By Chaya Kohn, LMHC

Text and Image published in collaboration with the Jewish Press

It happened again. Of course it did. Why would she expect anything different when it happens every day? She comes home tired from the day, emotionally and physically drained.

The day always plays out the same, starting with the mornings. Bracha wakes up to the sound of her alarm blaring. She leans over to turn it off and in that brief second, all the hurtful thoughts in a strong firm voice come flooding in:

“Don’t get up!”

“No one will miss you!”

“You are worthless!”

“How many mistakes will you make today?”

 “Why try?”

“Why live?”

After an agonizing amount of time, she finally rolls out of bed to get dressed. She arrives at work an hour late because every step towards getting herself and her family ready for the day was too hard. Her energy is already spent. Sweaty palms, hands shaking, and heart throbbing, Bracha continues her day slowly. Emails go unanswered, phone calls are not returned, and deadlines are missed. It’s too hard to stop the thoughts; it takes too much energy. Every conversation with her coworkers and superiors leaves Bracha’s stomach in knots. She findsherself unable to think clearly or focus on the topic being discussed. Every day, Bracha worries about losing her job. It wouldn’t be the first time, nor the last.

After a day that seems like an eternity, her work day is finally over. Her trip home is filled with dread because now she has to take care of her children…yet another responsibility. She loves them, she really does but she is already irritable and filled with self-doubt from the day’s events. She quickly loses her patience and raises her voice louder than she would like, but she just can’t stop herself. At last, the children are in bed for the night. Bracha uses this quiet time to review her day and enumerate all of her failures.  She adds “horrible mother” to her list.

Bracha is sad, scared, and in a lot of pain. The only remedy that she knows will make that pain go away is to eat. Satisfying the need to be comforted and numbed, food, and lots of it, minimizes the shaking and the voices. Food makes her feel better while she is eating but afterwards, and sometimes even while still eating, the shame and self-loathing set in. Bracha wants to escape. She wants to curl under her blanket, go to sleep, and perhaps…not wake up.  She just can’t face another day.

What can be done?

Let’s say you are walking down the street and you see someone on the ground, bleeding from their head. What would you do? Of course, you would immediately contact Hatzalah or 911.  An Emergency Medical Service would arrive and bring the patient to a hospital where they would be treated. In this scenario, the individual’s wounds are visible on the outside. Clearly, they needed help and your actions enabled them to get that help.

Bracha is injured on the inside.  She is silently struggling with depression and anxiety. How can her internal wounds be “seen” and treated?

Depression and anxiety can affect your family, friends, colleagues, and community members. It can take on many different forms and levels of severity. Like Bracha, an individual can experience symptoms throughout the day. Some other symptoms to look for are: lack of interest in activities, sadness or feeling down, hopelessness, trouble concentrating and making decisions, irritability or excessive anger, avoidance of social activities, poor appetite or overeating, dwelling on the past, trouble sleeping, lack of energy and low self-esteem, issues in workplace, relationship problems, and difficulties staying calm. 

If Bracha’s story resonates for you or someone close to you, know that help is available. There are licensed mental health professionals who focus on the care and treatment of those who are suffering with the pain of depression and anxiety.

According to the Anxiety and Depression Association of America, studies have found psychotherapies, such as Cognitive Behavior Therapy (CBT) and Behavioral Therapy, to be effective. These therapies work on exchanging negative thought patterns with more accurate and realistic ones. One specific technique within CBT that has been found to be significantly useful in treating depression is Behavioral Activations (BA).

BA helps us understand how our behaviors influence our emotions. It encourages us to focus on increasing participation in positive-feeling activities and decreasing participation in activities that maintain negative emotions. If prescribed by a psychiatrist or primary care physician, another form of treatment along with therapy is psychotropic medications which can be an effective modality for treating depression and anxiety. 

Do your research and seek out those organizations, clinics, and qualified licensed mental health professionals who can help. Treatment providers are in your communities, I implore you to take steps toward helping yourself or a family member who might be suffering silently with depression. Summon the courage to change your life or the life of a friend, family member or community member, for the better!