Saturday, August 30, 2014

Depression and Chronic Disease

Which comes first the depression or the chronic disease? 

According to the Centers for Disease Control & Prevention (CDC) ... This association between depression and chronic disease appears attributable to depressive disorders precipitating chronic disease and to chronic disease exacerbating symptoms of depression. In other words-people with depression develop chronic disease and those with a chronic condition can become depressed. 

Depression is one of the most common complications of chronic illness, with a third of people with a serious medical condition having such symptoms. The more serious the disease, and the disruptions to quality of life, the higher the depression risk.

Research indicates depression rates for the following conditions:
• Coronary artery disease: 18-20% experience depression
• Parkinson’s Disease or Multiple sclerosis 40%
• Cancer or Diabetes: 25%
• Chronic pain syndrome 30-54%

 “Caregiver depression” is also a risk and needs to be taken seriously. Since people in this position will often put the needs of their charge over their own, it’s easy for them to experience feelings of sadness, anger and loneliness.

Consider the following:
 • Recognize the signs and symptoms of depression. Be aware that these can also be a sign of changes in your health status. Consequently, it’s important to report this to your medical provider sooner rather than later.

Feelings of helplessness and hopelessness. A bleak outlook—nothing will ever get better and there’s nothing you can do to improve your situation.

Loss of interest in daily activities. No interest in former hobbies, pastimes, social activities, or sex. You’ve lost your ability to feel joy and pleasure.

Appetite or weight changes. Significant weight loss or weight gain—a change of more than 5% of body weight in a month.

Sleep changes. Either insomnia, especially waking in the early hours of the morning, or oversleeping (also known as hypersomnia).

Anger or irritability. Feeling agitated, restless, or even violent. Your tolerance level is low, your temper short, and everything and everyone gets on your nerves.

Loss of energy. Feeling fatigued, sluggish, and physically drained. Your whole body may feel heavy, and even small tasks are exhausting or take longer to complete.

Self-loathing. Strong feelings of worthlessness or guilt. You harshly criticize yourself for perceived faults and mistakes.

Reckless behavior. You engage in escapist behavior such as substance abuse, compulsive gambling, reckless driving, or dangerous sports.

Concentration problems. Trouble focusing, making decisions, or remembering things.

Unexplained aches and pains. An increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain. 

 • If you’d like a better gage of what you are feeling, there are on-line depression tests you can take. One such test is from Psychology Today and will take about 20 minutes. 

• Talk to your medical provider The sooner you are treated for the depression the better you’ll feel on all levels. Be honest with your provider and tell them how you feel.

• If you are a caregiver, recognize that “caregiver depression” is a possibility for anyone, so do what you can to prevent it by:
     Reaching out to others for help-join a support on-line or in person; utilize respite services, which might be available from the medical facility where the person receives their care and/or from a condition specific organization (e.g. Parkinson’s Disease Association); organize a Lotsa Helping Hands website  to make it easier for people to help you and your charge.
      Make yourself a priority: Make time to relax and do things you enjoy. Exercise, going out to dinner with friends, attending a religious service, meditating, watching your favorite TV show, going to the movies, getting a massage, etc. are all ways you can improve how you feel. Be sure to keep your own medical appointments.

-       Don’t isolate from family and friends: Continue to enjoy their company when possible.
-       Use a journal to write about how you feel.

• • You can reduce your risk for depression by following many of the suggestions in Healing the Whole Person: Ways to Increase Well-Being 

• • If you feel suicidal, get help immediately by calling Suicide Help 1-800-273-TALK (8255) or National Hopeline Network at 1-800-784-2433 or go to Suicide Help: Dealing with Suicidal Thoughts and Feelings. Caregivers should check out Suicide Prevention: How to Help Someone Who is Suicidal. 

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