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 My nearly half-century of grief started one sunny December afternoon a week before Christmas. I was 14. 

“She’s gone, Son,” my Dad said as he fought back tears and put his arm over my shoulders. He had come from the hospital to pick me up from my high school.  

My mother was admitted to the hospital the previous afternoon following what we later learned was a ruptured brain aneurysm. She was only 34. I had two little brothers ages six and three. 

Adding to the shock of Mom’s death was guilt that I caused it. I had been caught in a vandalism incident with some other guys. My parents had to pay my portion of the damage. I believed for years that my behavior raised her blood pressure so high that the aneurysm burst. It was only a coincidence, of course, but it took a long time for me to believe I wasn’t to blame.

“Since losing a parent is one of the most devastating losses a child can experience, a man who has gone through this can’t help but to bring  experience into his adult romantic life. His feelings may be especially strong during holidays,” per psychologist Nina Edwards, Ph.D.  Major depression started just after Mom died. I had no one to talk to about my feelings.  My dark mood often filled my head with thoughts of suicide as I walked alone at night in our small Southern town going with no place.

Every kid is one caring adult from being a statistic. Suicide is the second leading cause of death for ages 15 to 24. Fifty percent of deaths in this age group involve alcohol or drug abuse. In most cases, alcohol and drugs are ways of self-medicating mental disorders. I did that with alcohol abuse the next 20 years. 

A teenager does not yet know the appropriate words to describe how he or she is feeling. It is also thought that the school systems should teach children and teenagers how to identify the symptoms of depression and its causes to enable them to get help for themselves as rapidly as possible. That didn’t happen in my little high school in North Central Arkansas and it rarely happens now at most schools.

My long journey through mental illness began that cold December day in 1964. It was brutal. My mother’s sudden death was a traumatic event that triggered a genetic predisposition to bipolar disorder. If there was ever any question about a genetic relationship with bipolar, it was answered in my family, at least. My dad, he discovered two years before his death when he was 62, had bipolar. He could have been diagnosed and treated over 30 years earlier had fear of stigma not convinced him he could just self-medicate depression with alcohol. My brother who was the six-year-old when Mom died was diagnosed with the disease when in the U.S. Army and then discharged without treatment. Fear of stigma kept him from getting professional help once back in civilian life. He self-medicated with alcohol and prescription narcotics until he ended his life at age 35. My step-sister had major depression for many years, too afraid of stigma to reach out for psychiatric help. She died by suicide five years after our brother’s death. My surviving sister was diagnosed with bipolar when in her mid-30’s and now in her late 40’s has stopped hiding her illness from family and friends as she stabilizes with medication and lifestyle changes. My youngest brother is struggling with symptoms of major depression possibly related to PTSD from his service as a U.S. Marine during the Balkan Wars.  

Memories of happy Christmases’ past vanished that Christmas 53 years ago. The four decades following Mom’s death were marked with a major depression each December, ruining the holiday for my wife and — after our divorce — for my partner.

I was eventually treated for major depressions after graduate school, but it was the wrong diagnosis, as often happens with people who have bipolar disorder. I was finally correctly diagnosed when in a major manic episode. I was 42. By then, my untreated bipolar behavior had taken away my family, career and reputation. 

As I approached the 40th anniversary of Mom’s death following another failed relationship, I met a grief counselor by chance. Grief counselors aim to help people cope with grief, mourning the death of loved ones or with major life changes that trigger feelings of grief. He said he often advises his clients to write a letter to their diseased loved one. “Go somewhere to be alone,” he said, “read your letter aloud and then burn it.” I decided to try the ritual on December 17, 2004. I was 54.

Here’s an excerpt from that letter:

Mom,

I’m so sorry I could not let go of my grief over your death. It was 40 years ago, today, but each December I relive those days and it always leads me into a depression. Depression ruined happy holidays with the mother of your grandchildren and undiagnosed and untreated mental illness eventually destroyed my marriage.

Please forgive me for holding on to my grief. You wouldn’t have wanted that. I finally learned that the power of guilt is not in the failure of others to forgive me, but in my failure to forgive me. 

Love,

Your son Tommy

The ashes from the burning letter floated above a cliff overlooking the Pacific Ocean near San Francisco that sunny afternoon. I never had another Christmas depression and my journey to finally stabilizing with bipolar disorder moved forward.


 
 
It is the biggest economic burden of any health issue in the world and is projected to cost $6 trillion by 2030. Two-thirds of these costs are attributed to disability and loss of work. And yet shockingly, of the 450 million people worldwide who suffer from mental health conditions 60% do not receive any form of care. “Jobs” is the key word in American politics these days. How to get them back from other countries is important, of course, but what about helping companies retain the employees they have by successfully promoting mental wellness in the workplace?

Employers need to use an informed approach to help boost employee satisfaction, retention and productivity while protecting the company’s legal and financial interests. How? Here are four ways:

* Prevention: Promote mental health as part of an overall corporate wellness campaign. For example, bring in professionals who specialize in mental health and substance abuse issues to present mandatory, yet interesting educational seminars. That will help reduce the stigma attached to mental and substance abuse disorders. Businesses who have done this reported reduction in health expenses and other financial gains for their organizations.

* Awareness: Changes in sleep, mood, appetite, weight, behavior, and personality are caused by many drug addictions and mental health disorders. Other telling symptoms include tardiness, missed deadlines and unexplained or unauthorized absences from work to counter these problems, it is critical that management and HR be given sensitivity training and that professional information and referral resources are readily available. Taking these steps can help employers manage situations before they get out of control.

* Work-Life Balance and Accommodations: The Family Medical Leave Act entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and professionally diagnosed medical reasons, including mental illness or alcohol/substance use disorders. The Americans with Disabilities Act (ADA) requires employers to provide “reasonable accommodations” to assist people with disabilities, including mental health impairments, perform job duties. Employers can help employees with mental health issues by encouraging the use of written checklists, instructions and offering more training time. Sometimes providing a mentor for daily guidance and meeting regularly to discuss progress.

* Employee Assistance Programs (EAPs designed to address substance abuse and addictions, as well as personal and family problems, mental health or emotional issues, marital or parenting problems, and financial or legal concerns. EAPs have evolved and grown in popularity during the last 25 years. The number of organizations with an EAP increased from 31% in 1985 to 75% in 2009. Providing a variety of treatment options for an employee will not only help reduce their suffering - it will curtail the incidence of impaired functioning at work.

 More jobs in America? According to the National Alliance on Mental Illness, some 60% to 80% of people with mental illness are unemployed. In part, this is the crippling nature of the disease. But a large part of the problem that we have in hiring people who have some mental disorder is that we lack the sophisticated vocabulary to talk and act regarding these illnesses.

Managing mental health should hold no fear for managers – whether they realize it or not, they already have many of the skills needed to look after their employees’ wellbeing. Sometimes all it takes is an open mind. Mental health is the mental and emotional state in which we feel able to cope with the normal stresses of everyday life. If we are feeling good about ourselves we often work productively, interact well with colleagues and make a valuable contribution to our team or workplace. The good news is that line managers already have many of the skills needed to promote positive mental health at work. They are usually well-versed in the importance of effective communication and consultation, and the need to draw up practical workplace policies and procedures. Add to these skills an open mind and a willingness to try and understanding mental health problems, and organizations can make real progress in tackling the stigma often associated with mental health.

“The problem with the stigma around mental health is really about the stories that we tell ourselves as a society. What is normal? That’s just a story that we tell ourselves.” -- Matthew Quick (Author of The Silver Linings Playbook)


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