as I could plan a memorial service for my mother, meet and make plans with funeral directors, coordinate with out-of-town family, untangle her financial affairs, launch the bureaucratic estate settlement process with the Register of Wills, negotiate with her landlord, make repairs to her apartment, sell her furniture on Craigslist, and move all her other belongings out of her apartment within three weeks. Not the ideal way or frame of mind to launch a campaign.

So the first month of my campaign was put virtually on hold while I dealt with my mother’s affairs and coped with the sudden loss emotionally. In a spiritual way, I felt Sandra Sachs with me during the campaign, watching over me as I traveled door-to-door and marched with people who were struggling day-to-day. It occurred to me that maybe it was fate that I was running at all. It was my mother who loved politics and took pride in identifying herself as a Democrat, the party of inclusion and champion of the vulnerable, with her roots as the daughter of Eastern European immigrants who settled in the gritty outskirts of Boston and who lived a hardscrabble, working-class life. She would have been proud, I thought, looking down. No one from my family had ever run for political office before. The Kennedys we were not.

My mother’s keen interest in politics landed her on Capitol Hill as a staffer for U.S. Senators Bill Bradley (D-NJ), who ran for president in 2000, and Daniel Moynihan (D-NY), no small feat for a woman who spent her initial post-college years in the 1960s into the 1970s raising kids, and then battled back from debilitating depression to gain a foothold in the workforce.

At one candidates’ forum in particular, at a large residential retirement community outside of Baltimore, I felt my mother’s presence with me. I eschewed my usual stump speech in favor of an effort to connect with the seniors on an emotional and personal level, as excerpted from Don’t Knock, He’s Dead:

“I have a good idea of the issues you have faced and your current challenges,” I told the Charlestown [Retirement Community] residents, “but not because I read it or heard a policy wonk or a politician talk about them. I know from personal experience, from trying to help my mother with problems the last couple of years of her life before she died, when her health was going downhill.”

I told them about my mother’s challenges with downsizing and finding appropriate housing; exploring assisted living facilities; searching for viable transportation when she couldn’t drive; navigating a poorly coordinated, frustrating health care system; determining finances; and finding social outlets.

I wasn’t aiming for sympathy, but nevertheless several of the attendees and my fellow candidates offered me condolences and said my speech was heartfelt afterwards. Once again, I didn’t know if my speech had earned me any votes, but I was proud that it was memorable.

Nearly four years later, following a dinner celebrating my daughter Rebecca’s graduation May 20, 2017 from the University of Maryland, Rebecca told me she was sad that Nana – my mother – wasn’t there to celebrate with us. Another prideful campaign sadly missed. Whenever Maryland plays the University of Michigan, often now that Maryland is in Michigan’s athletic conference, Rebecca said she’ll think of her grandmother, who took great pride in transcending her poor, neurotic family in working class Malden, Massachusetts to arrive at a beacon of rah-rah American collegiate life in Ann Arbor, Michigan, and who ingrained the “Go Blue!” Michigan chant in her grandkids.

And I’ll always think of my mother when I recall my run for politics, one of her other great loves.

Midlife Men and Divorce: Risky Business

For the capstone class – the 22nd! – of my 5 ½-year master’s degree program in clinical mental health counseling, I had to choose a narrow “clinical population” for a research project. Somewhat shamelessly, self-servingly and unimaginatively, I essentially chose myself: a midlife man who has experienced divorce.

The findings were not pretty for the divorced midlife’s male’s future, though I acknowledge I intentionally selected research that highlighted why this population would be candidates for mental health treatment.DivorceHeartPhoto

Research has come to varying and sometimes contrasting conclusions on divorce and midlife men (roughly age 35 to 60), and mitigating factors are difficult to account for. However, numerous studies have shown that midlife men who have experienced marital breakdown have had greater propensity to become depressed, anxious or develop other psychiatric disorders; abuse alcohol or drugs; suffer from higher rates of illness, earlier death and suicide; harbor anger; live with loneliness and social phobia; qualify for work disability; and experience lower levels of physical health, mental and emotional well-being, and happiness and self-esteem.

And the majority of time, men aren’t the ones pulling the trigger on divorce, which studies show is one of the most psychologically distressing events in life. Research indicates that wives frustrated by an inability to improve their troubled marriages may be more likely to end them, with one study concluding that husbands initiate only a quarter to a third of marital separations.

These are research-based outcomes of divorce that pose challenges for the midlife man:

  • Recently divorced men were more likely than other groups to receive psychiatric treatment and be prescribed medication for mental health disorders. One study concluded that major depression was nine times higher among men who had been separated or divorced compared to stably married and single men.
  • Remarriage in midlife brings with it a whole new set of complications and negotiations that cause stress, indicating that marriage alone does not prevent mental and physical problems. One study found that remarriage was associated with an increased risk of depression compared with men who remained divorced.
  • Men often rely on their wives for their social lives and support for their health and emotional well-being, as women generally have stronger social support networks. Without their marriage, men can become prone to social isolation and loneliness.
  • A common dynamic of divorce is “non-acceptance” of marital dissolution. The ongoing feelings of attachment are associated with depression. The reality for some divorced fathers is continuing angry disagreements with and hostility toward their former wife a decade or more after breakup.
  • Once divorced, men’s physical health can decline, as wives often assume a role for monitoring and influencing their partner’s health behaviors.
  • While women experiencing divorce were at higher risk for mood and anxiety disorders, men were at higher risk for new substance abuse disorders. One study indicated that divorced 46-year-old men comprised a disproportionately higher share of binge and heavy drinkers compared to other groups of the same age.
  • The mortality risk for inconsistently married men (those who had divorced and remarried) was more than 40 percent greater than for consistently married men, and men who were currently separated or divorced had a mortality risk 2.5 times greater than consistently married men.
  • Men who had been divorced had a higher prevalence of work disability many years after the initial divorce.

As for me, I was the prototype of the midlife divorced male: separated at 42 and divorced at 45 in an action initiated by my ex-wife, with two pre-adolescent kids. I also have remarried, and while my wife Amy has been a wonderful social and emotional support, as the research indicated about wives, the second union has inevitably come with some stress due to new family dynamics and inter-relationships, financial complications and psychological adjustments.

I have avoided many of the pitfalls of the midlife divorced male, such as substance abuse or physical health decline, but did not escape divorce unscathed. When first threatened with divorce and teetering on the brink, I suffered from depression that affected my appetite, sleep, energy level and concentration. I struggled with non-acceptance when the reality of pending divorce flooded me like an unstoppable tidal wave. I lost a big chunk of my social connections and outlets. Worst of all, it was hard not to feel like a failure at something so important, and as a letdown to my kids.

Researchers have come to different conclusions over whether such a thing as a “midlife crisis” really exists, or whether it is a pop culture phenomenon, especially for men. But there’s no doubt that midlife is the time men walk through the landmines of marital upheaval, and when they are most prone to its potentially harmful and long-lasting mental health effects.

 

‘Play the Whole Tape:’ The Struggle of Addiction

Alcoholic_AAMtgThe lanky young man with the tattoos took a break from his intricately-detailed pencil-sketching to look up from his art and turned to face me after I introduced myself to the group.

“Have you ever been addicted to drugs?” he asked.

“No,” I responded.

“Ever been addicted to alcohol?”

“No,” I said again.

“What can you know?” he mumbled with disgust and turned back to focus on his artwork.

It was my first day as a co-leader of a substance abuse therapy group, an internship for my clinical mental health counseling master’s degree as I make a career transition from public relations to counseling. The group leader smoothed the edges by telling the group members they can learn different things from counselors who had addiction problems and those who haven’t. The leaders with whom I have worked had substance abuse histories and can talk the language of the streets and drug culture; I can’t.

When a member glorifies the days of using, as those in substance abuse recovery are wont to do, one leader admonishes: “Play the whole tape,” meaning remember the misery that accompanied the action, the “ripping and running.”

Later in the session, the young man apologized to me and the group for his abrasiveness, saying he had discovered just before the session that a good friend from childhood had died by drug overdose. That type of emotional volatility and chaotic, unpredictable life is common among members.

In my two months co-leading and leading this three-hour-long group session, I have learned from members and have become more comfortable guiding and interacting with them. The members provide a fascinating window on life’s struggles and many life themes: redemption, commitment, determination, acceptance, grace, hope, resilience, courage, meaning, generosity, self-centeredness, self-destruction, temptation and despair.

Group members represent a microcosm of society: male and female; fathers and mothers; black, white and Hispanic; teenagers to seniors; those from childhoods of abuse, neglect and deprivation and others from relatively stable, caring families; workers and jobless; people doggedly seeking change and others going through the motions.

Some have been homeless, shunned by family members. Many have been imprisoned, and some still are dealing with charges that could result in jail time with any transgression. Some have risked their lives to get drugs, running dangerous streets at all hours, banging on doors of drug dealers. They have lost children, jobs, health, relationships, dignity, trust and respect over their addictions. Many have been through rehab before, but reverted to previous habits, some as soon as they exited. Their emotional lives have been engulfed with fear, shame, guilt, resentment, anger and damaged self-worth.

I don’t have any particular unique or profound insight into the scourge of addictive behavior and those who come under the influence of alcohol and drugs. I only have impressions as a person and professional new and fairly oblivious to this world. My biggest takeaway is that these individuals are not addicts, but people with addictions. In our society, we tend to apply labels to people that come with proscribed traits and characteristics, effectively straight-jacketing people into circumscribed boxes.

The experience has reinforced for me that addiction does not define the group members, a lesson I also learned first-hand when a roommate suffered a relapse. In fact, addiction is not at the core of their being at all. They are so much more than “addicts.” I appreciate the regular group members I have gotten to know for their sense of humor, loyalty, caring, openness, friendliness, raw honesty, suffering and commitment.

One woman exemplified the power of passion, hope and resilience – and the difference between those who truly accept and want to beat addiction and others who may be biding time – in an activity I led challenging the members to identify their strengths. Some struggled to come up with more than two; a few others declined to offer even one when called upon to share. But this woman, for whom the phrase “to hell and back” would apply, rattled off about a dozen assets. She appears to want recovery bad; her emotional pain is palpable. She has a medical condition that might keep others away, but she refuses to miss or give up. She’s a good person who got some raw deals in life and made some regrettable choices that sent her into a downward spiral, like many of the members, and she’s developing the courage to own it all. She is recognizing her worth as a human. She expresses faith.

I’m pulling and praying for her and the others to beat their addictions and find serenity and contentment, and hope I can be a positive influence, however small, on their recovery.

 

Thoughts on Struggle, Resilience, Gratitude and Grace

Counseling has given me a new perspective on struggle, resilience, gratitude and grace, at this time of year when we may slow down enough to think about these phenomegracena.

I’m working as a therapist intern at a mental health agency in Baltimore that serves low-income clients. Many have substance abuse problems. Some have been drug dealers. Some have spent time in prison. Many have been victims of crime or domestic abuse; some have perpetrated violent crimes.

Some have been homeless or evicted with no place to go, and some are on the verge of homelessness. Some are shunned by their families. Some were criminally abused or neglected as children.

All are struggling mightily, yet they have resilience. They want better. They want to overcome. They don’t quit. The question, however, is always: How motivated are they to change? When I think about resilience I’ve had to summon to face challenges, it doesn’t compare.

Many of our clients are on the margins of society, nearly invisible. Many have dropped out of the job market. Some want to return, but it’s a struggle to re-enter. Some have become isolated or reclusive, out of distrust or fear of failure, rejection or disappointment. They want independence, but it’s a struggle to get there; many have to lean on others for help. It’s easy to see: Once you fall into a hole, the climb to emerge can be arduous.

They are grateful for people who care about them, whether a therapist, a social worker or a friend or family member who stuck by them during difficult times when others didn’t. They are grateful for sobriety, kids and grandkids, and new chances.

Our clients inhabit a world and have lived through experiences with which I had no familiarity until my counseling internships. For the clients who have let me into their worlds and taught me about the enormous challenges they both inherited and created themselves, I am grateful. They have blessed me with a real-world education that books and classes can’t approximate. I hope I am providing a certain kind of education for them in return.

As for grace, Gerald G. May, M.D. described “living into grace” in Addiction & Grace:

“Living into the mystery of grace requires encountering grace as a real gift. Grace is not earned. It is not accomplished or achieved…It is just given.

“But living into grace does not depend upon simple receptivity alone. It also requires an active attempt to live life in accord with the facts of grace [which]…are simple: grace always exists, it is always available, it is always good, and it is always victorious…

“The risk, of course, is to my addictions; if I try to live in accord with grace, then I will be relinquishing the gods I have made of my attachments…I must make conscious efforts of will; I must struggle with myself if I am going to act in accord with those facts. Living into grace requires taking risks of faith.”

As we enter a new year, I hope and pray our clients are able to recognize grace working in their lives and find the strength to take the risks of faith to live into grace.

Ch-Ch-Ch-Ch-Changes: The Midlife Transition

At midlife, I’m in transition…constantly.

Over the last year, in my early 50s, I’ve faced more challenging transitions than any other year of my life. It keeps me always somewhat on edge.

My life has been like a David Bowie song, minus the stutter:Changes_DavidBowie

Ch-Ch-Ch-Ch-Changes

Turn and face the strain…

As my kids reached the ages of 20 and 18 and I pursued a second career change, I have:

Left a full-time job in public relations after seven years, been unemployed and learned to live without a steady paycheck

Become a full-time graduate student

Scrambled to find part-time work, even trying out as a “coach” for a company that teaches soccer and educational skills to pre-school kids, something out of my element

Completed an internship in a new field, mental health counseling (therapy)

Adopted, to some degree, the minimalism approach to life

Switched from graduate school and the counseling internship to a six-day-per-week job as a tennis instructor for the late spring and summer months for a much-needed cash infusion

Moved from the D.C.-Baltimore suburbs to a Delaware beach town to work as a seasonal tennis instructor

Transitioned from married and family life to bachelorhood, living with two single roommates for my summer hiatus at the tennis resort

Adapted to an empty nest, with one child in college and another entering this fall

Acknowledged that my 20-year-old daughter really has become an independent adult, observing her navigate a semester abroad in France and travel around Europe

It’s been a lot of change for one year; most of it was of my own volition and some of it was thrust upon me. Overall, encountering transitions has been positive, though sometimes admittedly nerve-racking. It has kept me motivated, challenged and stimulated. One thing’s for sure: I have never been bored or complacent during this transitory period.

The transitions have required me to look within and summon my confidence and belief in myself, which has been something I’ve often struggled with. I’ve had to do this on a daily basis in both my counseling internship and tennis teaching job, working in environments that were completely unfamiliar and in positions where I’ve had to try to project confidence immediately with strangers.

The transitions will keep unfolding. I expect to graduate with the counseling degree in May 2017, and then embark on the new career for real, but in what capacity, I’m not sure. My son will move out for good to his campus dorm in August. I’m even thinking of moving from the area I’ve lived for the past 28 years to a smaller locale in the South, as I transition to the new career and seek a warmer, slower-paced, more gracious lifestyle more befitting of the minimalist philosophy.

Transitions have been healthy for me. At a time of midlife when many may be stagnating and biding time until a retirement of unknown purpose and activity, I feel optimistic and excited about my future and the opportunities and meaning transitions will bring.

For anyone contemplating a meaningful transition in midlife, I recommend taking the risk, or you may regret missing your window down the road.

The Rewarding Work of Helping People Change Their Lives

Until you work in a mental health setting, you never realize the prevalence of depression, anxiety, mood and attention deficit/hyperactivity disorders, trauma, substance abuse, paranoia, anger issues, family dysfunction and other mental health problems in our society.

In the midst of a career transition from public relations to counseling, I just completed the first year of my internship at an outpatient mental health clinic that served Medicaid recipients for my counseling degree program. I counseled people with all those issues. All took medications as part of their treatment. Therapy was the other half of their recovery and managing their symptoms.

Gaining better awareness of ourselves and understanding our current behaviors and how the past may have affected them can be a lifelong and complex process. At the risk of oversimplification, recovery and a more healthy and satisfying life for people suffering from mental health issues (excluding those without severe mental illness or psychosis) comes down to several key factors:

  • Desire and readiness to change

  • Commitment to take actions

  • Ability to implement new ideas or behaviors

  • Willingness to accept reality

  • Fortitude to replace negative or destructive thoughts with more positive ones

I found clients were able to change their thinking and behaviors, and as a result, their feelings and emotions, to varying degrees and on different timetables. One client reported she had consciously changed a negative pattern of thinking to a more positive one within a few weeks, and as a result had significantly reduced stress and anxiety and slept better. Her entire presentation changed from forlorn and dragging to bright and eager. That told me clients had the ability to make rapid and meaningful changes. When you observe someone change like that, it’s a beautiful thing.

Others struggled with the same issues of anxiety, anger or dependency for months with small improvements and back slides. They had walls that were harder to penetrate, built over lifetimes of learned behaviors, ingrained messages and adaptations to survive circumstances.

Overall, the internship provided a fascinating window into the human experience and human behavior through my adult and child clients and their families. It was a privilege to get to know them, and difficult to tell them I had to leave when my internship ended.

The internship also taught me how little I know about mental health disorders and strategies to help people who suffer from them. There’s so much to learn about the science and art of mental health and therapy. And about how to be comfortable just being with people, showing authentic caring, developing a connection and earning their trust. But I’m learning, and excited about expanding my knowledge, getting better at being helpful and more courageous about challenging people to dive deeper below the surface to confront the roots of their problems. All signs indicate it will be a rewarding new career. I’m glad I took that gamble.

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