Sometimes, silly things can turn a good self-image upside down -- things you'd never expect to bother you much. Moving house, for example, is something most of us have done. Last year, over 38 million Americans changed addresses. And realtors predict this year will be a banner one for house sales.
Yet moving away from home and friends is no trivial event. It can cause emotional stress that reaches a peak just after a move or that bubbles to the surface years later as apparently unrelated problems.
Diane Fleck moved a year ago with her husband and three young children from a small, cramped house in Adelphi, Md., to a larger one in Howard County.
"Two weeks after the move, when all the boxes were unpacked, I began to feel very unsure of myself. I felt overwhelmed. I'd cry easily. I'd lie in bed early in the morning and visualize our old house in detail. That would make me feel worse, but I couldn't seem to stop. After a while, I couldn't stay home alone."
Fleck's feelings finally came to a head one Saturday morning when, after burning breakfast, she became hysterical. "The kids were frightened, and I was too, for them. My husband drove me to the emergency room of our local health center, where they gave me a mild tranquilizer and arranged an appointment with a psychiatrist."
"When I saw him the next week, he assured me that my reaction wasn't uncommon," Fleck says.
"Typically, people don't think they're depressed or angry or lonely because they move," says Dr. Ellen McDaniel, associate dean of psychiatry with the University of Maryland at Baltimore. "They just don't see moving as a stressful experience. It's only in taking their histories that I find they've recently changed homes," she says.
This stress can be channeled into physical illness. "I see a growing number of patients with problems linked to moving," says Dr. James Chaconas, an Arnold, Md., family practice physician. "We know that stress suppresses the immune system," he says, "and I often get patients who've recently moved with severe bronchitis or other bacterial or viral infections."
But what is it about moving that's so stressful? Dr. Joanne Mendelman, an Annapolis psychotherapist, explains: "Whenever we live in a place, we form attachments to physical objects there -- things as simple as lilac trees and local brands of ice cream. It's a source of security."
She says people identify themselves by these attachments and that when they move away, they break ties with things as well as with friends or relations. Then comes a feeling of abandonment.
"It doesn't matter that we're doing the abandoning and not being left to ourselves; the feelings are the same," she says.
Grief is also a common emotion. "It's too dramatic to say moving is like a death in the family, where you don't feel the impact of what's missing until you settle back into your routine but there are definite similarities," says McDaniel.
They have to do with intangibles. For example, "You miss people, but more than that, you miss the predictability of having a relationship with them. You may think you miss the old lady in the post office who has given you stamps once a week for 20 years, but you miss the ability to see her as well," she says.
Many moves arouse anger. Anger at being uprooted. Anger at being forced to throw away familiar things. Some people focus that emotion on their innocent families; others on that outward symbol of their turmoil, the movers.
"We get angry when people invade our household. They pack up our most precious possessions and throw them around," says Mendelman. "They walk into our very private bedrooms and tear apart the bed, where we've slept and had our most intimate relationships," she adds. For some people, it's the worst invasion of privacy they'll ever experience.
Children may express their feelings as anger, and though as a group they're flexible and weather moves well, the initial events may be stressful. This is because relationships with school and friends are a great part of a child's sense of security and self, says Mendelman.
Younger children have fewer psychological problems with a move since their world is still centered on family. But even for them, there are pitfalls. In a 1982 study in Houston, researchers interviewed 330 children hospitalized for burns and found the rate of house-changing was three times that of the general population. The peak danger time, the researchers wrote, was from two to five months after a move.
And, last, no trauma is complete without guilt. Guilt lurks if dependent relatives or friends are left behind. It also occurs if a move is for obviously positive reasons, such as when a job offers a higher salary but you're ambivalent about the change.
Fleck changed houses for "a whole handful of good reasons" including a larger house, better schools and less noise and traffic. When she felt unhappy, she also felt guilty. "It bothered me that nobody else seemed upset and that they couldn't understand why I was unhappy," she says.
All this is fairly bleak. Psychologists say many people do have happy moves. Those who have a higher number of positive reasons for moving have fewer problems. So do those who can start conversations with strangers and who tolerate a wide range of others' behaviors, according to surveys cited by sociologist Robert Gutman.
If you don't have these virtues, you can still move untraumatically by being aware of possible stress for a few months after moving. "Tell yourself it's O.K. to experience this grief, this loss," says Mendelman. She also suggests more concrete tactics (see box).
If people still have troubles, a bit of counseling is worthwhile. Fleck, who "never takes pills" and never previously saw a psychiatrist, found a few months of counseling combined with a prescribed mild antidepressant very helpful. Now, she's fine.
Mostly, the best cures are time and the realization that you've got plenty of company.