The Stress Doc Letter
Cybernotes from the Online Psychohumorist
May 2000, No. 1, Sect. 2
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
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 -- its 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 dont 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 employees burnout process which has been
simmering and eroding from within. Theres 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 Ive
given to the company, after all Ive 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
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
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 dont
want to directly fire the person for fear of legal consequences
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 individuals 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 theyve 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 theres 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 whats 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 employees 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"
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 theres 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, its 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
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!]
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
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
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,
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
(email@example.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:)
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.
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!
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
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
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 firstname.lastname@example.org 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