September 11 As a
Defining Moment:
A Six-Month
Perspective
By John Schneider, PhD
At the recent six-month anniversary of September 11, numerous articles and surveys appeared that indicated two things: We aren't over this, and New Yorkers are reeling from a "wave of depression."
It is true that people with chronic issues that began before September 11 have seen their symptoms increase. It is true that many who had previously moved beyond difficulties are caught back in them. It is true that still others are facing uncertainties and difficulties never encountered before. Some individuals are suicidal, some face flashbacks, some are back into addictions, others are leaving marriages. Instead of the number of people seeking help decreasing over time, there has been an increase. I agree that people clearly aren't "getting over it."
But as I read these articles and feel gratified that the usual tendency to gloss over problems once the magical "six-month" mark has passed is being challenged, I am concerned about using the word "depression" to describe what's going on. By its definition, "depression" means a plunge from wellness to illness, from stability to fragility.
I have been a mental health professional for over thirty-five years, and "depression" and how it differs from normal reactions to trauma, stress, and change has been a focus of my work. Thus I offer a word of caution:
Most of what is happening isn't depression or even an illness. Most of what is happening is a healthy response to a shared defining moment. This could be a defining moment that creates possibilities never dreamed of before. It could also, unfortunately, as defining moments also do, end old possibilities and dreams.
And so it is with those most directly affected by the terrorist attacks of September 11. Some have and will profit from various approaches to trauma debriefing, therapy, medications, and respite. Others will commit suicide. Still others will become abusive or will lose their capacity or desire to remain a firefighter, police officer, market analyst, street vendor, or therapist. Life, in whatever form it now takes, is transformed from the old ways, sometimes for the better, sometimes not.
None of them can be expected to forget, to dismiss this experience as a forgettable rather than a defining moment. What they're feeling should not be called "depression," for it is not a sign of weakness or psychopathology that they don't get back to life as usual.
The meaning of life comes from embracing such times, from grieving what was lost as a result, and from remembering what is most significant about those losses in order to create new possibilities.
When this happens, priorities will shift and wonderful things can happen. I have seen times of the most devastating loss become the motivation to grow and transform. But at the same time, if the truth be told, additional losses can result.
This doesn't mean that others must stand by and watch helplessly if they see loved ones deteriorating before their eyes. It is important to know the differences between depression, discouragement, and grief. Depression can result from trauma and loss. By six months, depressed people are different from those who are grieving or discouraged in the following ways:
Depressed people feel disconnected from everyone and everything.
Nobody cares--enough.
Life has no pleasure in it.
Life has no meaning in it.
Nothing helps.
Life is over.
Nothing ever changes.If these statements characterize how you or a loved one feels, professional help is needed.
People who are grieving or discouraged are more likely to experience the following thoughts:
"Walk in my shoes" before judging me.
There is at least one person I feel safe with.
Pleasure may be harder to find.
I don't know what meaning my life has now.
Being in a safe place or with nurturing people helps enormously.
I don't know how to forgive.
Everything is changing.If these statements seem to characterize the way you or a loved one feels, support and validation may be what are needed. Such validation can sometimes come from understanding counselors and alternative health practitioners, but more often will come from family, friends, religious communities, and support groups.
Try out how it feels to say, "I am depressed." Then try, "I am grieving" or "I feel discouraged." To a depressed person, each statement feels the same. To those dealing with significant life changes, there is a difference that represents a healthy, healing process that will take the time it needs to transform the way we were.
We can help others by validating for them that things are as bad as they seem--at least for now. We can witness their process of transformation and remind them that aspects of themselves they once believed permanently lost can still exist. We can believe in their capacity to rise to the occasion. We can put aside our judgmental natures and make it safe for people to admit to moments of panic and cowardly and destructive actions, to help them find ways for forgiveness and restoration. We can celebrate with them when they fight back from serious injuries and massive burns to restoration of health.
Indeed, we can hold their hope while they explore the darkest spaces of their existence, for validation can help people measure their life story by whatever moment defines "before" and "since."
John Schneider, PhD is a retired professor of Psychiatry from Michigan State University living on Old Mission Peninsula. His book, The Overdiagnosis of Depression: Recognizing Grief and Its Transformative Potential explores this topic in greater depth. He is a clinical psychologist in private practice who, along with Mary Raymer, MSW helped to start the Traverse City Healing Community Response Team, a group of volunteer professionals responding locally and nationally in the aftermath of September 11th.