Leaving the Shadowland of Stress, Depression, and Anxiety

By Pamela Coburn-Litvak, Ph.D.

We all experience two types of stress: (1) the stress we seek and (2) the stress that seeks us. We bring the first type on ourselves through poor lifestyle choices or poor thinking habits. The second type comes to us through life circumstances: accidents, abuse, and trauma. The first type is more common and contributes to chronic stress. The second type, though less common, can hit much harder. Both are dangerous because both are capable of throwing us into an emotional shadowland-a dark place filled with fear, deep sadness, and despair. The emotional aftershocks of stress can include: - depression, - anxiety, - post-traumatic stress disorder, - substance abuse, and - self-harm. Written by a neuroscientist (and trauma survivor), this book explains exactly how stress leads to mind-brain disorders like depression and anxiety. Using up-to-date clinical research and biblical principles, it then describes the best ways to leave the shadowland.

• Language: English
• Publisher: Covenant Books, Inc.
• Release date: Apr 20, 2020
• ISBN: 9781646702701

Book preview

9781646702701_cover.jpg

Leaving the Shadowland

of Stress, Depression, and Anxiety

Pamela Coburn-Litvak, Ph.D.

ISBN 978-1-64670-269-5 (Paperback)

ISBN 978-1-64670-270-1 (Digital)

Copyright © 2020 Pamela Coburn-Litvak, Ph.D.

All rights reserved

First Edition

All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods without the prior written permission of the publisher. For permission requests, solicit the publisher via the address below.

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Table of Contents

Medical Disclaimer

Introduction

The Shadowland of Depression

Entering the Shadowland

Entering the Shadowland

Leaving the Shadowland: Cognitive Behavioral Therapy

Four Roads out of the Shadowland

Dancing on the Gray

Leaving the Exaggerated Life

Seeing Light Behind the Clouds

The Difference Between What You Know and What You Think You Know

How Not to Major in Minors

How Not to Minor in Majors

Ending the Blame Game

Embracing Emotion

No More Monsters

The Acceptance Paradox

Conclusion

Image Credits

Endnotes

Suggested Reading List

About the Author

Medical Disclaimer

This book is meant to complement, not replace, professional medical guidance. Please follow professional guidance for any and all mental health treatment.

Introduction

In the middle of the journey of our life

I found myself astray in a dark wood

where the straight road had been lost sight of.

—Dante

My dad died last year.

He had already lived longer than might have been expected. By his fifties and sixties, he had already survived cancer and heart disease. But by his seventies, his lifelong smoking habit had completely destroyed his lungs. Despite constant medical treatment, his body was slowly but surely shutting down. He moved slower and slower through life, as if he was fighting his way upstream in a relentless, swiftly flowing river. It was clear that the fight was wearing him out.

During his final illness, my own family and I were also in the final stages of a cross-country move from Michigan to California. My husband, Oleg, had accepted a job near San Francisco. He had moved to California ahead of the rest of the family to find a new house and get settled. I stayed behind in Michigan to help our two daughters finish out their school years, sell the old house, and pack up our belongings.

One week before we were scheduled to move, my mom called me to tell me that Dad was not doing well. My parents have been divorced for over thirty years, so Mom had learned this from Dad’s stepdaughter, Magen. Our blended family is like most others, I suppose—messy and confusing. But numerous efforts had been made over the years to keep everyone informed of important life events. So Magen had called Mom earlier that day to say that Dad was declining fast. He had been hospitalized a few months before with pneumonia but had never fully recovered. Fluid and mucus had continued to collect in his lungs, making it harder and harder to breathe. He was slowly drowning.

Just a few days before, he had been up and around, mowing the backyard (on his riding mower, of course) and babysitting Magen’s young daughters. But the lack of oxygen and buildup of toxic waste in his bloodstream was beginning to impair brain function. Dad had become dizzy and disoriented, then had lost consciousness. Magen told Mom, I don’t think he will survive the weekend.

So I stopped packing boxes and dropped all moving preparations. Early the next morning, my twin sister and I flew down to my dad’s and stepmother’s home in Alabama. We brought with us the two oldest grandchildren, my older daughter and my sister’s daughter, hoping that Dad would recognize them and be able to say goodbye.

Magen is a nurse and had taken expert care of Dad since he had left the hospital. As she led us all toward the back bedroom, she warned us not to expect too much. He’s looking really bad now, she told us. Her voice, though calm and professional, was edged with tears. She took a deep, shaky breath and continued, He can’t talk anymore, but he may still be able to hear you. You can talk to him, but that’s about all you should expect.

Dad lay on a hospital bed in the middle of the room. The sound of his labored breathing lay heavy in the air, rasping against the metallic hum of the medical equipment sitting in one corner. It enclosed us all as we exchanged hugs with my stepmother, Donna, and other family members.

My father had never been a large man. Like most of the Coburn family, he was short in stature, but strong. Now he seemed very weak. It seemed he was using all his remaining strength just to push each breath in and out. He had once had the robust coloring of his Irish ancestors—red hair and snappy blue eyes. Now his eyes were closed, and his hair was the same shade of whitish gray as his skin.

My sister and I sat on opposite sides of his bed and held his hands. They too felt strange and not part of the man I had known. Dad had made his living as a computer programmer, but in his spare time, he had loved to build things. So I was used to his hands feeling rough, powerful. Now they felt frail and papery-soft, like an old woman’s. In the ten years since I had seen him last, he had aged at least twenty.

But it was not his appearance that hit me the hardest. It was the absence of him, his powerful personality that had so easily dominated every room he stepped into. Dad had always been the center of attention and had always been a jokester. Several years earlier, Donna had called 911 after he collapsed on the kitchen floor. The paramedics found him kneeling on his hands and knees near their cat’s food bowl, struggling to breathe.

Can you come with us, Paul? they had asked politely, stepping through the scattered cat food and trying to lift him to his feet.

Sick as he was, Dad couldn’t resist a joke in that moment. He stayed put on the floor and huffed, with a wicked glint in his eye, "Can’t you see I’m trying to eat?"

But he didn’t joke when I saw him that last time, and he didn’t laugh. He never opened his eyes or acknowledged us in any way. I couldn’t help but wonder where they had hidden away my loud, rowdy father. The man on the bed looked like an old, worn-out version of him.

My daughter and niece took turns having a quiet moment alone with him. I assume they told him about their work and classes and the boys they were dating. Then my sister and I took our turns.

I don’t know what my sister said. I just sort of rambled, telling him in clumsy, disjointed sentences about what was going on with me, with Oleg, and our two girls. Like Dad, Oleg is also a computer programmer. So I told him about Oleg’s new job and our upcoming move to California. I told him that the girls had both just celebrated graduations—the older from college and the younger from junior high. I told him our older daughter had started physical therapy school and our younger daughter was looking forward to starting high school in California. I told him I was writing a book. I tried to explain how exciting, though sometimes maddening, the writing process had been for me.

Dad had always been the conversationalist of the family—he could keep people entertained for hours on end.

I struggled awkwardly in his silence.

My words just seemed to sink like stones, small and inconsequential, into the great void of his dying.

But Magen’s words kept running through my mind, He can still hear you. So I did the best I could.

When I ran out of things to say, I told him I would let him rest a little. I kissed him on the forehead, then left the dark room to rejoin the rest of the family outside in the Alabama sunshine.

It was the last time I spoke to him.

Magen called us at the hotel later that evening to tell us that Dad had died. She had not been there because she had gone out on a short errand. Donna had been in the kitchen but had suddenly felt a strong urge to go to Dad’s room. She went in and took his hand. The final wave came a few minutes later, swelling and sweeping him to another shore. His strangled breathing faltered, then stopped.

By the next morning, Dad had been moved to the local hospital where Magen worked. All the medical equipment was gone, too. Donna said she didn’t want to see it anymore. She and Magen made arrangements for his cremation and interment at a military cemetery in St. Louis, Missouri, where he had spent much of his career.

We flew home the following day. A week later, Oleg and I packed up the moving truck and left for California as planned. Our older daughter stayed behind in Michigan to continue physical therapy school; our younger daughter moved with us and started high school on the west coast. In between unpacking and furnishing the new house, I finished writing the chapters of this book.

It was a strange and difficult year.

This is my first experience with the death of a parent, so I don’t really know how to explain it or compare it to anyone else’s experience. I suppose I have grieved as most of us do.

But in my case, my grief has also been complicated by…how should I say this? By family history.

I remember with great fondness the father of my early childhood—the one with the flaming red hair and personality to match. That father had been a playmate to my two sisters and me, running around with us at the park and throwing us up into the air like mini-acrobats. He had tucked us in bed each night with songs and funny stories and bristly kisses.

This is the father I grieve the most.

I didn’t know until I was much older that that young man had already experienced great loss in his life.

I only have one picture of him as a little boy, sitting with his mother, father, and older brother—two more sisters and another brother would come later. He was no more than four or five when the portrait was taken. His freckled face is slightly blurry because he is laughing at something the photographer said or did—and who would wonder? No boy that age would be able to keep still for a boring family portrait.

In the picture he is leaning back against his mother, a striking woman whom I never met, because she died of leukemia when Dad was twelve. There is a family story about her that I have no way of verifying—as she lay dying, she reportedly told her grieving friends and family, "If you could see what I see, then you would not want me to stay."

Death released her but shattered her family. My poor grandfather was incapable of dealing with five grieving children, so he farmed them out to relatives and friends. There they stayed until they were all grown.

So my Dad lost his mother, father, siblings, and home in quick succession. I suspect that these early events were his emotional undoing. This was his ground zero, where his whole world imploded. And it must have all happened so fast, in the blink of a young boy’s eye, against his wishes and beyond his control.

I believe this created the emotional fury that came later. Because the father of my late childhood was an angry man. It was not normal anger. It was more of a frenzied rage, laced with curses and threats. He often hit my mother; he threatened to do far worse. He filled our home with fear.

My mother finally left my father when I was eleven. I respect her for doing this more than I can say. It must have taken a truckload of courage. My father fought for custody and lost, primarily because my twin sister and I testified against him in court. Unlike other children, I did not try to get my parents to stay together; I did not personalize their divorce in any way. The only thing I felt when their marriage was finally over was relief.

But the father after my parents’ divorce was even angrier than the one before. Looking back now, I can see that this was his second ground zero, where he lost another family. The pain must have been unbearable.

During the years that my mother was dating other men, then met and married my stepfather, Dad continued his threats, which I took very seriously. I suspect, in a perverse way, my father’s threats were a way to convey his pain. But of course, they had the exact opposite effect to what he intended: they drove an emotional wedge between him and us that lasted the rest of his life.

That wedge loosened a little when my father also married again. Frankly, I think my stepparents are both better matches for my parents. It would have been close to impossible to find a better match for Dad than Donna, a woman of equal parts grace and grit. She brought great healing into Dad’s life. In turn, Dad helped raise Donna’s two youngest children, including Magen, who cared for him at the end. Dad lived with and loved his third family for over three decades. In my opinion, Magen is every bit as much his daughter as I am.

These are the memories I have of my father. It grieves me that so few of them are happy ones.

The memories feel fresh and raw in the wake of his recent passing. I suppose that’s why I wanted to write about them here. But there’s another reason: in my own life story—and going further back, in my father’s life story—you can see a pattern beginning to emerge.

The pattern is this: the stress and trauma we experience in life all have their emotional aftershocks. Depending on life circumstances and other factors we will get into later, some of these are easier to survive than others. But some are so massive and strike so deep they can shatter our mental and emotional well-being.

This book is about how to treat mental disorders that arise from trauma and the stress of life.

I have spent the last twenty years studying and teaching how stress affects the brain. What I have learned can be boiled down to a single statement: the true danger is often not the stress itself, but the emotional and psychological aftershocks that follow.

I’m not talking about physical stress here, like accidents or natural disasters. We all know how devastating those types of stressors can be—just ask those who have survived a hurricane, earthquake, or wildfire; or have experienced human atrocities like sexual assault or mass shootings.

It’s obvious that those types of stressors represent physical threats to the body.

But have you ever noticed that even physical stressors can have a biting, psychological edge to them?

Maybe you’ve had this experience: you were in a car accident six months ago, but you still have nightmares about it now. You wake up from each nightmare in a cold sweat, with your heart pounding in your ears.

Each nightmare feels like you are reliving the event all over again. And every time, you experience the same wave of fear.

I’ve felt that fear, too. In fact, most of us already know that a severely stressful event can continue generating feelings of terror and anxiety for weeks, months, or even years past the original event.

It can also lead to feelings of depression. Maybe you or someone you love was hurt in the car accident. And every time you think about it, you wonder if you could have done something to avoid it. You feel angry that it happened. You feel crushed by the losses it took from you and those you love.

While I was writing and editing this book, several stories hit the national and international news of allegations of sexual assault. These involved a Hollywood producer, a TV father figure, a Supreme Court justice, several news anchors and producers, and hundreds of Catholic priests.

I had both a personal and professional reaction to these stories.

Personally, I was shocked and horrified. I was also horrified at how these stories tore our country apart, with people lined up on opposite sides screaming at each other. Some question the truth of many of these stories, but that is not my point for bringing them up. I don’t want to argue here if only three-quarters or half of the stories are true. I just want to say that such atrocities should never happen at all.

Professionally, I was not surprised to hear that calls to national hotlines for assault victims doubled or even tripled in the weeks and months following each story cycle. The stories disturbed many sleeping monsters: suppressed memories of groping hands and harsh threats whispered in the dark.

These victims know firsthand that physical forms of trauma often lead to psychological trauma, the mental and emotional aftershocks that haunt the mind long after the initial event has passed.

Psychological stress also includes the fears or obsessive worries we have about the future. We humans are unique in being able to pull feelings of fear, anxiety, and despair from both the past and future, into our present reality.

And this is a heavy burden for our minds to bear.

What we commonly describe as feeling stressed out can be described in other ways: feeling worried, feeling anxious, feeling sad, feeling helpless, or feeling hopeless.

These feelings are associated with the two most common mind-brain disorders in the world today: anxiety and depression. This means that there must be a direct link between the stress we experience and the resulting feelings of anxiety and depression.

As a stress researcher, I have spent nearly two decades studying that link, with the goal of learning how to break it.

Cognitive behavioral therapy (CBT) is of the best treatments for stress-induced mental illness.

Breaking the link requires us to think about mind-brain disorders in perhaps a different way than we have up until now.

We need to think of them the same way we do physical disorders, like heart disease or cancer. These do not occur spontaneously and for no reason. Several things, for example, can contribute to heart disease: diabetes, too much blood clotting, inflammation and hardening of the arteries, and high blood pressure. Identifying any, or all, of these underlying causes helps us predict with better accuracy how the disease will progress and how to best treat it.

And what is true of the body is also true of the mind—depression and anxiety do not occur spontaneously and for no apparent reason. These mind-brain disorders are often the direct result of trauma or stressful life events. When we understand this, we will have a better idea of how these disorders will progress and how to best treat them.

It turns out that retraining the mind through psychotherapy is one of the best treatments for stress-induced depression and anxiety. This book will give a step-by-step method of how to do this. While there are many types of psychotherapy, I have focused on the type with the longest and most distinguished success rate: cognitive behavioral therapy.

Why Did I Write This Book?

I see mental illness from two angles. I see and understand it in a scientific way because that’s my job. Neuroscientists like me study how the brain changes with mental illness in order to learn how to best treat it.

But I don’t just see mental illness from the outside; I also see and understand it from the inside. I know what depression and anxiety feel like because I suffered from these disorders for much of my life.

For me, part of the cause is clearly genetic. In fact, I suspect depression is deeply rooted in my family tree. But looking back over my life history, I can also identify times where stressful life events—and childhood trauma—played a role in my depression and anxiety.

To me, stress-induced mental illness feels like being trapped a shadowland. I mean this in a scientific sense—severe stress can lead to some of the darkest mental health issues we know of: post-traumatic disorder, clinical depression, clinical anxiety, substance abuse, self-harm, and even suicide.

I also mean this in an emotional sense. The world feels like a darker place. Those who have been there, too, will know exactly what I mean. Those suffering from anxiety find this shadowland a terrifying place. They stumble along, with their heart pounding and their breath choking in their chest. Each step is a fearful one because they live in dread of the next stressful event.

Those suffering from depression find it a desolate place. Each step is a hopeless one because life has lost its meaning. They begin to wonder what there is to live for.

If you are reading this, I suspect that you already know that depression and anxiety often go together—that depression is often riddled with fear. That, once in the shadowland, one’s mind seems to betray one, bending and twisting the things that happen into grotesque shadows that no longer reflect reality. The dread of navigating such thoughts creates anxiety. And at its edges, this anxiety crumbles into feelings of hopelessness and despair.

If you’ve picked up this book, you probably know these feelings all too well. You know what living in this shadowland is like.

There’s another kind of fear that’s harder to talk about, at least, for me. I think that’s because my own pride weaves its way in and out of this fear. It stems from the still-popular, but wrong, belief that depression results from some sort of weakness or character flaw.

It’s obvious how pride comes into it—nobody likes to feel weak or flawed, particularly someone who’s supposed to be an expert. Until a couple years ago, I was too scared to tell anyone beyond a small handful, only those in the innermost rim of my inner circle, about my personal struggles with it.

You may wonder if I felt safe at least in scientific circles, among those who study the biological/psychological underpinnings of this disease. I didn’t. Truthfully, I feared that disclosing my illness would result in more criticism from my colleagues, not less. After all, since I understood depression, it seemed like I should be less susceptible to it.

Perhaps you’ve felt the same fear and are likewise hiding from the judgment of others. This is tricky because, in a distorted mental landscape, it’s often impossible to accurately interpret others’ opinions. Since I never told anyone, I really have no way of knowing what they thought. I suspect that I frequently projected my own sense of shame onto others’ faces and body language.

And I know for sure that this fear created a great paradox in my life—while the outside world knew only of my professional acquaintance with depression, a mere facade of scientific facts and figures; inwardly, I was locked in a terrifyingly intimate struggle with it.

You might think that I got interested in neuroscience because of my personal history. But this is not true. I had no burning desire to revisit the trauma of my childhood, and I certainly did not plan to build a career around it. My interest in studying the brain was, at least consciously, completely dissociated from personal experience.

They say that in medical school, med students start imagining that they have the symptoms of every disease they are studying. Something similar happened to me in graduate school. As I started reading deeper in the research literature, it slowly dawned on me that I knew what these neuroscientists and clinical psychologists were talking about when they described depression and anxiety, and not just in the scientific sense. I knew in a visceral sense.

It was kind of like going to an art class to learn how to draw, only to find that the model drawing I had been assigned to study was eerily familiar, like a picture that hung in my home as a child—one that I never liked because it gave me nightmares. Or taking a class in music theory and hearing a piece that resonated deeply, painfully in my bones and echoed down corridors of tortured memory. These were the uncomfortable feelings I had when I realized for the first time that I suffered from stress-induced depression.

Although I certainly didn’t plan to study neuroscience because of my illness. Later, I was grateful that I did, because I realized this combination of scientific knowledge and personal experience gave me a unique opportunity to learn the most effective ways to treat it. That’s what this book is all about.

If you are interested in learning more, I invite you to visit my website Leaving