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How to Treat Comorbid Depression Associated with Chronic Illness

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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.

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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 November 18, 2021

10 Proven Ways to Judge a Person’s Character

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10 Proven Ways to Judge a Person’s Character

We all fall into the trap of judging a person’s character by their appearance. How wrong we are! All too often, the real character of the person only appears when some negative event hits them or you. Then you may see a toxic person emerging from the ruins and it is often a shock.

A truly frightening example is revealed in the book by O’Toole in Bowman called Dangerous Instincts: How Gut Instincts Betray Us. A perfectly respectable, charming, well dressed neighbor was found to have installed a torture chamber in his garage where he was systematically abusing kidnapped women. This is an extreme example, but it does show how we can be totally deceived by a person’s physical appearance, manners and behavior.

So, what can you do? You want to be able to assess personal qualities when you come into contact with colleagues, fresh acquaintances and new friends who might even become lifelong partners. You want to know if they are:

  • honest
  • reliable
  • competent
  • kind and compassionate
  • capable of taking the blame
  • able to persevere
  • modest and humble
  • pacific and can control anger.

The secret is to reserve judgment and take your time. Observe them in certain situations; look at how they react. Listen to them talking, joking, laughing, explaining, complaining, blaming, praising, ranting, and preaching. Only then will you be able to judge their character. This is not foolproof, but if you follow the 10 ways below, you have a pretty good chance of not ending up in an abusive relationship.

1. Is anger a frequent occurrence?

All too often, angry reactions which may seem to be excessive are a sign that there are underlying issues. Do not think that every person who just snaps and throws his/her weight around mentally and physically is just reacting normally. Everyone has an occasional angry outburst when driving or when things go pear-shaped.

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But if this is almost a daily occurrence, then you need to discover why and maybe avoid that person. Too often, anger will escalate to violent and aggressive behavior. You do not want to be near someone who thinks violence can solve personal or global problems.

2. Can you witness acts of kindness?

How often do you see this person being kind and considerate? Do they give money to beggars, donate to charity, do voluntary work or in some simple way show that they are willing to share the planet with about 7 billion other people?

I was shocked when a guest of mine never showed any kindness to the weak and disadvantaged people in our town. She was ostensibly a religious person, but I began to doubt the sincerity of her beliefs.

“The best index to a person’s character is how he treats people who can’t do him any good, and how he treats people who can’t fight back.”

Abigail Van Buren

3. How does this person take the blame?

Maybe you know that s/he is responsible for a screw-up in the office or even in not turning up on time for a date. Look at their reaction. If they start blaming other colleagues or the traffic, well, this is an indication that they are not willing to take responsibility for their mistakes.

4. Don’t use Facebook as an indicator.

You will be relieved to know that graphology (the study of that forgotten skill of handwriting) is no longer considered a reliable test of a person’s character. Neither is Facebook stalking, fortunately. A study showed that Facebook use of foul language, sexual innuendo and gossip were not reliable indicators of a candidate’s character or future performance in the workplace.

5. Read their emails.

Now a much better idea is to read the person’s emails. Studies show that the use of the following can indicate certain personality traits:

  • Too many exclamation points may reveal a sunny disposition
  • Frequent errors may indicate apathy
  • Use of smileys is the only way a person can smile at you
  • Use of the third person may reveal a certain formality
  • Too many question marks can show anger
  • Overuse of capital letters is regarded as shouting. They are a definite no-no in netiquette, yet a surprising number of  people still use them.

6. Watch out for the show offs.

Listen to people as they talk. How often do they mention their achievements, promotions, awards and successes? If this happens a lot, it is a sure indication that this person has an over-inflated view of his/her achievements. They are unlikely to be modest or show humility. What a pity!  Another person to avoid.

7. Look for evidence of perseverance.

A powerful indicator of grit and tenacity is when a person persists and never gives up when they really want to achieve a life goal. Look for evidence of them keeping going in spite of enormous difficulties.

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Great achievements by scientists and inventors all bear the hallmark of perseverance. We only have to think of Einstein, Edison (who failed thousands of times) and Nelson Mandela to get inspiration. The US Department of Education is in no doubt about how grit, tenacity and perseverance will be key success factors for youth in the 21st century.

8. Their empathy score is high.

Listen to how they talk about the less fortunate members of our society such as the poor, immigrants and the disabled. Do you notice that they talk in a compassionate way about these people? The fact that they even mention them is a strong indicator of empathy.

People with zero empathy will never talk about the disadvantaged. They will rarely ask you a question about a difficult time or relationship. They will usually steer the conversation back to themselves. These people have zero empathy and in extreme cases, they are psychopaths who never show any feelings towards their victims.

9. Learn how to be socially interactive.

We are social animals and this is what makes us so uniquely human. If a person is isolated or a loner, this may be a negative indicator of their character. You want to meet a person who knows about trust, honesty and loyalty. The only way to practice these great qualities is to actually interact socially. The great advantage is that you can share problems and celebrate success and joy together.

“One can acquire everything in solitude, except character.”

Stendhal

 10. Avoid toxic people.

These people are trying to control others and often are failing to come to terms with their own failures. Typical behavior and conversations may concern:

  • Envy or jealousy
  • Criticism of partners, colleagues and friends
  • Complaining about their own lack of success
  • Blaming others for their own bad luck or failure
  • Obsession with themselves and their problems

Listen to these people talk and you will quickly discover that you need to avoid them at all costs because their negativity will drag you down. In addition, as much as you would like to help them, you are not qualified to do so.

Now, having looked at some of the best ways to judge a person, what about yourself? How do others see you? Why not take Dr. Phil’s quiz and find out. Can you bear it?

Featured photo credit: Jacek Dylag via unsplash.com

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