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. 

Depression Symptoms & Warning Signs 

 • 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:

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     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.

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      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. 

Take a Break: Marbled Milk Fun

A layer of milk, with a few drops of food color, followed by a drop of dish soap will result in an amazing display of movable and ever changing art. 

You can save this art, by laying a piece water color paper on top and pulling it off. Let the paper dry and you have gorgeous note paper. Need better directions, check out Science Art for Kids. 

Not interested in today’s activity? Check out the Take a Break Pinterest for lots of Take a Break ideas. 

Living within your means: Un stuff yourself

Those affected by chronic disease tend to have considerable financial issues and with that in mind, I wrote the posts Ways to Save Money on Monthlies (Bills)  and Health Costs: When you have some money but not enough.  However, as a result of a recent discussion with a friend I realized there was a fundamental concept that I hadn’t addressed-society does not value living within our means. The belief is that we must continue to shop, consume, and amass in order to have a healthy and growing economy.  Consequently, we are bombarded daily, in all directions with advertisements and other strategies to make us want to spend money. Talk about an unhealthy situation!

Contrast this with the Yankee slogan of  “Use it up, wear it out, make it do, or do without.” Given the hardscrabble conditions of Northern New England, this attitude was essential to survival. However, the development of a tourist economy, mass media,  credit cards, “labor saving devices,” loans and the proliferation of “big box” stores offering “low cost” goods has definitely dealt a blow to Yankee thrift. People now over extend on credit cards, purchase items they don’t need and have debt levels that their parents, let alone grand parents couldn’t even imagine.

Fortunately, there is a growing movement to simplify and return Yankee thinking to its rightful place. Yes, there are lots of websites that offer “thrifty tips” so you can save up and buy a bigger house, or take your dream vacation etc. More interesting to me are the “cashless” people who are seeking a way of life based on something other than consumerism. Some examples include:

• Heidemarie Schwerme, featured in the film "Living Without Money,” she is now in her 70s and has been doing so for over 15 years.  “Living Big on Less.”  is the website developed by the makers of the film. 

• Mark Boyle and his Moneyless Manifesto. You can also watch Mark  in the Moneyless Man. 

• Two Raging Grannies. 

While I think these are fascinating ideas to explore, it’s the space between the extremes of all or nothing-the living within your means- that interests me the most.  Therefore this post and things to consider:

Differentiating between Needs and Wants: Ask yourself the following questions before making purchases:

• How would having this impact my life today, 10 weeks, 10 months and 10 years from now?

• Is it essential for my health and well being? Food, housing, clothing, medications and means of mobility are essential. Within that are elements that separate a need from a want. Things like sodas, snack foods, luxury clothes and cars are not essential. A metro card instead of a car is a reasonable answer to mobility and far cheaper. Nuts versus cake for food, water over soda, and provided they are of equal value, a generic instead of a brand name prescription are all examples of choices that meet the need in an affordable and healthy manner.

• Do you measure your self worth by what you have versus who you are? Are you a victim of “keeping up with the Joneses?” Do you want something because someone else has it or is it something you need? Keep in mind that your neighbor/friend may be accruing significant debt to pay for that great vacation or new car. Is that how you want to live?

Adopt the Buyerarchy: Use what you have; borrow what you need; swap; make it yourself; try a thrift store and buy only when you’ve tried the other options. Studies show that when you purchase with cash, versus a credit card, you actually spend less and are smarter in your selection. Of course, never pay retail whenever possible.

Develop social capital: Volunteerism is still an important feature of Northern New England towns. Activities, such as a barn raising or a sewing bee, were opportunities for people to socialize, check in on their neighbors and get something done. Basically, if you want to make sure someone is going to be there when you need the help, be there for others.

Today, there are many websites and community organizations that have established
barter programs. One example is U Exchange. If you are fortunate to live in a community with a barter program, participate.

Condition specific support groups, such as a Parkinson’s group, are incredibly valuable and there are multiple benefits. In addition to being part of such a group, since many of these are based out of health centers, volunteer in your community.

Downsize Possessions: A photographer friend use to tell me, “the more toys I have, the more I have to work.” Since he preferred sitting on his stoop talking to the neighbors, he reduced his living space and requirements so he only needed to work about a day and a half per week. What brings us joy and contentment is our connections with one another not the pile of stuff in the closet.

Significantly reduce or eliminate TV Time: The more time you spend watching TV, the more you are barraged by advertisements (the average American sees thousands of ads daily) and the more you will want to spend money. Video streaming not only eliminates your cable bill but also the exposure to advertisements.

Spend time in nature: A walk in a park versus mall walking has a host of benefits including the calming effects of nature and the reduction in temptation to purchase things you don’t need.

 Define your Self worth by how you live not by a bank account: Years ago a friend of mine, who had been very ill for quite sometime was on the mend and she said, “I have no money in the bank, but I’m very rich.” She went on to explain that the most important thing in life was having people that loved her and vice versa.

Spend Time with Those Who Share Similar Values: If your closest friends prefer to spend their time shopping and maxing out their credit card, chances are your going to feel it’s the “norm” to do likewise. We are very influenced by the company we keep so if you want to keep your costs under control, socialize more with friends and family who feel the same way.

If you haven’t checked out the previously related posts, you might find the following helpful: Ways to Save Money on Monthlies (Bills)  and Health Costs: When you have some money but not enough. 

 “Do what you can. Where you are. With what you have.” Theodore Roosevelt