Columns

CREATING CHANGE 

In my private practice, a lot of clients come to me and complain about disappointment,  especially around a major birthday (30, 40, 50) or some other important life marker.  It's not surprising:  at the beginning of a new year, people have high expectations "Hey, it's a new year, I'm gonna change my life".  But, by the middle of January, they typically feel bummed out and majorly disappointed.  I hear clients say: "I thought it was gonna be so great, but it's the same old crap as last year."  We want to work with these difficult emotions, but it just feels impossible to really make any headway.  What to do?

Whether it's January or June, most of us can only sustain our intentions to change for about three days max.  After that, we fall back into the same old patterns.  What's the big surprise?  We've had years to develop these emotional patterns, yet we expect in three days we can undo the cumulative damage of decades.   What a set-up for failurre. 

New Year's Resolutions rarely work; nothing "magically" changes just because it's a new year.  If we want things to change, we need to behave and think differently.  Let's examine some obstacles that may be in the way of creating meaningful change.  Here are three that may be familiar:

You aren't willing to do the work

If you just wait for happiness (more money, a new lover, a better job) to come to you, what do you think will happen?  Likely, nothing!  New results require new thoughts, actions, speech, and intentions.  Before giving up on your resolutions (tempting, isn't it?) look past the obvious and dig deeper.  For example: if you want a boyfriend, what for?  If it's to stop feeling lonely, then a boyfriend may not fix your problem.  Your loneliness is the real problem.  If you think you need a new job, what for?  Do you want to leave your current job because you find some of the people difficult?  Guess what?  There are usually difficult people at every job.  Rather than running away, set your intention to learn how to deal with difficult people.  See what I mean about digging deeper?  A recent client told me he wanted to look like a particular very handsome movie star.  I asked him why.  He said, "because then I'll feel sexy and confident."  I suggested we work on how he can feel that way WITHOUT looking like someone else. 

You're too impatient

How many of us feel impatient about change and don't want to wait forever to become happier?  After all, we deserve to be happy, don't we?  Look at how long we're suffered already.  This kind of logic may work for a TV commercial ("because you're worth it") but it doesn't work in real life.  If you've spent 25, 35 or 45 years feeling you're not worthy of a good job/man/house/whatever, do you really expect to easily and quickly change that?  When my clients want to take on big psychological "makeovers", I encourage them to take it slowly.  We can't sustain major change when we try to do it dramatically and quickly.  I know it isn't as exciting - it wouldn't make good TV - but lasting change in our lives comes gradually, step-by-step. 

You feel overwhelmed

When I have a new client who says, "I have so many problems, I don't know where to start", I encourage him or her to do the following:

Make a list of all the things that bother you and rate these problems (on a scale of 1 to 10) by how much pain each one brings them.  For example, "I hate my job" is a 7, "I feel so lonely" is a 9, "I don't like my body" is a 3.  We then start to work on the most painful stuff first and we focus on one problem at a time, breaking it down into small, do-able action steps. For example, saying "I hate my job" over-and-over is only going to bring you misery.  Instead, ask yourself questions like: "What about my job bothers me the most?  What do I like about it?" Any seemingly unsolvable problem can be broken down into a series of "smaller", more easily solved problems.

You're too hard on yourself

I guarantee you that by being kinder to yourself, any changes you want to make in your life will happen more quickly and painlessly. 

Let's look at one of the most difficult emotions for men to express: sadness.  Whether we're gay, bisexual, trans or straight, most of us were raised with traditional heterosexual values about men, masculinity and crying.  If you're like me, raised in a small town in Ohio, you got some version of:  "Boys don't cry...just suck it up.  If you cry, you're weak and everyone will know it and think you're a sissy."  Now, if you were raised with absolutely NONE of this, I salute your wonderful parents and caregivers. However, if you're like most of us, you got some of the "don't express sadness" crap that I did.  So I invite you to reconsider your way or feeling and expressing sadness.  In this column, I'll share my ideas on "how and when to cry".  Check it out, keep an open mind and see how it feels:

Were you brainwashed to believe that crying is shameful and a sign of weakness?  Were you a little gay/bi/trans (hereafter "GBT") boy who was told to "just suck it up" and grew up to become a tough-as-nails adult who long ago decided: "I'll never let anyone see me cry again"?  Most of us got the message that strong people rarely cry and only sissies and fragile people do.

This is bullshit. 

Sadness is an emotion natural to us all.  The ability or inability to EXPRESS sadness is a learned behavior, and can be unlearned.

Many men I work with don't even know what emotions they're feeling.  Somehow, there is a "disconnect" between what we feel and our ability to recognize what we feel.  A lot of this stuff comes from our childhood; we're "programmed" - from birth - how to handle our emotions.  If our emotions were validated and mirrored back to us, we realize it's okay to feel them.  However, if our emotions were invalidated and we were encouraged NOT to feel them, we become masters of emotional repression.  Over time, this gets "hard wired" in our brains so we don't even have to think about repressing our emotions...we just do it automatically.

Richard Rohr, author of many books on male spirituality, writes that women need to learn to express their anger and men need to learn to express their grief.  I think he has a point:  many of my female clients cry when they are angry, while many of my male clients get angry when they're actually sad.  Good mental health means being able to responsibly express both anger and sadness, regardless of gender. 

For some people, crying feels like giving in...like surrender.  Most of us feel better after a "good cry": our bodies are more relaxed and our tension and stress levels go way down.  It is also true, however, that crying may open the door to feeling more emotionally, and sometimes that is not what we want. 

Let me give you 2 simple exercises:  the first one will allow you to modulate the intensity of your feelings, the second will help you to connect your emotions to what's going on in your body: 

(1) When you want to feel more, breathe deeply.  When you want to feel less, breathe shallowly.   Your breathing strongly affects your ability to feel your emotions.  Try it.

(2) An excellent way to get in touch with feelings like sadness, anger or grief is to notice where in your body you feel them.  For example, let's say your sadness is in your chest.  Pay attention to it, and see what the sensation is like.  Does it feel like tightness, a burning sensation, numbness?  Notice what's going on in your body. 

Some men have told me that they want to be able to cry, but find it difficult.  If this is true for you, the next time you're sad, try this:

Notice if your tears are right below the surface, pushing at the backs of your eyes.  If so, let your eyes relax; don't force the tears (it doesn't work). 

If you were told as a kid, "don't cry...suck it up", you may need to be patient with your tears.  By starting to notice them and the physical sensations that accompany them, you're giving your tears more and more "permission" to come out.  It may take a while to undo all the "brainwashing" from your childhood.  Go easy on yourself and the tears WILL come!

I've had clients, who were afraid to cry, tell me, "Once I start crying, I won't be able to stop."  This is just a fear: believe me, you'll stop.  But you may need to cry quite a bit before that happens.  If you've dammed up your tears up for a long time, you've got quite a backlog there!  They may come out over time or over the course of a few days.  Let them out!  Your body and mind will thank you.

If you're new to crying, let the tears come out in private, in a safe, relaxed place.  You may want to start off alone, or with a trusted friend or lover there to comfort you.  Or, like some of us, you can practice in the dark of a movie theatre or watching a video at home.  Crying is like any other feeling, the more comfortable you get with expressing it, the easier it is to do so. 

Starting today, if it feels right to you:  why not let yourself cry?  Your body (and mind) will thank you

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INTERNALIZED HOMOPHOBIA:  IS IT AN EMOTION?

Here's an email I received that sums up the emotions (shame, guilt, embarrassment, anger) that often accompany internalized homophobia:

Dear Michael:

I am gay and have been out since I've been 18 (I'm now 25), but I gotta tell you:  I hate the way most gay men act and it embarrasses me to be gay.  I am not some macho "straight-acting" guy, but neither am I a man who wants to be called "hey girl".  Do I have a problem or are most gay men just a mess?

Embarrassed in Chicago

Internalized homophobia is self-hatred aimed at ourselves for being gay/bi/trans men.  While I respect the writer's preference for more masculine men, I question why more feminine men provoke his embarrassment and anger.  If you think that your gay brothers are "just a mess", that says more about you than it does about them. 

• Shame is an emotion that says:  you're not good enough,
• Guilt says: you did it wrong and you must pay.
• Embarrassment says:  You should feel bad about yourself.
• Anger says: who I am - or who you are - really pisses me off.

These emotions (and others) come on the wagon train of internalized homophobia.  When we secretly feel bad about being gay/bi/trans, a lot of difficult emotions are bound to surface.  Most of us have some kind of anti-gay/bi/trans feelings inside us, but what do we do with them?

We start by telling the truth about what we think and feel.  This is the first step on the path to freedom.  We stop fooling ourselves.  Even if we convince others we're cool, what really matters is what we say to ourselves.  Our own self-opinion is much more powerful than what others think of us.  This is why our own unspoken homophobia has great destructive power to mess with us consciously and - especially - unconsciously.  For example, if you say you want a certain kind of partner or job or career, but you feel bad about your sexual orientation, you'll probably find lots of subtle ways to subconsciously sabotage yourself.   Haven't you seen all these huge, overly muscled gym bunnies who can never get big enough to assuage their internalized fears of being too "feminine"?  A very wise, older friend of mine used to say, "The bigger the muscles, the smaller the self-confidence."  I'm not saying that this is always true, but it's worth thinking about. 

Gay/bi/trans men come in all shapes, sizes, colors, religions and degrees of masculinity, androgyny and femininity.  If really masculine men annoy you, then figure out why.  Is it envy?  Is it because you haven't yet expressed that side of you?  If really feminine men make you uncomfortable, do the same:  figure out why.  Is it envy that they can be so emotionally free?  Would you like to be able to express that side of yourself but find it makes you cringe?  Most of us are "triggered" by other gay/bi/trans men in some ways, and these "triggered" emotions are the little alarm clocks I spoke of earlier that are encouraging us to "Wake up and pay attention!  There's something here worth investigating."  I see a lot of this in internet dating ads that say,"straight-acting" or some version of that.  If you find yourself tempted to write that as something you require, I invite you to:

Define for yourself "straight-acting":

Define for yourself "gay/bi/trans-acting":

Then take a look at what you've written:  are there elements of each that you find attractive and elements you find unattractive?  Just notice, don't judge yourself.  This is just for you. 

To be really free and happy, most of us would like to have a wide range of possible emotional and physical responses to the many situations that life throws our way.  Some very masculine men are quietly assertive and gentle, while some very feminine men are bold and fearless.  Neither is "right" or "correct", it's both/and, not either/or.  Why not explore it all?  Why not explore the parts of your personality that have long been "missing"?  You'll know what they are by the types of men that make you uncomfortable. 

For example, the above email writer doesn't like to be called:  "Hey girl" and he has every right to respectfully and calmly ask someone not to call him that.  The key words here are: "respectfully" and "calmly".  If that's hard for him to do, then he has some work to do on himself.  If someone "triggers" some difficult emotions in you, it's really more about what's going on inside you than what's going on with them.  What if they said, "Hey stud" or "Hey boy" or "Hey handsome"?  Do any of these make you uncomfortable?  If so, it's time to do a little work on yourself.  

When homophobia shows up in your life, don't stick your head under the pillows and hope it will simply go away.  Instead, wake up and take a look at what's going on.  We all have little bits of homophobia that tend to linger: it's part of living in this heterosexist world.  So when homophobia rears its ugly head, let's identify it and own it so we can - ultimately - let it fade away back into the heterosexist craziness from where it originated.  

THE "D" WORD

Is it a weakness to feel depressed?  What is depression anyway?  Does it show up differently for men than for women?  These are questions I hear a lot of in my private practice.  So many of my clients talk about depression without really knowing what it is.  Recent psychological research is discovering that depression in men often looks really different than it does in women.  This is pretty surprising news.  If it's true, what does this mean for all you gay, bi and trans men out there?  Let's talk about the "D" word.

According to Los Angeles Times writer Melissa Healy, "for men, depression is melancholy on steroids...fast driving, heavy drinking, lots of recreational drug use - for all too many men - are symptoms of depression."  What happens if these symptoms are ignored and not addressed?   In researching her article, Healy found that, for almost 25,000 men a year, the end result of unrecognized depression is suicide.  For many depressed men - regardless of sexual orientation - there is often no cry for help: no river of tears, not even much sadness, just a quiet, tragic ending of a man's life.  According to Healy, in the United States, a depressed man is four times more likely than a woman to commit suicide, yet he is only half as likely to be diagnosed with depression.  It's the "D" word indeed:  Don't ask for help, Don't tell anyone how lousy you feel, and Don't get better. 

As gay, bi and trans men, is this true for us?  According to most of the research I've read, depression is more prevalent among GBT men than in heterosexual men.  Historically, oppressed communities (e.g., non-white, non-middle class, non-heterosexual) have higher rates of depression than straight, white, middle class men.  If so many of us are likely to depressed, what exactly is depression anyway?

Depression in GBT men often looks different than the stereotypic cluster of sadness, guilt and withdrawal that many of us think of when we imagine a depressed person.  Some depressed GBT men suffer symptoms of depression - such as impotence and loss of sexual interest, but others may become wildly promiscuous, complain of sleep troubles, fatigue, headaches or stomach problems - without ever considering that there may be a psychological source to all or some of their symptoms.  Statistically, depressed GBT men are more likely to behave recklessly (e.g., unsafe sex), self-medicate with alcohol and/or drugs, drive too fast and/or seek out emotional confrontation.  All those feelings of depression have to go somewhere!  We turn the unhappiness on ourselves and have internal symptoms or we aim it at other people and sabotage our relationships big-time.

What causes depression?  No one knows for sure.  For all the research that shows that there are genetic markers that run in families, there is equal research that shows it is more environmentally-based.  In my experience, it's likely a combination of the two.  The success of anti-depressants acknowledges that there is a biological component of depression, yet anti-depressants don't make you "happy", they just keep you from feeling super lousy.  They don't solve your problems and they don't make life great.  They can take away that totally hopeless feeling that makes you feel like crawling into bed and never coming out...but once you crawl out of bed, then what?  This is where pills don't help much.  Facing the CAUSE of our depression usually means walking through fire.  Ironically, this is something that we GBT men have been trained to do.  But we're told we should do it ON OUR OWN.  Is this why we're so bad at asking for help?  Would John Wayne, James Bond or any of the X-MEN be able to turn to their best friend and say, "Dude, I think I'm depressed"?

Historically, there's the machismo thing:  depression has long been equated with "weakness", being a "sissy" and "shame".  Where I grew up, in rural Ohio, you were supposed to just "grin and bear it" or "pull yourself up by your bootstraps" as my grandpa (the local butcher) told me when I was little.  We may be living in 2011, but the psychological remnants of "boys don't cry" are still with us.  So instead of admitting we feel like shit, many of us react in the exact OPPOSITE way:  we hide our feelings of depression by acting tough, cool, like we have it all together.  We put on a (fake) smile, hit the bars and clubs, drink way too much and go home with someone cute because we don't want to wake up alone.  Sound familiar?  

How can you tell if you're "clinically depressed" or just "a little depressed"?  Easy:  does it go away on its own and you feel good about life again?  If so, you're what I call "normally depressed" by the usual crap that life throws us all.  When you can bounce up in a week or two, you're not clinically depressed.  But when you feel like shit for three, four, five weeks or more, then you may be "clinically depressed".  You can't just "snap out of it", as Cher told Nicholas Cage in "Moonstruck".   

GBT Latino, African American and Asian Pacific men may suffer the most from cultural taboos against depression.  For example:  a 1996 survey found that 63% of African Americans considered depression "a personal weakness".  In his book "Lay My Burden Down", Harvard Med School psychiatrist Dr. Alvin Poussaint writes that an epidemic of suicide among young black males is only part of the hopelessness and self-hate among African American men.  These kinds of heavy cultural messages don't easily go away, and all men suffer - silently - as a result.  So what can we do?

As GBT men, once again, it is up to us to lead our straight brothers out of ignorance and into a new way of being a man.  Many of us, although raised in the same world as our hetero brothers, found that as GBT men, we had to make our own way in the world.  The traditional rules of the world didn't work for us; we were forced to be pioneers and create our own paths.  Once again, we need to be pioneers and create a new path to mental health.  When we find that we feel shitty for weeks at a time, we need to be man enough to get help.   Depression is debilitating; most of us can't beat it alone.  This is where our friends, our chosen families, our homeboys come in:  we need to be honest with each other, ask for help and notice when someone we love needs help but may be too embarrassed to ask.  We need to be man enough to admit, "Hell yes, I'm depressed." 

For many of us, the first step in healing our depression is to hear, "I think you're depressed" from someone close to us.  If you suspect depression in your friend or partner, don't downplay the changes you see or criticize his behavior.  Instead, tell him that you're worried about his mood or behavior.  Educate him: let him know him that depression is common in GBT men and doesn't always feel like sadness.  Let him know that that  "talk therapy" - with or without anti-depressants - brings relief to four out of five men (according to recent research).  Urge your friend/partner to see his doctor and talk with him/her about how he feels.  Many doctors have a short "depression quiz" they give clients to see if depression is just beneath the surface of other more physical symptoms.  You could also talk to a psychotherapist, trusted older friend or minister/rabbi to get a reality check on if you seem depressed or not.

Above all, don't be afraid to talk about the "D" word:  ask for help, tell someone you trust how lousy you feel and know that you can get better.  We're all in this together...isn't this what Brotherhood is really about?

THE ANTI-DEPRESSANT LIFESTYLE

Anti-depressants are very helpful for lots of people, but they are not the end-all for depression.  Many people run to their doctors for anti-depressants.  You know anti-depressants:  they're those pretty little pills that make ugly, weepy people into happy, beautiful people who run through fields of flowers (at least on TV commercials).  It sounds too good to be true, and often, it is.  I'm not a doctor, and yet I've seen that for many of my clients, they don't work so well, or there are side effects (weight gain, nausea, dry mouth, headaches, sexual dysfunction) that make them not worth the trouble.  When you want to feel less depressed, medication is only ONE alternative.  To feel better  - with or without medication - I recommend that you consider what I call "the anti-depressant lifestyle":  

1. Do some kind of exercise every day; at least 20 minutes every day.  It needn't be the gym, but it needs to be something strenuous enough to get an endorphin lift:  these "natural" anti- depressants are better than anything money can buy. 

2. Do not isolate.  This is important:  even if initially you don't enjoy it, force yourself to be around people.   Slowly increase your social contacts and you'll be less self-obsessed and won't feel so alone in your sadness.

3. Force yourself to say hello to at least 3 people a day.  Practice being approachable and pleasant-looking.  This may sound obvious, but many people look unapproachable and aren't aware of it.  If you feel really brave, you could try smiling a little bit!  

4. Avoid alcohol or recreational drugs.  Alcohol is a depressant and you know where that takes you, and the aftermath of recreational drugs is often intense sadness and loneliness. 

5. No anonymous sex.  This is not the time to put yourself out there and risk rejection or have sex that leaves you feeling empty and lonely. 

6. Get out in nature, be around trees, flowers and plants...or the ocean, or the desert.  Let Mother Nature work her soothing magic on you...plus you can check out all those good-looking men and women in jogging/hiking shorts. 

7. Spend time around animals, if you like them (and if you don't, I feel sorry for you).  If you have animals, this is the time to let them comfort you.  Even goldfish are good listeners...you can imagine what they'd say!  Animals are proven depression lifters.  No animals of your own?  Volunteer to walk a friend's dog or hang out with friends who have pets...petting a sweet dog or an adorable cat can be more effective than any anti-depressant. 

8. Watch what you eat and drink.  If you're tempted to eat junk food, (1) get yourself out of the house and eat at a healthy place or (2) buy some healthy food and make a nice, simple meal for yourself.  A junk food diet contributes to depression (especially the highs and lows of large amounts of sugar and caffeine), so feed yourself healthy stuff and you'll feel less depressed. 

9. Make yourself get dressed and leave the house, even on non-work days.  Stay in bed if you're tired, but not if you're sad.  My rule of thumb is:  it's okay to stay in bed for the morning, but not for the whole day. 

10. If you're depressed, let yourself have a good cry whenever you can.  It's cathartic, and you're likely to feel better after.  Keeping strong emotions inside is not good for your mind or body. 

11. Sometimes, depression or anxiety is too much for us.  If you have suicidal feelings, pay attention to them.  Do not ignore them.  This is a sign that you need professional help.  Call your doctor, therapist or go to the nearest hospital Emergency Room and ask to speak to the On-Duty Psychiatrist.  Get help. 

12. One of the best depression-fighters is to get off your butt and volunteer.  No matter what your interests or time availability, there are people and organizations that need your help, e.g.,   volunteer to read to kids at a nearby elementary school or show up once-a-month at a senior citizen home,  When you give to others, you feel good about yourself and you put yourself in social situations where you're likely to meet like-minded people...and what could be better than that?

WHEN SHOPPING IS A PROBLEM

Many of my friends and clients spend lots of time shopping.  Shopping has become a form of entertainment.   Many of us happiness-seekers have big problems with delayed gratification, especially when advertising tells us, "Get it now, don't wait, only an idiot would be patient."  So we focus on accumulating as much cool stuff as we can.  That L'Oreal commercial "Because I'm worth it" sums it all up.  As an advertising slogan, it's awfully good.  It messes with our heads because...of course we're worth it.  We're worth whatever we want.  Don't we deserve whatever we want?  This kind of thinking can suck anyone into a whirlpool of spending, temporary satisfaction, and - ultimately - depression that leads to more spending and eventual debt.  Debt does not equal happiness, can we agree on that?

Here is a recent email that nicely wraps up (pun intended) the situation:

Dear Michael:

I am embarrassed to be Emailing you, but here goes: I can't stop buying myself stuff.  I am $84,000 in debt from several years of continual shopping (I make less than half that amount as my yearly salary). How do I get out of this hole?  Whenever I feel down, I go shopping.  I would like to stop this bad habit, but how?  Life is so hard...don't I deserve to have nice things to comfort me when I feel bad?   ,

In Hock up to my Ass in Atlanta

Dear Mr. Hock:

Thanks for having the guts to Email me.  I imagine this isn't an easy thing to confess; I admire your honesty.  So here's mine in return: yes, you do deserve to have nice things when you feel bad, but do they need to cost $84,000?  And, my friend, a debt of more than twice your annual salary will not bring you comfort.   It's more likely bringing you a whole lot of stress and unhappiness. 

You deserve comfort when you feel bad, but, brother, this ain't it.  Comfort doesn't have a hidden price tag that will come back and bite you in the ass when the credit card bills come flooding in.  Comfort comes from taking a good long look at yourself and asking "Why am I so depressed/angry/lonely/sad?"  Go to the root of the problem, and stop with the $84,000 band-aids already!

We all want to be happy and sometimes being a good consumer looks like an easy path to get there.  Really good advertising - and there's a lot of it around these days - tries to manipulate our emotions.  As a result, it's no surprise that so many of us feel we're not living up to our (earning/achieving/sexual) potential and are cosmic losers.  This doesn't mean we can't enjoy nice things.  But, it's wise not to make them the most important thing in your life.  If you have money and beautiful objects, great!  But if you don't, can you be okay with that too?  Or will it suck you down into depression? 

Let's ratchet up the consumerism dial and ask another question: are we people or are we brands?  I recently read how a young gay man decided to turn himself into a brand so he could become wealthy and popular. This is not the way to happiness.  If it worked, Paris Hilton would be up there with the Dalai Lama and Mother Teresa.  This future Donald Trump (or Ralph Lauren) stated that,

"...typically younger gay males 17-21, use skills they've yet to learn in marketing 101, and turn themselves into a product, complete with brand recognition...branding one's self (sic) is the new way to claim a piece of fame in our local bar and club scene". 

This could be amusing if it were playful, but it's pretty damned sad to me.  Do we want a piece of fame so badly that we're willing to commodify ourselves to get it?  So much for having personality, intelligence and social skills.  Being a big-time consumer and turning yourself into a brand may get you some good stuff, but it usually brings anxiety and depression, NOT happiness.  Author Patricia Pearson, in her new book, "A Brief History of Anxiety (Yours and Mine)" found that 28.8% of Americans will suffer anxiety in their lifetime - the highest level in the world - and that $4.2 Billion is spent annually, in the USA alone, on treating anxiety. 

I believe that there is a relationship between the crazy anxiety epidemic in this country and the out-of-control consumerism that so many of us get sucked into.  As a therapist, I typically see several people a month who have racked up huge debt as a result of the "I'm worth it" school of thought.  Believe me, they don't come to me because they're happy...they come to me because they want to find a way out of the low self-worth that comes from thinking you're nothing but your brand, your house, your clothes or your stuff. 

Consider these questions:

•1.    Are you someone who loves to shop? 

•2.    Does it make you happy?  If so, for how long?

•3.    Is it hard to stop buying stuff? 

•4.    Are you in debt from continual shopping? 

Going to the Mall when you're unhappy is not that different from standing in front of the refrigerator, opening the door and saying, "Okay food, make me happy."  Neither food nor shopping can make us happy for long.  Here is my Happiness/Shopping theory: most new things (clothes, jewelry, haircuts, makeup, computers, electronic gizmos, etc.) make us happy for three days' max.  After that, it wears off and then what?  You have a credit card bill coming and how long will it take you to pay THAT off?  And we're not even talking about the interest here (I'm not Suze Orman).

As I tell my clients: it's not what you're buying that matters, it's WHY you're buying it.  I like nice things too, but I don't expect them to make my loneliness or boredom go away.  In fact, I don't expect much of them at all.  I buy something because (1) I can afford it and (2) I like it.  Period.  No more, no less.  If you go shopping to avoid feeling something, then, mister, you're headed for trouble.  How long do you think you can avoid your troubles this way?  One client of mine recently bought a $40,000 car because he was bored with his life.  Another client took a $3,000 trip to Europe because he was fed up with dating women who "didn't appreciate me."  When the newness of the car and the European trip wear off, where are these folks?  Back where they started, with a big ole debt to make them feel even worse!

The retail world is happy to make money off our insecurities...especially in this tight economy.  Luxury good retailers appeal to this sense of insecurity (buy something from us and you'll be envied and admired).  On the other end of the spectrum, discount stores seemingly appeal to our intelligence (buy something from us and you'll be a smarter shopper than your friends).  Rather than fall for their marketing tricks, before you step out your front door, ask yourself: What is my motivation in going shopping?  In this hyper-media-driven society, we are continually encouraged to indulge our narcissism and self-pity: "I deserve it."  Of course you deserve it.  We ALL deserve nice things...but using this logic to rack up a huge debt is bullshit rationalization.      

You deserve comfort when you feel bad, but, dear reader, this ain't it.  Comfort doesn't have a hidden price tag that will come back and bite you in the ass when the credit card bills come flooding in.  Comfort comes from taking a good long look at yourself and asking "Why am I so depressed/angry/lonely/sad?"  Go to the root of the problem, and stop using shopping as a temporary fix.  Debtor's Anonymous groups are really helpful for some people, and credit assistance/consolidation services are available too.  But first, look within, then go for (external) help and support. 

LET'S GET CLEAR:  WHAT EXACTLY ARE ANXIETY AND DEPRESSION? 

As a psychotherapist, clients (and people at parties) often ask me about the difference between anxiety and depression.  Often they lump the two together, saying stuff like, "my doctor gave me pills for anxiety and depression" or "I think I'm depressed...do you?" I also hear anxiety lumped together with worry and panic attacks.  And many clients ask me if I think they're bi-polar.  It's all quite confusing, isn't it?   Well...I love to demystify the psychobabble that so many people throw around without really knowing what they're talking about.  Many doctors and psychiatrists are fond of quoting "The Diagnostic and Statistical Manual of Mental Disorders".  This thick book is full of psychological terms that insurance companies require us to use in order to justify your mental health care.  But what does all this theoretical stuff mean to real people with real lives?

Here are my "common sense" definitions: 

Depression generally means that a person feels sadness, irritability or tension and has less interest in the usual pleasures of life.  Other signs of depression include:  low energy (you feel slowed down); a change in appetite or sleeping habits (too much or not enough), and problems making decisions or concentrating.  Depression may be caused by an imbalance of brain chemicals or be a reaction to a difficult event (a death, a breakup, losing your job, etc.)  In my experience, it's often a combination of the two.  At its most severe, depression can result in feeling worthless, hopeless and suicidal.

Anxiety is harder to quantify.  After all, who doesn't experience "normal" anxiety?  It's part of life.  However, when psychotherapists like me use the term in our work, it's more specific.  Anxiety - like bad sex - comes in many forms.  For most of us, it appears as excessive worry, obsessive negative thoughts, restlessness, headaches, poor sleep and/or concentration.  Here are brief descriptions of different "types" of anxiety; these are the diagnoses that most doctors and psychotherapists use, usually because the insurance companies demand them: 

Social anxiety - prolonged and intense fear and/or embarrassment in social situations. 

Panic disorder - sudden feelings of intense fear - often called a "panic attack" - accompanied by physical symptoms that can mimic a heart attack, e.g., dizziness, nausea, feeling suffocated or trapped.

Generalized Anxiety Disorder - daily feelings of worry and anxiety that last for 6 months or more. 

Obsessive Compulsive Disorder (OCD) - there are two ways that this form of anxiety shows up:  (1) thoughts that you can't stop from repeatedly thinking ("obsessions") or (2) actions you can't stop ("compulsions") that temporarily lower your anxiety.  This is the "I can't sleep without checking every door to make sure it's locked" school of behavior. 

Post Traumatic Stress Disorder (PTSD) - a specific, intense kind of anxiety.  It is a reaction to a life-threatening trauma, like wartime combat, being raped or robbed at gunpoint.  Symptoms include flashbacks, nightmares or memories of the event.

Most of us - even yours truly - experience periods of anxiety and depression throughout our lives.  Life throws us good times and bum times, and we all feel it.  However, if anxiety or depression interferes with your ability to get through the day, your doctor may consider you  "clinically depressed" or find that you meet the criteria for "generalized anxiety disorder".  This is usually when doctors recommend anti-depressants or anti-anxiety medications. 

I'll close with that universally misunderstood phenomenon:  bipolar disorder.  Bipolar disorder used to be called "manic depression" because, to meet the diagnostic criteria, you must: (1) experience symptoms of mania, intense/extreme moods, sleeplessness and increased energy that result in reckless behavior, and (2) depression (defined above).  This isn't about extreme moodiness; real mania is - luckily - quite rare.  It's not about dancing drunkenly on the bar at your favorite bar or occasionally buying something expensive at Nordstrom. True mania is an ongoing experience of staying up for days with little need for sleep, racing thoughts, extreme (delusional) self-confidence, super-high unfocused energy, and, worst of all, repeatedly engaging in behavior that endangers you or others. 

If you wonder if you're "clinically" anxious or depressed, talk with an GBT-friendly psychiatrist about your concerns.  I encourage you to be a mildly cynical patient (it's good for your health) and to switch doctors if your doctor talks down to you.  It's always wise to question whether "pills" are right for you or not.  For some people, medication is a real lifesaver (take that Tom Cruise!), while for others, it may help a little, but not be worth the side effects.  Be cynical about information you find on Internet sites: you can find anything out there, from one extreme to the other.  Quiz your doctor and trust yourself. 

BLAME, REVENGE and FORGIVENESS (in that order)

When we've been betrayed, we often want blame and revenge.  If we are really lucky, we may eventually get to forgiveness.  Consider this letter as a springboard into the topic:

Dear Michael:

I feel like such an idiot.  I allowed myself to fall in love with this guy who really wasn't that interested in me.  I thought he was, at the beginning, but he gradually stopped texting me and wanting to get together.  I let myself fall for him, a lot harder than I realized.  I probably shouldn't have slept with him either, because now I really miss that too.  I want revenge on him - like sleeping with his best friend (I could probably have him too!)  What should I do?

Broken Hearted Boy in New Hampshire

Dear BHB:

You met someone, opened your heart, loved him and he left (or faded out).  It's painful and we've all been there.  For many of my clients, the initial reaction to a broken heart is to do one (or both) of the following:

1.      Blame yourself.

2.      Blame him.

Neither one of these does much good, nor will they help you feel better in the long run.  Let's look at each:

Blaming yourself: what did you do wrong?  Were there signs that you ignored?  Did you have blinders on or did you go into this aware of the pros and cons of loving this man?  If the former, then think of it as a chance to learn something so you don't repeat your gaffe.  If the latter, then perhaps there's nothing else you could have done, and nothing to blame yourself for. You can't predict the future: it's always a risk to love someone.  But, isn't it usually worth it?  If, on the other hand, this is a pattern of yours, then perhaps you keep picking unavailable or unsuitable men to love.  This is good stuff for psychotherapy: you can ferret out the subconscious stuff that keeps pushing you to give your number to one Mr. Wrong after another.  

Blaming him: Okay, I admit it.  In the short run, this can be fun, and your friends are likely to encourage it.  So if you must, indulge in this for a while: two weeks' max.  Then, baby, you got to move on.  If he lied to you, cheated on you or treated you poorly, then tell yourself the truth about it and give yourself permission to feel your anger towards him.  I also recommend that you write about it.   Write a no-holds-barred "evil" letter to him - don't hold anything back - and do NOT send it.  You can also hit the bed or sofa with a tennis racket or scream in your car what an asshole he was.  The point of all this stuff is so you don't stay stuck in blame or revenge.  You could be furious for months while he's off having a good time.  Letting go of your anger isn't for him, it's for your benefit - so you can move on with your life.   

As for your broken heart, no one can tell you exactly when you'll be "over" this.  And maybe that's a good thing.  Is it so wrong to grieve the loss of your lover?  Remember both the good and bad times you had as well as his good and bad qualities.  Don't idealize or demonize him.  He probably did the best he could.  For all you know, he's with his therapist right now talking about how stupid he was to let you get away!

Healing a broken heart is a gradual process.  Expect good days and bad days, days when you cry a lot about "the man who got away" and days when you barely think of him.  This is part of the natural process of healing, it comes in stops and starts, ups and downs. 

While initially you may want to "stay busy" and avoid feeling your feelings, eventually, you need to feel them.  Numbing yourself with drugs, alcohol, shopping, workaholism or revenge sex with his friend (tempting, I admit) are only temporary diversions, and are likely to leave you feeling worse than before. 

And don't pretend that everything's "great" or that you're ready to forgive him when you're not.  Putting on a fake smile and pretending you're "over it" will make you feel even worse.  Simply tell people the truth, e.g., "I'm hanging in even though it hurts like hell".  Don't force forgiveness.  Let yourself feel and express all your negative emotions, for a while anyway (like two weeks' max).  You might even allow yourself some revenge fantasies...but don't try and make them come true.  Eventually, the pain of being dumped or rejected recedes and you'll return to yourself again, hopefully wiser and stronger as well as grateful for the love you gave and received. 

SELF-HATE, FEAR & YOUR MIDLIFE "CRISIS"

As gay/bi/trans ("GBT") men, if we're lucky, we're all becoming older.  Few of us die from AIDS and HIV, unlike our less fortunate brothers of the 1980's and 1990's.  And yet, for many of us, age brings not so much peace and wisdom as self-hate and fear.  We hate ourselves because we're not young and pretty anymore.  We're afraid of our future because we feel we're becoming more-and-more invisible. 

I get a lot of emails from mid-life GBT men saying some version of:  "I hate my wrinkles, my gray hair, my love handles, my expanding belly.  Who's going to want me now?"  Only recently are we starting to see attractive images of older GBT men in popular culture.  But, for decades, it was considered a crime to be an old GBT guy:  we were supposed to become "invisible", remember?   There were bars for older men - cruelly called "wrinkle rooms" - and we were supposed to stay away from hot young guys, who supposedly were terrified we would hit on them and remind them of who they would eventually grow up to be.  Ugh.  What a horrible vision of our future.  No wonder so many of our brothers didn't want to live very long; if this is our destiny, who wants it?

Luckily, this is no longer our destiny.  We can start to erase all those years of GBT self-hatred from our psyches and begin to drop the fears of "invisibility" and "wrinkle rooms".  As enlightened GBT men, most of us have looked at our own racism and homophobia, but let's look at a more subtle form of discrimination and self-hatred: ageism.

Straight and gay media lovingly promote the high-priced anti-aging products of their advertisers. They are unlikely to encourage us to love ourselves just as we are. Instead, we are brainwashed to think we are barely acceptable unless we hide or eliminate our gray hair, receding hairlines, love handles and wrinkled skin. Happy, secure GBT men won't buy overpriced anti-aging products; but scared and desperate men will...and do.

How can we escape the self-hatred of ageism? First off, be willing to identify old parts of yourself that you've suppressed. Those needs and desires can be very important for us as we pour the"foundation" for the second half of our life.  Ask yourself: what do I really care about? What do I want to spend my energy on? We are a generation of GBT men who (in general) are better educated, healthier and more affluent than our forefathers. We may live for another 40 or 50 years. But, as one of my 40-something clients recently asked me, "What am I gonna do with all that time?"

Popular culture calls this a "midlife crisis", but does it have to be a crisis? 

Midlife crises shake up our lives for better and for worse, but - surprisingly - the biggest mistake is not having one at all. A midlife crisis is a period of a time of intense growth and dramatic life changes that are exciting and terrifying. The "crisis" usually occurs between our late 30's and early 50's.  How do you know you're having a midlife crisis? It's not only about how your looks change; more importantly, it's about realizing that your values have changed.  You realize that the values that have guided you for so many years no longer work. Something's gotta give!

Most midlife crises are triggered by introspection, events like a death or a relationship ending, unhappiness with physical aging and/or money or career concerns.  For many of us, physical aging hits us - hard -about this time. As one client told me, "What will I do when I'm not young and cute any more?" Unlike celebrities and movie stars, most normal people visibly age. More importantly, we psychologically age. This is also known as becoming "wiser", and it's a good thing.  Wisdom, however, has a way of pulling the rug out from under our youthful illusions ("I'm going to be famous." or "Once I find my soul mate, everything will be perfect".)  Few of us manage to manifest all the dreams of our 20's and 30's, and when we do, the money or the success or the partner rarely measures up to our idealistic standards.

Some of us, in midlife, go through a period of reckless behavior. If we're in a monogamous relationship we may have affairs or even end a long-term relationship. We may find ourselves drinking more, taking more recreational drugs, shopping and spending money we really don't have and/or charging expensive vacations that will take us years to pay for.  All these behaviors are ways of acting out and avoiding reality.  They're detours off the path.  We can take them, but sooner or later, we have to face the music:  we're getting older and our lives have to change.  How are we going to handle this?

Instead of acting out like some overaged teenager - kicking and screaming into your 40's and 50's - I suggest that you use this time to make your life even better.  Take more healthy risks:  try things that make you uncomfortable, like learning a new sport, going to social gatherings and starting conversations (rather than waiting for people to come to you), volunteering or even going back to school to switch careers.  At times like these, lean on your friends and family. These folks can be your rock.  As you begin to change your life, you need them more than ever. Ask them for support, call them when you get scared, and hang with them when you need some comfort.   It's okay to be scared, but don't wallow in self-pity.

When you ask "Who's going to want me now?" the answer needs to be: "I do". If you don't want to be with yourself, who else would want to be with you? Mid-life is the perfect time to start to please yourself by finding out what's missing from your life (self-esteem, excitement, joy, spontaneity, fulfilling sex) and taking steps to have it.

If we are lucky, we get to be older.  Because of AIDS, previous generations of our brothers didn't make it to midlife, so let's be grateful we're still alive and use our 30's, 40's and 50's to learn from past mistakes and set the course for our future: a future based on more than unwrinkled skin...a future based on wisdom and self-acceptance.