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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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The Gentle Art of Saying No

The Gentle Art of Saying No

No!

It’s a simple fact that you can never be productive if you take on too many commitments — you simply spread yourself too thin and will not be able to get anything done, at least not well or on time.

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But requests for your time are coming in all the time — through phone, email, IM or in person. To stay productive, and minimize stress, you have to learn the Gentle Art of Saying No — an art that many people have problems with.

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What’s so hard about saying no? Well, to start with, it can hurt, anger or disappoint the person you’re saying “no” to, and that’s not usually a fun task. Second, if you hope to work with that person in the future, you’ll want to continue to have a good relationship with that person, and saying “no” in the wrong way can jeopardize that.

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But it doesn’t have to be difficult or hard on your relationship. Here are the Top 10 tips for learning the Gentle Art of Saying No:

  1. Value your time. Know your commitments, and how valuable your precious time is. Then, when someone asks you to dedicate some of your time to a new commitment, you’ll know that you simply cannot do it. And tell them that: “I just can’t right now … my plate is overloaded as it is.”
  2. Know your priorities. Even if you do have some extra time (which for many of us is rare), is this new commitment really the way you want to spend that time? For myself, I know that more commitments means less time with my wife and kids, who are more important to me than anything.
  3. Practice saying no. Practice makes perfect. Saying “no” as often as you can is a great way to get better at it and more comfortable with saying the word. And sometimes, repeating the word is the only way to get a message through to extremely persistent people. When they keep insisting, just keep saying no. Eventually, they’ll get the message.
  4. Don’t apologize. A common way to start out is “I’m sorry but …” as people think that it sounds more polite. While politeness is important, apologizing just makes it sound weaker. You need to be firm, and unapologetic about guarding your time.
  5. Stop being nice. Again, it’s important to be polite, but being nice by saying yes all the time only hurts you. When you make it easy for people to grab your time (or money), they will continue to do it. But if you erect a wall, they will look for easier targets. Show them that your time is well guarded by being firm and turning down as many requests (that are not on your top priority list) as possible.
  6. Say no to your boss. Sometimes we feel that we have to say yes to our boss — they’re our boss, right? And if we say “no” then we look like we can’t handle the work — at least, that’s the common reasoning. But in fact, it’s the opposite — explain to your boss that by taking on too many commitments, you are weakening your productivity and jeopardizing your existing commitments. If your boss insists that you take on the project, go over your project or task list and ask him/her to re-prioritize, explaining that there’s only so much you can take on at one time.
  7. Pre-empting. It’s often much easier to pre-empt requests than to say “no” to them after the request has been made. If you know that requests are likely to be made, perhaps in a meeting, just say to everyone as soon as you come into the meeting, “Look guys, just to let you know, my week is booked full with some urgent projects and I won’t be able to take on any new requests.”
  8. Get back to you. Instead of providing an answer then and there, it’s often better to tell the person you’ll give their request some thought and get back to them. This will allow you to give it some consideration, and check your commitments and priorities. Then, if you can’t take on the request, simply tell them: “After giving this some thought, and checking my commitments, I won’t be able to accommodate the request at this time.” At least you gave it some consideration.
  9. Maybe later. If this is an option that you’d like to keep open, instead of just shutting the door on the person, it’s often better to just say, “This sounds like an interesting opportunity, but I just don’t have the time at the moment. Perhaps you could check back with me in [give a time frame].” Next time, when they check back with you, you might have some free time on your hands.
  10. It’s not you, it’s me. This classic dating rejection can work in other situations. Don’t be insincere about it, though. Often the person or project is a good one, but it’s just not right for you, at least not at this time. Simply say so — you can compliment the idea, the project, the person, the organization … but say that it’s not the right fit, or it’s not what you’re looking for at this time. Only say this if it’s true — people can sense insincerity.

Featured photo credit: Pexels via pexels.com

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