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How to Treat Comorbid Depression Associated with Chronic Illness

How to Treat Comorbid Depression Associated with Chronic Illness

No one likes being sick or hurt.  Try to imagine what it would feel like to know that you would be sick or hurt forever; a person with a broken leg can often find solace in that he or she will only have to suffer from limited mobility and pain for a finite period of time, but other people are not as lucky.

While working in the field of psychology, I came into contact with a number of people who suffered from chronic illnesses like Parkinson’s disease, or the lasting effects from catastrophic medical events such as strokes.  Often, people who have been diagnosed with a chronic illness or condition suffer from comorbid depression, which is a type of depression that is resultant from a primary physical or psychological ailment.  However, comorbid depression must be taken as seriously as major depressive disorder, and there are some things caretakers can do to help treat the depression of a loved one.

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Two things everyone needs to thrive

I believe that there are two things every person needs, healthy or well.  First, every person needs a support system beyond the practitioners who are paid to help them.  There is no “right” support system.  Some people rely heavily on familial support whereas others turn to friends and neighbors.  I found that the most challenging type of person to work with was one who did not have a loved one in the world, as caretakers often need to provide companionship as well as care-taking.  In a best-case scenario, loved ones can act as caretakers and provide continual support through genuine companionship.

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The second thing every person needs is meaning. Often, limited mobility, embarrassing consequences of a speech impediment, or clumsiness due to a neurological disorder can make it difficult to go outside and face the world.  I heartily believe that every person has the capacity to do something meaningful, whether they provide support on online message boards, push the candy cart at the hospital, volunteer at a bookstore, hold a part-time job, or focus on spending time with loved ones. The idea that a person can do something meaningful after suffering from a traumatic medical diagnosis can seem like a pipe-dream, but there are many ways to help change a person’s thought patterns from “I’m useless” to “I am a good and important person.”

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Talk therapy / psychopharmalogical treatments           

There is no one-size-fits-all option for treating depression, though some of the most popular and widely accepted treatments include talk therapy and psychopharmalogical treatment (i.e. taking antidepressant medications).  Often, working with a therapist in addition to taking prescription medication can yield the best results. Keep in mind that a good therapist will not want to see patients twice a week for the rest of their lives, and similarly, people often take popular antidepressants such as SSRIs or SNRIs for a finite period of time. A good analogy I like to use is how most people recover from a knee injury: they may need to use a crutch, see a physical therapist, and take anti-inflammatory medication for a period of time so that they can heal. People suffering from depression are no different—instead of viewing the need for therapy or medication as a failure, it’s best to consider it as a temporary treatment plan so the person can heal.

Have something to look forward to

The most dangerous part of depression is that severe depression coupled with a notable medical condition can cause people to lose the will to live. When a person slips into a state of complete despair, their immune system can become less effective, leaving them susceptible to other serious conditions (e.g. a cold could more readily progress into pneumonia and have a greater chance of more complications). Try to always have something realistic to look forward to, like trips to an equine therapy center, a favorite homemade meal, visits from grandchildren, or trips to baseball games. Sometimes, spending quality time together can be the best motivator to live, improve, and thrive.

Comorbid depression is a serious condition that needs to be addressed. With increasing advances in medication and talk therapy, depression is far more treatable than it was a few decades ago. Ironically, caretakers might find that by helping treat a loved one’s depression, they can improve the quality of their own lives as well.

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Last Updated on January 24, 2021

How to Say No When You Know You Say Yes Too Often

How to Say No When You Know You Say Yes Too Often

Do you say yes so often that you no longer feel that your own needs are being met? Are you wondering how to say no to people?

For years, I was a serial people pleaser[1]. Known as someone who would step up, I would gladly make time, especially when it came to volunteering for certain causes. I proudly carried this role all through grade school, college, even through law school. For years, I thought saying “no” meant I would disappoint a good friend or someone I respected.

But somewhere along the way, I noticed I wasn’t quite living my life. Instead, I seem to have created a schedule that was a strange combination of meeting the expectations of others, what I thought I should be doing, and some of what I actually wanted to do. The result? I had a packed schedule that left me overwhelmed and unfulfilled.

It took a long while, but I learned the art of saying no. Saying no meant I no longer catered fully to everyone else’s needs and could make more room for what I really wanted to do. Instead of cramming too much in, I chose to pursue what really mattered. When that happened, I became a lot happier.

And guess what? I hardly disappointed anyone.

The Importance of Saying No

When you learn the art of saying no, you begin to look at the world differently. Rather than seeing all of the things you could or should be doing (and aren’t doing), you start to look at how to say yes to what’s important.

In other words, you aren’t just reacting to what life throws at you. You seek the opportunities that move you to where you want to be.

Successful people aren’t afraid to say no. Oprah Winfrey, considered one of the most successful women in the world, confessed that it was much later in life when she learned how to say no. Even after she had become internationally famous, she felt she had to say yes to virtually everything.

Being able to say no also helps you manage your time better.

Warren Buffett views “no” as essential to his success. He said:

“The difference between successful people and really successful people is that really successful people say no to almost everything.”

When I made “no” a part of my toolbox, I drove more of my own success, focusing on fewer things and doing them well.

How We Are Pressured to Say Yes

It’s no wonder a lot of us find it hard to say no.

From an early age, we are conditioned to say yes. We said yes probably hundreds of times in order to graduate from high school and then get into college. We said yes to find work, to get a promotion, to find love and then yes again to stay in a relationship. We said yes to find and keep friends.

We say yes because we feel good when we help someone, because it can seem like the right thing to do, because we think that is key to success, and because the request might come from someone who is hard to resist.

And that’s not all. The pressure to say yes doesn’t just come from others. We put a lot of pressure on ourselves.

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At work, we say yes because we compare ourselves to others who seem to be doing more than we are. Outside of work, we say yes because we are feeling bad that we aren’t doing enough to spend time with family or friends.

The message, no matter where we turn, is nearly always, “You really could be doing more.” The result? When people ask us for our time, we are heavily conditioned to say yes.

How Do You Say No Without Feeling Guilty?

Deciding to add the word “no” to your toolbox is no small thing. Perhaps you already say no, but not as much as you would like. Maybe you have an instinct that if you were to learn the art of no that you could finally create more time for things you care about.

But let’s be honest, using the word “no” doesn’t come easily for many people.

3 Rules of Thumbs for Saying No

1. You Need to Get Out of Your Comfort Zone

Let’s face it. It is hard to say no. Setting boundaries around your time, especially you haven’t done it much in the past, will feel awkward. Your comfort zone is “yes,” so it’s time to challenge that and step outside that.

If you need help getting out of your comfort zone, check out this article.

2. You Are the Air Traffic Controller of Your Time

When you want to learn how to say no, remember that you are the only one who understands the demands for your time. Think about it: who else knows about all of the demands in your life? No one.

Only you are at the center of all of these requests. You are the only one that understands what time you really have.

3. Saying No Means Saying Yes to Something That Matters

When we decide not to do something, it means we can say yes to something else that we may care more about. You have a unique opportunity to decide how you spend your precious time.

6 Ways to Start Saying No

Incorporating that little word “no” into your life can be transformational. Turning some things down will mean you can open doors to what really matters. Here are some essential tips to learn the art of no:

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1. Check in With Your Obligation Meter

One of the biggest challenges to saying no is a feeling of obligation. Do you feel you have a responsibility to say yes and worry that saying no will reflect poorly on you?

Ask yourself whether you truly have the duty to say yes. Check your assumptions or beliefs about whether you carry the responsibility to say yes. Turn it around and instead ask what duty you owe to yourself.

2. Resist the Fear of Missing out (FOMO)

Do you have a fear of missing out (FOMO)? FOMO can follow us around in so many ways. At work, we volunteer our time because we fear we won’t move ahead. In our personal lives, we agree to join the crowd because of FOMO, even while we ourselves aren’t enjoying the fun.

Check in with yourself. Are you saying yes because of FOMO or because you really want to say yes? More often than not, running after fear doesn’t make us feel better[2].

3. Check Your Assumptions About What It Means to Say No

Do you dread the reaction you will get if you say no? Often, we say yes because we worry about how others will respond or because of the consequences. We may be afraid to disappoint others or think we will lose their respect. We often forget how much we are disappointing ourselves along the way.

Keep in mind that saying no can be exactly what is needed to send the right message that you have limited time. In the tips below, you will see how to communicate your no in a gentle and loving way.

You might disappoint someone initially, but drawing a boundary can bring you the freedom you need so that you can give freely of yourself when you truly want to. And it will often help others have more respect for you and your boundaries, not less.

4. When the Request Comes in, Sit on It

Sometimes, when we are in the moment, we instinctively agree. The request might make sense at first. Or we typically have said yes to this request in the past.

Give yourself a little time to reflect on whether you really have the time or can do the task properly. You may decide the best option is to say no. There is no harm in giving yourself the time to decide.

5. Communicate Your “No” with Transparency and Kindness

When you are ready to tell someone no, communicate your decision clearly. The message can be open and honest[3] to ensure the recipient that your reasons have to do with your limited time.

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How do you say no? 9 Healthy Ways to Say “No”

    Resist the temptation not to respond or communicate all. But do not feel obligated to provide a lengthy account about why you are saying no.

    Clear communication with a short explanation is all that is needed. I have found it useful to tell people that I have many demands and need to be careful with how I allocate my time. I will sometimes say I really appreciate that they came to me and for them to check in again if the opportunity arises another time.

    6. Consider How to Use a Modified No

    If you are under pressure to say yes but want to say no, you may want to consider downgrading a “yes” to a “yes but…” as this will give you an opportunity to condition your agreement to what works best for you.

    Sometimes, the condition can be to do the task, but not in the time frame that was originally requested. Or perhaps you can do part of what has been asked.

    Final Thoughts

    Beginning right now, you can change how you respond to requests for your time. When the request comes in, take yourself off autopilot where you might normally say yes.

    Use the request as a way to draw a healthy boundary around your time. Pay particular attention to when you place certain demands on yourself.

    Try it now. Say no to a friend who continues to take advantage of your goodwill. Or, draw the line with a workaholic colleague and tell them you will complete the project, but not by working all weekend. You’ll find yourself much happier.

    More Tips on How to Say No

    Featured photo credit: Chris Ainsworth via unsplash.com

    Reference

    [1] Science of People: 11 Expert Tips to Stop Being a People Pleaser and Start Doing You
    [2] Anxiety and Depression Association of America: Tips to Get Over Your FOMO, or Fear of Missing Out
    [3] Cooks Hill Counseling: 9 Healthy Ways to Say “No”

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