My annual birthday custom typically included
anticipating a sumptuous meal with my husband,
opening thoughtfully presented gifts from my
four lively teens, lunching out with treasured
friends stretched casually over several weeks'
time, and savoring the largest section of the
most decadent chocolate cake ever conceived.
So as my 45th birthday drew near, there were
myriad activities I should have been looking
forward to, but I wasn't. In truth, the very
thought of commemorating this previously ritually
joyous event made me even more depressed.
Depressed? Did I mention the word depressed?
Couldn't have...not me. Not the "I'm always
in control of my subdued emotional persona"
type, which I had effectively portrayed to the
world for the past forty-four years of my existence.
Why did I find it so painful to face the truth
of my current predicament?
The depression was triggered by a simple elective
shoulder surgery. Something transpired within
my psyche during those subsequent post-op days
that sent me spiraling into a black, obscure
night of the soul. The worst aspect of this
terrifying, albeit temporary experience, was
that I felt powerless...utterly helpless...and
Although I never, ever, would have anticipated
reacting so dramatically to an elective surgical
procedure, I had to face up to what happened
to me during those early post-surgery weeks.
If I had been privy to an outsider's unbiased
observation of my inner-emotional workings,
I would have clearly declared that the woman
in question (me) was undoubtedly depressed.
Yet I couldn't name it so at the time. I was
too ashamed; too humiliated by this debilitating
label...in fact, I was horrified that others,
including intimate family and friends, would
come to the same conclusion that I secretly
feared. I was not in control; rather, I was
so emotionally out of control that I worried
my mind was coming unhinged.
Having never experienced such drastic fluctuations
in my emotional state before, I didn't recognize
the symptoms of depression. True enough, I wasn't
sleeping.... enduring continual shoulder pain
for weeks on end will inhibit even the best
sleeper from gaining daily needed rest. I had
also stopped exercising for a solid month post-surgery,
something I've never done in my entire adult
life. This too, may have contributed to how
off-kilter my body felt.
Most significantly, most terrifyingly, it was
as though someone was pinning me against the
wall...and no matter how mightily I struggled,
I couldn't break free. It was in this skewed
frame of mind that I unwisely began contemplating
life.... my faith, my marriage, my work, and
my future. Pondering the past, present, and
future through these murky lenses was not smart.
This habit alone increased my sense of despair,
my lack of hope.
Thankfully, I had outside support or I may
have begun believing that things really were
hopeless. Because my family and friends continued
to speak positive words of truth, accurately
assessing my life, indeed my very person, I
was able to heed that small, still-sane, voice
in me that continued to resist these negative
mind-speaks. It was in a battle to be sure -
one that I fought hour by hour.
Often, I found myself placing a desperate telephone
call to a trusted friend for perspective, to
vent, to question, and for prayer.
Now I can see that some of the most helpful
advice I received during those darkly tenuous
post-op weeks, were the suggestions to care
for my physical body, to treat myself with a
tender care, and to allow myself generosity
of forgiveness, and time.... lots of time to
rest, recover, and rejuvenate. Admittedly, I
felt as though I was spoiling myself adhering
to such loving counsel...but after a bit; I
realized my friends were right. And wise. My
body needed a quiet period to heal...it was
up to me to see that I made the right choices
to allow this to happen.
When I met with the surgeon after my operation,
difficult as it was, I briefly explained my
emotional tailspin. With a prescription for
a sleep aid in hand and some fresh determination,
I left the office feeling a bit more ready to
proactively heal in the most "stationary"
sense of the word.
Sleep eventually became a blessed respite and
my outlook improved dramatically. Daily exercising
helped me "work out" some of the doldrums
as well. I ate with authority.... meaning with
full intention of building nutritious food stocks
into every meal. And...I continued to lean on
my family and friends, for conversation, for
hugs, and for simple caring.
It took a full three months before I realized
I was "me" again. Even then, every
once in a while, when I grew especially tired
or stressed, I felt that ominous dark cloud
begin to dodge my steps. So, I would retreat
a bit from life's busyness, rest some more,
and relish everyday simple joys.
Who could have foreseen that during one of
the most productive and most satisfying periods
of mid-life that a simple elective surgery could
wreck such emotional havoc? Certainly not me.
Like many other women, I failed to take into
account all of the life stresses that I'd endured
in previous months, which included primary care
giving for not only my own busy family of four
teens but also an elderly relative whose chronic
health problems intensified my work load. Other
life factors, both positive and negative, such
as losing close friends to cancer, job transitions,
the decision to change churches, to celebrating
the graduation of a child all played a part
in the everyday lifestyle stresses I faced in
I recall thinking to myself prior to having
surgery, one more stress (having surgery) won't
make any difference. But it did; it was the
last and final straw before my body said, "No
more," loudly enough for me to listen.
I wish mine were an isolated case, yet countless
other women have experienced similar uncontrollable
responses to their own "mid-life triggers"
into depression. Sadly, it can come by way of
trying to take care of one's physical body.
In the course of his practice, orthopedic surgeon,
Dr. Christopher A. Foetisch, Toledo, OH, has
noticed that mid-life women sometimes enter
the office already depleted by life's stresses
and then surgery tips them over the edge and
while this may occur in only 5-10% of female
patients, for these women the onset of depression
is emotionally devastating and completely unexpected.
Also, most commonly prescribed pain medications
derive from the opiod family of drugs whose
side effects are "depressant" in nature
- simply taking the necessary pain medications
post-operatively may exacerbate symptoms of
an already existing case of depression. Consider
the patient who is currently struggling emotionally
and then begins experiencing occurrences of
headaches, loss of appetite, restlessness, mental
sluggishness or sleep disturbances as a result
of taking prescribed pain meds.
Mid-life women are all too often literally
sandwiched betwixt and between their partners,
children, parents, friends, and colleagues'
needs and expectations thus forfeiting their
own health in the process. At some point, every
woman must take the time to carefully assess
her life with tempered realism. Otherwise, the
sudden and frequently devastating onslaught
of depression may render her incapable of functioning
and feeling utterly hopeless. By exploring some
common mid-life depression triggers, women can
be better equipped to handle seasons of depression
and emotional tension.
Common Top Depression Triggers:
Positive Life Stresses
Job promotions, weddings, vacations, even the
most coveted of life's milestones can precipitate
short-term depression in mid-life women. Surprisingly,
many women don't realize how much emotional
toll these beneficial experiences can take on
their mental and emotional psyche. As with everything
in life, balance is key. Realistic planning
is also highly recommended for all women, no
matter what their age or station in life.
Negative Life Stresses
Family emergencies, extended care-giving responsibilities,
financial upsets, unresolved relational issues,
childcare dilemmas, and workplace challenges...are
part and parcel of most women's daily lives.
Long-term perspective is a must, coupled with
a strong support group of fellow travelers who
can provide empathy, care, and unconditional
acceptance. Enlisting (and lending) anticipated
help before the next major landslide of distressing
events is especially crucial at this period
Shifts in Health
Sadly, many mid-life women neglect their health
by avoiding regular check-ups with the family
doctor, gynecologist, dentist, and ophthalmologist,
not recognizing how quickly most delineations
from former good health can be detected and
corrected. Simply showing up can make a difference.
Women especially need to be checked for ever-changing
levels of hormones; informed about how their
current meds will affect their bodies and emotions;
and what signs to be on the watch for according
to their particular family health history.
Pro-active Ways to Help Manage Depression
Exercise, Stretch, and Sleep
As women age, regularity in habits and scheduling
becomes increasingly important. The body will
respond to even the simplest minor alterations
in your good health habits. Discover the least
resistant path to consistently exercise, eat
healthily, and sleep effectively - and make
these habits a priority.
Striving for excellence is exemplary...expecting
perfection is counter-productive. All of life
is riddled with imperfection, brokenness, and
frailty. It is the wise woman who does what
she can to make a positive difference. Wiser
still, is the same woman who understands she
cannot fix every thing, person, or situation...and
she makes peace with that fact.
Prudent women recognize healthy boundaries that
include immediate family and close friends.
Surround yourself with people who support your
efforts, stand by your decisions, and are ready
to offer assistance when required. Have the
courage to distance yourself or even end ties
with individuals who diminish the woman you
seek to become or pressure you to compromise
on your core values.
Michele Howe is a reviewer
for Publishers Weekly, Inspiring Retail and
BookReporter.com. She has published over 900
articles and reviews and is the author of eight
books for women including, "Prayers of
Comfort and Strength" and "Going It
Alone: Meeting the Challenges of Being a Single
Mom." She can be reached at: firstname.lastname@example.org