East West - The Asian American Lifestyle Magazine

By Isabelle Gan, originally published October 2004

The morning sun peeks in through the window of a New York City* apartment as the phone rings and Megan Lee* awakens to a familiar battle. Lee picks up the phone and a friend’s voice coaxes her to rise out of bed.  In a few minutes she’s eating a bowl of oatmeal for breakfast.

“It’s just a struggle to get up,” says Lee, who suffers from clinical depression. “And then when I’m up, I look at my bed and I feel like I want to lie down and just sleep.”

Completing that first simple task in the morning is a small victory in her everyday battle to return to normalcy. 

First diagnosed with bipolar disorder in her late 20s, Lee’s depression is far from a mood swing or a brush with the blues.

“It’s the type of depression where you can’t sleep at night and you shake at night,” says Lee, now in her mid-30s.

Her recent bout of mania and depression forced her to take time off from her job as a schoolteacher.

“This mental illness has pretty much destroyed my life,” she says.

Depression is an especially serious issue for women.  Statistics show women are almost twice as likely as men to be diagnosed with clinical depression, a mental illness that impairs a person’s sleeping and eating patterns and ability to function in society.

In Lee’s case, bipolar or manic-depressive disorder causes her to have severe shifts in her mood.  A manic episode triggers a burst of energy, characterized by verbal aggression, agitation and excessive spending.  Her high is soon followed by an agonizing low.

“It’s a very dark period,” says Kasy Silver, a Florida psychotherapist who treats women with depression.  “What’s important is to realize that it will lift.”

Getting professional help, especially for those with major depression, is the first step to overcoming the disease.

“If you get to the point where you can’t function, that’s the time you look at taking medication,” she says.

Lee’s doctor put her on a mood stabilizer drug to prevent swings between mania and depression.  She is currently looking for a psychologist to provide her therapy.

In Silver’s practice, cognitive behavior therapy, taken in tandem with medication, is a key tool for helping depressed women.  The therapy emphasizes the role of thinking and its direct relationship to how a person feels and behaves.  It promotes rational thinking by identifying thoughts that cause certain emotions and replacing them with others that result in more positive feelings.

“I tell my patients to write their thoughts down so they can rationalize them,” Silver says.  “For example, a lot of my clients will think, ‘I’m never going to get better.’ If they write it down and see it, they realize how irrational it is to think the word ‘never.’”

Lee tries to apply those methods every day.

“Sometimes I’m just so depressed I feel like it will go on and on.  But I tell myself it won’t.  What I tell myself is I just need time.  Time will lift it,” she says.

During her first bout with depression seven years ago, Lee forced herself to get out of her apartment to enforce those positive thoughts.

“I volunteered at a local library for their summer reading program,” she recalls. “It really helped to keep busy.”

Once a group of daily activities was in place, she found it easier to get through the day.

“Interests or activities can be helpful for women who are prone to depression, to act as a buffer, by building a network of friends, to improve self-esteem and serve as a distraction from their negative thoughts or feelings,” says Shemira Murji, a neuropsychologist in Phoenix, Ariz.

She emphasizes the importance of educating patients about depression as a mental illness.

“Depression is not a sign of weakness or a character defect,” she says.  “I think when there’s more acceptance and understanding of this disease, there will be more willingness to seek out treatment.  This will be particularly important for Asian Americans, as they underutilize mental-health services because of the stigma associated with (mental) illness.”

A second-generation Korean American, Lee is familiar with that shame.  For seven years after she was first diagnosed with bipolar disease, she hid her problems from friends and relatives.

“It’s an uncomfortable topic, and Asian Americans don’t like to talk about that kind of stuff,” she says.

Eventually, she became more open about it, especially after realizing that depression is an illness, something that can be cured.

That realization fostered a feeling of hope, a lifeline to hold on to.

Silver builds on that positive emotion, asking her patients to look even more closely at themselves.

“Women are raised to nurture.  Unfortunately, we are raised not to think about ourselves,” she says.

Often it is simple exercises that help make the therapy more effective.

“Several times a day, I ask my patients to stop and ask themselves, ‘How am I feeling and what do I want?’ ” she says.  “It works wonders.  Some of my patients realize they want something simple, that they’d like a nap or some lunch.  It’s training yourself to think about your feelings.”

She also encourages patients to make small, positive changes in their lives, one at a time.

“For example, a lot of women tell me just looking nice helps,” she says.  “The key is to create small goals.  Don’t make it too hard so you don’t fail and feel too bad.”

It can be as simple as making a commitment to take a shower and put on something nice to wear each day as she had one of her patients do for several weeks.  Then, she asked the woman to put on a piece of jewelry.  The final step was to put on make-up as part of her routine.  Eventually, she made appointments to go out outside with friends.

“It’s all about baby steps,” Silver says.

Once the simple goals are achieved, patients can then reach for bigger goals — like forging relationships and building a community for themselves to help ease feelings of isolation.  Murji emphasizes the importance of belonging to a community beyond their own families, like a church or volunteer organization.

“Support systems, understanding and a sense of connectedness are vital for one's emotional well-being,” she says.

Lee recently started attending bipolar support group meetings twice a week.  Although she remains skeptical about its benefits, she forces herself to go.

“It gives me a reason to go out at night,” she says.

A community is even more important during the holidays, when feelings of isolation are exaggerated by a tremendous pressure to be happy and fulfilled.

“I become more aware that other people have families and I don’t,” Lee says.  “I notice more how many of my friends are married and I’m not. I feel more alone.”

This Christmas season, she has resolved not to keep to herself, but to go out of her way to join friends.  More importantly, she continues to hold on to hope.

“I’m going to try and reach out to people this year,” she says.  “When you’re depressed, you really need to think it’s a temporary state. I know it will lift.”

*Certain details about the person’s identity were changed to protect their privacy.