Tag Archives: depression

Understanding senior loneliness and depression

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Courtesy Vista Springs Assisted Living

By Vista Springs Assisted Living


It’s important to be involved with your loved one’s health as they age so you can best assist them with medications, doctor’s visits, and other care needs. While being aware of the physical needs of your family members is essential, it’s equally important to be mindful of the state of their mental health. 


Seniors can often suffer from loneliness and depression that goes undiagnosed and untreated. Typically this omission comes from the fact that seniors tend to hide mental health concerns from their families out of guilt or shame. That’s why it’s critical to know what signs to be on the lookout for in senior family members and understand how depression and loneliness manifest in elderly people.

A serious epidemic

Shockingly, many people are under the impression that loneliness and depression in old age are a normal part of the aging process. This couldn’t be further from the truth. Loneliness and depression are diagnosed medical conditions that aren’t just a part of growing old, but are part of a serious epidemic in seniors. 


Just as with younger people, untreated depression and loneliness in seniors can have severe consequences on both mental and physical health. And, when paired with other health conditions that many older people experience, the symptoms of these mental health issues can have even farther-reaching long-term effects.

Four unexpected consequences of loneliness and depression

  1. Higher chances of developing dementia
  2. Increased medical costs from associated illnesses
  3. Seniors are more vulnerable to financial abuse when isolated
  4. Increased likelihood of early mortality

What is senior loneliness?

Senior loneliness is a specific type of social isolation that occurs when an older person no longer engages in the world around them as they did when they were younger. This condition often occurs in seniors who live at home and don’t have daily social interactions.


While living at home rather than moving to a senior living community is a favorable idea for most seniors, it can become extremely lonely if transportation and mobility become limited. And, if children and grandchildren are too busy with their own schedules to visit often, older family members can find themselves alone and overwhelmed with feelings of worthlessness and detachment. 

Signs of senior loneliness

  • Lack of appetite
  • Changes in sleeping patterns, particularly restless sleep
  • Increased time at home
  • Less frequent communication with family and friends
  • Debilitating medical diagnoses
  • Despondent attitude 

What is senior depression?

Like loneliness, senior depression is often the result of changes in health, mobility, or mindset. While it’s reasonable for seniors to have some feelings of anger or sadness about their changing position in life, a serious mental health condition like depression is different than these general emotions and should never be taken lightly.


If you believe a loved one is suffering from depression, speak to them immediately and ensure they have access to the necessary resources should they reach a breaking point, such as the National Suicide Prevention Lifeline at 1-800-273-8255. 


Depression should never be ignored, even if having a conversation with your senior family member about their mental health is difficult. By being open and willing to listen to them while also being on the lookout for signs that overall sadness has progressed into something more, you can help protect your loved ones.

Signs of senior depression

  • Overwhelming feelings of sadness, hopelessness, shame, or guilt
  • Loss of interest in activities and hobbies
  • Weight loss or gain
  • Lack of energy
  • Changes in sleeping patterns
  • Thoughts of suicide
  • Drop in cognitive ability
  • Neglecting personal care

How you can help

The consequences of senior loneliness and depression are frightening to consider, but the good news is that there is plenty that you can do to help your loved ones. The number one thing you can do is to be there for your family members and make time to check in and visit with them. 


In addition, you can offer them rides to social events if you live close by, take them out for dinners and shopping trips, and encourage them to find new opportunities to engage with other people. Socialization is essential for maintaining cognitive and mental health in old age, so doing your part to help seniors stay social goes a long way in preventing and treating loneliness and depression.


If you are still concerned that your loved one isn’t getting the necessary interactions they need to stay healthy, you might want to talk to them about assisted living. Assisted living provides seniors not only with the care services they need to age in place, but plenty of opportunities for making new friends and relationships with other residents. 


Reprinted with permission from Vista Springs Assisted Living.




‘It is more than a skin blemish’

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Adolescence is a tough time, and blemishes make it all the tougher. (Courtesy Spectrum Health Beat)

By Jason Singer, Spectrum Health Beat


It’s intuitive that acne causes depression, but a massive new study out of England shows just how devastating acne can weigh on people’s psyches.


Researchers, following nearly 2 million men and women in England over a 15-year period, found a 63 percent increase in clinical depression in the first year people had acne compared to those without acne.


Most people were younger than 19 at the start of the study, but they ranged in age from 7 to 50.


“This is not surprising,” said Adele Cadieux, PsyD, a pediatric psychologist with Spectrum Health Helen Devos Children’s Hospital. “Unfortunately acne begins when kids are much more focused on their physical appearance” than other qualities.


Acne is mostly unavoidable: About 85 percent of people will experience a breakout at some point, making it the most common skin condition in the U.S., according to the American Academy of Dermatology. Women are more likely to get acne, and more likely to suffer depression because of it.


There are ways, however, to reduce children and teens’ risk of suffering depression after an outbreak.

Recognize the signs

Acne is a skin condition in which hair follicles become plugged with oil and dead skin cells. This can cause whiteheads, blackheads or pimples on the face, forehead, back, chest and shoulders.


Many people think of acne as a relatively benign condition, but the study shows otherwise, researchers said.


“For these patients with acne, it is more than a skin blemish—it can impose significant mental health concerns and should be taken seriously,” Dr. Isabelle Vallerand, the lead researcher, noted in a statement.


Parents concerned about their children should look for possible signs of depression.


“If (kids) mention they might not want to go social or extracurricular activities, or their child’s behavior or grades start changing, or they seem more withdrawn,” those could be signs the child is struggling with something, Dr. Cadieux said.


“Whether the child identifies whether any of this is related to acne or not, it’s important to take that next step of trying to evaluate what’s contributing to these changes.”


The best way to find out answers: Ask questions, Dr. Cadieux said.


If kids seem reluctant to talk to their parents, take them to a pediatrician or encourage a special teacher, coach or religious figure to talk with them, she said. Sometimes children are more likely to open up to non-family members than they would a parent.

‘You’re on a stage and being judged’

An effective way to gird children and teenagers against depression is to focus on qualities other than physical appearance.


“One of the things that is really important for kids is to focus on aspects of their life that are going well,” Dr. Cadieux said. “Families can be very important in providing some of that feedback, whether it’s their personal qualities, their skills, really anything other than focusing on physical appearance.”


Fostering those other skills and qualities—getting them into music classes, sports leagues, coding or theater camps, depending on their interests—can also help them form an identity around those qualities rather than their physical appearance, doctors said.


If those efforts don’t work, counseling is an option.


The increase in risk of depression is the worst in the first year of acne, and lasts for five years, the study showed. Although still high, the increased risk of depression decreases each year after the first year of diagnosis.


After five years, the increased risk disappears, even if the acne persists. This also isn’t surprising, Dr. Cadieux said.


“As you get older, your maturity level changes,” she said. “In adolescence, you’re so focused on physical appearance, as if you’re on stage and being judged.


“But as you transition into adulthood, you begin to recognize your skills, abilities and successes—you can build your self-esteem on these and not focus as much on physical appearance. These can help reduce the risk of depression.”


Reprinted with permission from Spectrum Health Beat.




Recognizing depression in older adults

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By Linda Cronk, Michigan State University Extension


According to the Geriatric Education Center of Michigan at Michigan State University, depression in older adults can seriously affect their quality of life and health. Stress, depression and anxiety can contribute to physical ailments including digestive disorders, sleep disturbances and lack of energy. Older adults who are depressed can also have an increased risk of substance abuse, reduced cognition, higher risk of suicide and a higher incidence of heart attacks.


Older adults can experience different reasons and risk factors for depression than younger adults. HelpGuide.org, a research-based website in collaboration with Harvard Medical School, says that common reasons and risk factors for depression in older adults can include:

  • Health problems – Illness and disability, chronic or severe pain, cognitive decline, damage to body image due to surgery or disease.
  • Loneliness and isolation – Living alone; a dwindling social circle due to deaths or relocation; decreased mobility due to illness or loss of driving privileges.
  • Reduced sense of purpose – Feelings of purposelessness or loss of identity due to retirement or physical limitations on activities.
  • Fears – Fear of death or dying; anxiety over financial problems or health issues.
  • Recent bereavements – The death of friends, family members, and pets; the loss of a spouse or partner.

Michigan State University Extension says that ways you can help are to learn about and recognize the signs and symptoms of depression in older adults and the elderly. Common symptoms include sadness, fatigue, abandoning or losing interest in hobbies or other pleasurable pastimes, social withdrawal and isolation (reluctance to be with friends, engage in activities, or leave home), weight loss or loss of appetite, sleep disturbances, loss of self-worth, increased use of alcohol or other drugs, or a fixation on death, suicidal thoughts or attempts.


Is it depression or dementia? According to Harvard Health Publications, here are some signs to watch for:

  • With depression, mental decline can happen quickly, but with dementia, mental decline happens more slowly.
  • When someone is depressed, they still know things like the correct time, date and where they are, but with dementia, they become confused and disoriented and sometimes lost in familiar locations.
  • With depression, people have a hard time concentrating, and they may worry about memory problems. People with dementia have short-term memory loss and don’t notice memory problems or seem to care.
  • When someone is depressed, language and motor skills are slow, but normal, whereas someone with dementia has impaired writing, speaking and motor skills.

There is good news! According to a study published by Harvard Medical School’s Harvard Health Publications, for those who stuck with treatment, depression resolved in seven out of 10 people. Completing a treatment regime can increase positive mood, strengthen personal relationships, increase satisfaction in activities of daily living and help people feel like themselves again.


If you are concerned that your loved one is suffering from depression as an older adult, help them connect to their primary care provider to assess the situation and to identify health and community resources to help them restore their quality of life.


For more information on depression read Depression Symptoms and Warning Signs.


This article was published by Michigan State University Extension. For more information, visit http://www.msue.msu.edu. To have a digest of information delivered straight to your email inbox, visit http://www.msue.msu.edu/newsletters. To contact an expert in your area, visit http://expert.msue.msu.edu, or call 888-MSUE4MI (888-678-3464).




‘A little bit of hope’

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Spravato may provide a dose of hope to people who struggle with treatment-resistant depression. (Courtesy Spectrum Health Beat)

By Jason Singer, Spectrum Health Beat


For the first time in decades, doctors have a new weapon to fight serious cases of depression.


Of the 16 million Americans adults living with depression, as many as four million have treatment-resistant depression, which means current treatments such as talk therapy, anti-depressants and electro-convulsive therapy have given them little or no relief.


But recently, the Food and Drug Administration approved ketamine, a fast-acting drug that differs significantly from Prozac, Paxil and other anti-depressants that have been on the market since the 1990s.


Even when antidepressants work, it often takes four to six weeks to kick in, while ketamine only takes several hours to begin showing positive effects, drug trials have shown. The approval is “welcomed news,” said David Franzblau, MD, a psychiatrist with Spectrum Health Medical Group.


“The prospects for ketamine as a long-term treatment remains to be seen,” said Dr. Franzblau, the site chief of the Spectrum Health Integrated Care Campus at East Beltline.


“Trials have shown that the duration of time before symptom-relief is generally much shorter compared to current antidepressants so it at least represents a promising bridge, if not a long-term treatment.”

A stubborn illness

Depression is a mood disorder that affects the way people feel and interferes with their ability to function at home and at work.


It can be associated with the loss of appetite, sleep disturbance, difficulty concentrating, memory impairment, and a loss of motivation and productivity, Dr. Franzblau said.


“Everybody experiences sadness and anxiety,” he said. “It’s the length of time and number of episodes, along with a constellation of other symptoms, that determine whether somebody has clinical depression.”


About one in 16 American adults suffer from clinical depression at any given moment.


“Depression is the most prevalent mental health disorder in the population,” Dr. Franzblau said. “I believe the adverse impacts of even the treatment-resistant variants can be substantially decreased, and thereby improve the quality of life (of all patients), with enough time and a systematic approach.”


The first step in combating depression is consulting with your primary care physician. First-line interventions that a mental health professional might recommend include counseling and medication.


Antidepressants regulate neurotransmitters like dopamine, serotonin and norepinephrine. But the results have been mixed, especially for the up to 33 percent of patients who have treatment-resistant depression.


One current intervention for treatment-resistant depression is electro-convulsive therapy. The benefits of electro-convulsive therapy “were observed accidentally,” Dr. Franzblau said, “like many scientific discoveries.”


The symptoms of depression among patients with epilepsy improved after a seizure.


“The brain is an electrical apparatus: brain activity, thinking, memory and mood regulation like arousal or anxiety, those are all electrical or electro-chemical events,” he said. “So ECT is basically inducing a seizure” in a controlled environment (often in an outpatient setting), helping severely depressed people who haven’t responded to medication.


There are misconceptions about the procedure, and suitable patients have to be chosen, but it can be effective in bringing about a recovery, Dr. Franzblau said. Sometimes one course of this treatment will suffice, or a patient may require periodic maintenance treatment.

From the club to the doctor’s office

Despite $12 billion a year spent on antidepressants globally, suicide rates have increased 25 percent nationally in the last two decades, and are rising in 49 of 50 states.


That’s why any new treatment is welcomed news.


Interest in ketamine—an anesthetic used frequently in hospitals and the battlefield—has grown steadily since the early 2000s.


In 2000, researches at Yale reported that doses of ketamine provided quick relief to seven people with depression.


In 2006, the National Institute of Mental Health documented 18 people with treatment-resistant depression who received the drug intravenously and reported their issues had disappeared almost immediately.


“What seems remarkable is that the drug also seems to help domains other than depression, like anxiety, suicidal thinking, and anhedonia”—the inability to feel pleasure, noted Dr. Carlos Zarate Jr, chief of the National Institute of Mental Health’s experimental therapeutics branch who led the 2006 study.


“It seems to have more broad effects, on many areas of mood,” shared in a New York Times article about ketamine.


Ketamine does have side effects. Ketamine was once a popular drug in the 1980s and 1990s known as Special K, and can cause hallucinations and psychotic episodes in people who are high risk for them. The drug also was less effective in drug trials for people over 65.


The drug maker, Janssen Pharmaceuticals, said the non-generic medication form esketamine, which will be marketed as Spravato, would have less dramatic side effects. Like with all new drugs, Dr. Franzblau said he’ll proceed cautiously because the benefits and costs become clear only after a medication has been used for some time.


“I anticipate I will use it,” he said. “I want to make sure that the benefits outweigh any complications and side effects.”


Esketamine will be administered as a nasal spray. Patients who receive it will have to be monitored for at least two hours, and won’t be allowed to drive on days they receive the drug.


The recommended course will be two days per week for four weeks.


In one drug trial, Janssen reported that those taking esketamine only relapsed into depression 25 percent of the time, as opposed to 45 percent with a placebo. All the people in the study had previously been diagnosed as having treatment-resistant depression, and had failed with other types of treatment.


“Clinical depression represents considerable suffering for the patient and their families,” Dr. Franzblau said. “At worse, it’s a lethal condition, as demonstrated by the rising suicides in our country. New treatments are needed and offer hope.”


Reprinted with permission from Spectrum Health Beat.


Don’t let anxiety or depression take control

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Break through the fog of depression. You can do it! (Courtesy Spectrum Health Beat)

By Diana Bitner, MD, Spectrum Health Beat

 

Depression and anxiety are both common and potentially serious health issues.

 

In fact, approximately 10 percent of us suffer from one of these disorders, with anxiety being more common in women than in men.

 

The symptoms of anxiety and depression can go away and come back throughout life if left untreated, and many people find it difficult to admit they have anxiety or depression, thinking there isn’t a cure for what they are experiencing. Fortunately, this couldn’t be further from the truth.

 

A few months ago, a patient I’ll call Cindy came to see me for her annual visit. She started to talk about her life and how she was feeling down most of the time. She didn’t understand why she was feeling this way—everything seemed like it should be nearly perfect.

 

Cindy is married, has three great kids and a part-time job she enjoys. She also has a strong group of friends at church and her parents live nearby, so she really feels like she has a good life.

 

As I probed a bit further with questions, she admitted she had been feeling down for about three months and wondered if she would ever feel like her old self again.

 

Her kids are doing well, but they are becoming busier with sports, church and school. Of course, this meant that Cindy is becoming busier as well. Although she generally isn’t feeling stressed or anxious, she started noticing some changes in herself: doubting how well she could handle her busy life, losing interest in playing games with her kids, making excuses to avoid going out with friends, cooking less (something she once loved to do), losing interest in sex, and exercising less.

 

When I asked Cindy about her extended family, she said that her mom had suffered from depression during Cindy’s childhood, and she remembers her mom withdrawing and spending quite a bit of time in her bedroom.

 

Cindy felt that her mom didn’t really know her and was never supportive of anything she wanted to do. In fact, when Cindy wanted to join the cheer team in high school, her mom would not take her to practice, and never encouraged Cindy to practice on her own or exercise to stay in shape. In addition, her mom always seemed sad and unusually quiet, her dad worked long hours and was never home, and her brother kept to himself most of the time.

 

Cindy obviously didn’t have a perfect childhood. She once had big dreams of attending college, but those dreams never materialized. She hadn’t thought about her college dreams in a long time, but talking to me about her childhood stirred up some old memories.

 

On a positive note, Cindy doesn’t drink much alcohol, never smoked, and eats a fairly healthy diet. She also walks the dog around her neighborhood daily, but she didn’t follow an intense workout program. Although she feels OK with her weight, she admits that she would feel better if she lost a few pounds.

 

Cindy just wanted to know how she could feel better. I certainly understand Cindy’s frustrations, and I was anxious to figure out why she was feeling this way and help her develop a plan to move forward.

 

I talked with her about anxiety and depression. We first looked at common risk factors of both: genetics (family history), low self esteem, prior traumatic events, abuse or neglect, substance abuse and early onset of anxiety and depression.

 

Cindy obviously had at least one of these factors in her life. We also talked about other reasons people struggle with these issues.

 

Anxiety and depression can be related to life events (past and present), but they can also be caused by chemical imbalances in the brain. The analogy I use to explain our brain chemistry goes something like this: brain chemicals are like money in the bank—we only have so much to spend before we run out. We make brain chemicals when we sleep, and genetically (linked to many genes), some of us make more than others. We spend brain chemical on life events, which can cause our supply to get low.

 

For Cindy, life events (busy kids, busy husband, busy household) were causing her to use her supply of brain chemicals. She also had unresolved issues come to the surface: her kids getting to do things she never did in her childhood, her husband working long hours (just like her dad did), and thinking more about her earlier dreams of college. Add to all of this a little weight gain, and you can imagine the stress Cindy felt.

 

When we have unresolved issues on our minds (like Cindy did), they cost brain chemicals. Sometimes we may not even be aware of some of the things that are floating around in our head. So, when our friends ask us out for coffee or it is time to make dinner, we don’t have enough brain chemicals to propel us forward. We slowly start to shut down, and life starts to pass us by. Depression can set in and affect not only ourselves, but our family, friends and co-workers as well.

 

There are several common symptoms of depression that you can look out for, including feeling down most days, losing interest in usual things, sleeping too much or not enough, losing or gaining weight, feeling unable to concentrate or think clearly, and thinking you are not good enough.

 

If depression is left untreated, other issues can arise, such as anxiety, diabetes, heart disease and thyroid disease.

 

In order to help Cindy, I first ordered some lab work, which included her blood count, thyroid levels, body chemistry function, vitamin levels, and sugar levels. All came back normal. My hope was that we could work together to treat her symptoms.

 

Cindy felt a sense of relief just getting her worries off her chest, and she became hopeful when I told her she wasn’t crazy. Her experiences are normal, common and treatable.

 

I first recommended that she see a therapist who practiced Cognitive Behavioral Therapy to help her sort out issues from her past. I also suggested more exercise in her daily routine, even if it is in small amounts (like 10,000 steps per day).

 

And, finally, I recommended a short-term course of medicine from a group called SSRIs (Selective Serotonin Reuptake Inhibitors). These drugs increase the brain chemical levels so there is “more money in the bank” to help people like Cindy get back on track and stop the downward spiral.

 

Cindy came to see me two months later, and she felt much more like herself again—hooray!

 

She had seen her therapist several times and had started a very low dose of the medication. She also developed a meal and exercise plan that worked well. Her kids and husband had noticed, and commented that they had missed having fun with her and were happy to have her back.

 

Cindy started to think about her part-time job and maybe quitting so she could go back to school. She had coffee with a friend and realized how good it felt to stay connected and laugh again.

 

I have no doubt that Cindy will be fine, but she will always have to be aware of her feelings, or even ask a friend to check in with her if she notices any new symptoms Cindy might be displaying. Cindy will inevitably experience stressful events in her future (we all will), so she will always be at risk for starting a downward spiral at some point.

 

However, with treatment and awareness, she should live a happy, connected and fulfilled life.

 

Reprinted with permission from Spectrum Health Beat.

 

Baby blues—or something worse?

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Postpartum depression can affect up to 20 percent of new moms, making it difficult for them to care for their baby. (Courtesy Spectrum Health Beat)

By Samantha Kauffman, Spectrum Health Beat

 

If you’ve experienced depression, it may help to know you aren’t alone.

 

More than 16 million people experience at least one major depressive episode at some point during the year, according to the National Institute of Mental Health.

 

The positive angle on this: We know of many things that can help fight depression, including therapy, exercise and medication.

 

Sometimes the treatment depends on the circumstances.

 

Depression after having a baby, known as postpartum depression, is more common than people may realize.

 

About 15 to 20 percent of women in the U.S. experience major depression after having a baby. This type of depression is different from the more common baby blues, which about 80 percent of new mothers will experience.

 

Baby blues pertains to hormonal changes from having a baby, as well as lack of sleep with a new baby and a new role that comes with new pressures and other circumstances.

 

Some people are surprised to learn that dads can also get baby blues and depression.

 

Postpartum depression in moms, however, is more extreme and can interfere with a woman’s ability to care for herself and her family. Severe symptoms usually require treatment.

 

Over time, we have come to realize that postpartum depression can happen quite often. Many moms will suffer in silence, however, because they don’t know what signs to look for or they don’t know what to do about it even when they know what’s happening.

 

This is one of the reasons the American College of Obstetricians and Gynecologists is recommending earlier postpartum visits after birth.

 

I should also point out that women can also suffer from depression during pregnancy, not just afterward. An estimated 14 to 23 percent of pregnant women will struggle with depression, according to the American College of Obstetricians and Gynecologists.

 

While it may seem reasonable to assume this depression results from a pregnant mom’s changes in hormones, this is only partly true.

 

Depression in pregnancy can also be triggered by an unplanned pregnancy, partner violence, a previous pregnancy loss, relationship issues and more.

 

Some of the symptoms to watch for:

  • Thoughts of death or suicide
  • Sleeping too little or too much
  • Sadness that won’t go away
  • Inability to concentrate
  • Loss of interest in things you once enjoyed
  • Anxiety beyond what might be considered a normal amount
  • Feelings of guilt
  • No desire to eat or eating all the time
  • Extra stress

Some of these symptoms are normal with pregnancy, so it’s important to remember that you need to watch for extremes.

 

Make sure you talk with your OB provider if you’re worried about depression or anxiety during pregnancy.

 

A study published earlier this year in JAMA Pediatrics found evidence suggesting that depression during pregnancy could result in poorer emotional and behavioral outcomes in children.

 

Of 101 pregnant moms surveyed for the study, 42 met the criteria for mild depression. Researchers then took MRIs of each baby’s brain at 1 month of age.

 

“Our study suggests that moderate levels of maternal depression and anxiety symptoms during pregnancy were associated with variations in the brain’s white matter microstructure or ‘wiring’ at one month of age,” said lead author Douglas Dean III, of the University of Wisconsin-Madison.

 

Up to 1 in 5 pregnant women experience depression and anxiety, according to the report, adding: “Mounting evidence links these conditions with poorer emotional and behavioral outcomes in children.”

 

Other studies, meanwhile, have found that untreated depression during pregnancy is linked to lower baby weight at birth.

 

Bottom line: If you are pregnant and feeling symptoms of depression or anxiety, please talk to your OB provider.

 

Reprinted with permission from Spectrum Health Beat.

Many Americans face pain, depression in their final year

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By Amy Norton, HealthDay

 

For a growing number of Americans, the final year of life is marked by pain, depression and other distressing symptoms, a study has found.

 

Experts said the study, published in Annals of Internal Medicine, highlights disturbing shortcomings in the U.S. health care system.

 

Researchers found that between 1998 and 2010, the number of Americans who suffered pain in their last year of life rose from 54 percent to 61 percent.

 

Meanwhile, the prevalence of depression rose from 45 percent to 57 percent, while other symptoms — such as breathlessness, confusion, severe fatigue and incontinence — either increased or did not improve.

 

“These findings are troubling,” said senior researcher Dr. Karl Lorenz, of the Pardee RAND Graduate School and the University of California, Los Angeles.

 

The increase in end-of-life symptoms, Lorenz said, has occurred despite national efforts to improve end-of-life care, dating back to the 1990s.

 

Those efforts have made a difference. The number of Americans in hospice care doubled between 2000 and 2009, the study noted. Hospice care focuses on easing symptoms and improving quality of life for people with a terminal illness.

 

But often hospice care isn’t offered until the last few weeks or days of life, Lorenz said.

 

“It’s often ‘tacked on’ to more-intensive care,” he said.

 

However, another expert said the findings are not actually about the typical American’s final year of life — because many people with chronic diseases are suffering these symptoms long-term.

 

“I think the findings are very valid, but the conclusions about what they mean are not,” said Dr. Sean Morrison, who directs the Hertzberg Palliative Care Institute at Mount Sinai Icahn School of Medicine in New York City.

 

“I think you’d see a high prevalence of these symptoms if you looked at older adults’ last two years of life, or last three, or last five,” Morrison said.

 

The issue, he said, is that more and more Americans are living longer with chronic ills — from heart and lung disease, to painful arthritis, to Alzheimer’s disease. At the same time, the health care system has grown increasingly specialized and “organ-specific,” with less focus on primary care.

 

“We’re doing a very poor job addressing the multiple health conditions so many older Americans have,” Morrison said. “We’re focusing on treating organs, and not on improving people’s quality of life.”

 

Morrison said the health care system — including medical schools — needs to pay much more attention to palliative care.

 

Palliative care refers to therapy that focuses on easing physical or psychological symptoms, rather than curing a disease. Hospice care, which is intended for people with a limited time to live, is one form of palliative care.

 

Other forms, though, can start as soon as a serious medical condition is diagnosed, and given along with treatments aimed at battling the disease. Usually, a team of providers, including nurses, nutritionists and social workers, is involved.

 

But Morrison said that to many people, including doctors, “palliative” is synonymous with dying. So it’s often not offered, even if it’s locally available.

 

“Other research shows that the overwhelming majority of Americans do not have access to high-quality palliative care,” Morrison said.

 

The current findings are based on a periodic health survey of older Americans. Between 1998 and 2010, slightly more than 7,200 study participants died, and their family members were asked about symptoms their loved one had suffered in the last year of life.

 

Over time, problems like pain, depression, periodic confusion and incontinence grew more common. Other symptoms, such as fatigue and severe weight loss, held fairly stable.

 

Lorenz said part of the increase could be due to awareness. More doctors may be asking family members about those symptoms — which would be a good thing, he said.

 

But the fact that pain and other distressing symptoms are so common is disturbing, he said.

 

Morrison agreed. “This really is an indictment of the health care system,” he said. “And the public should be outraged.”

 

He and Lorenz suggested that older adults ask their doctors about any palliative services available for their symptoms — at any point in the course of a disease.

 

Medicare covers hospice care, and many Medicare Advantage plans pay for other palliative services, Morrison noted.

 

But relatively few research dollars, he added, go into palliative care. “We invest so much in finding disease cures,” Morrison said. “We should also be investing in making life better for the people living with these diseases right now.”

 

Reprinted with permission from Spectrum Health Beat.

What Seniors Should Know About the Winter Blues

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Courtesy Vista Springs Assisted Living

By Vista Springs Assisted Living

When fall and winter roll around, it’s not uncommon for people to get a little blue. You or someone you know may feel more tired, unmotivated, and sad — but just because it happens every year doesn’t mean it’s normal. What’s commonly known as the “winter blues” could be something more. Especially during the cold and dark months, attention to senior mental health is critical for overall wellness.

It’s not just “feeling down”

Sadness and anger are part of a healthy spectrum of emotions, so feeling down or upset once in a while is totally normal. However, if a mood change lasts for a week or more, it could be a bigger problem than the blues.

Seasonal Affective Disorder, often abbreviated as SAD, is a mental health condition that affects sufferers during certain seasons. While it’s usually associated with winter, SAD can actually occur at different points of the year for different people. The disorder is more common during winter in the northern states, as our northern latitudes receive less sunlight than the south.

Aging adults may be at higher risk of depression and SAD, according to the Centers for Disease Control and Prevention. Senior physical health and senior mental health go hand in hand – depression is more common in people with other illnesses, such as heart disease and cancer, and around 80% of older adults have at least one chronic health condition.

Another condition that could be the cause of winter blues is vitamin D deficiency. While vitamin D deficiency is something that should be addressed no matter what age, the condition is particularly serious in aging and elderly adults. Symptoms of a vitamin D deficiency are easy to overlook, and include:

  • Muscle aches
  • Bone pain
  • Fatigue
  • Depression symptoms

If left undiagnosed and untreated for too long in seniors, a vitamin D deficiency can lead to a higher risk of osteoporosis, so be sure to talk to a medical professional if you’re concerned.

It’s treatable

The good news about the different causes of winter blues is that they’re pretty well understood by the medical community and they’re totally treatable.

There are a variety of treatments for SAD that have been tested and proven to work in almost all cases. Here are a few:

  • Antidepressants
  • Increased sun exposure
  • Light box therapy
  • Cognitive behavior therapy
  • Regular exercise
  • Mindfulness practices

If you think you might be suffering from SAD, talk to your doctor about what treatment is best for you.

For vitamin D deficiency, the treatment is a little more cut and dry. Incorporating vitamin D-rich foods into your diet is the most natural way to tackle a deficiency. Great foods include:

  • Egg yolks
  • Cheeses
  • Fatty fish
  • Beef liver
  • Fortified dairy products

A doctor may also recommend nutritional supplements, but remember to never begin taking vitamin supplements without first consulting a medical professional, as they may interfere with other treatments and medications.

If you or someone close to you goes through the winter blues, there’s a chance that treatment can help. Regardless of whether you feel the effects of SAD or vitamin D deficiency, be sure to pay close attention to your physical and mental health this winter. Spend time with family and friends, get plenty of exercise and nutrition, and make the cold months just as enjoyable as the rest of your year!

Reprinted with permission from Vista Springs Assisted Living.

Mindfulness can help detect depression

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By Tracie Abram, Michigan State University Extension

 

The transition of summer to fall is not many people’s favorite time of year as it brings on physical and mental fatigue. Muscles often tense due to the cooler weather, the decreasing daylight triggers an earlier bedtime, skin is drier due to lower humidity and appetites spike. The beautiful fall colors are a welcoming and enjoyable distraction from all the mentioned bodily reactions to this transitional time, but for some, these seasonal changes may be a trigger that leads to Seasonal Depression or Seasonal Affective Disorder. During the fall and winter months, people with Seasonal Depression experience having a lack of energy, sleeping too much, overeating, weight gain and a craving for carbohydrates.

 

Other forms of depression that can occur, no matter what the season, can be more difficult to identify. One way to help notice your moods is practicing mindfulness. Mindfulness is a practice of paying attention or focusing on your senses in the present moment without judgment. If a depressed mood is noticed for more than two weeks or there is a loss of enjoyment and interest in activities that used to be enjoyable, one should consider speaking to their primary care provider or appropriate professional, or at least, a trusted friend. Depression oftentimes occurs with anxiety or substance use disorders, and once a person has had an occurrence of depression, they are more susceptible to subsequent episodes.

 

Symptoms of depression affect one’s emotions, thinking, behaviors and physical well-being:

  • Emotional symptoms of depression: sadness, anxiety, anger, mood swings, lack of emotional responsiveness, feelings of helplessness, hopelessness and irritability.
  • Symptoms of depressed thoughts: frequent self-criticism, self-blame, worry, pessimism, impaired memory and concentration, indecisiveness and confusion, tendency others see you in a negative light, thoughts of death and suicide.
  • Behavioral symptoms of depression: crying spells, withdrawal from others, neglect of responsibilities, loss of interest in personal appearance, loss of motivation and using alcohol or other drugs.
  • Physical symptoms of depression: chronic fatigue, lack of energy, sleeping too much or too little, over eating or loss of appetite, constipation, weight loss, weight gain, headaches, irregular menstrual cycle, loss of sexual desire and unexplained aches and pains.

If you or a loved one are experiencing any form of depression, talk about what you are noticing. If you are concerned about others, ask them if they are having suicidal thoughts, listen to them non-judgmentally, give reassurance and encourage them to seek medical attention. Offering to take them to their appointment may increase the likelihood that they will attend. If they dismiss or deny your help, tell them you will check in on them over the week. It is important to keep your promise to do so. Remember, people in depressed moods have impaired memories, they lose track of time and have difficulty recalling how long they have been feeling blue. If symptoms persist, ask others who are close to the depressed person to help you in the intervention process.

 

Helping people recognize their moods can be a stressful and scary task, especially if you do not practice being mindful of your own well-being. Attending a program that can help you become more aware and/or improve your mindset could be a starting point. MSU Extension provides a community-based program series that teaches the basics of mindfulness to help participants be more aware of their thoughts, emotions and physical self as they encounter stressors. Mindfulness is proven to help relieve stress and pain and improve health and well-being, to learn more, sign up for a class near you.

 

This article was published by Michigan State University Extension. For more information, visit http://www.msue.msu.edu. To have a digest of information delivered straight to your email inbox, visit http://www.msue.msu.edu/newsletters. To contact an expert in your area, visit http://expert.msue.msu.edu, or call 888-MSUE4MI (888-678-3464).

You Are Not Your Mental Illness

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Photo courtesy of Cherry Health

By Maram Hekhuis, Outpatient Therapist at Heart of the City Counseling Center

 

Many people either do not recognize or are in denial that they have mental illness, even though mental illnesses are very common and widely spread in our society. This can be due to fear and anxiety about being judged or stigmatized by others, not being prepared to cope with learning that they have a mental illness, or their loved one has a mental illness. Many people fail to recognize that mental illness does not define who you are! You have a diagnosis of mental illness, but you are not your mental illness.

 

You are not schizophrenic, autistic, or depressed. You have diagnosis of schizophrenia, autism, or depression. Having a mental illness does not mean you are robbed of the opportunities to have a quality life such as having a job, being in a relationship, building a family, having safe housing, having access to health care and/or being affiliated with a certain group. It is important to recognize that even though you have a mental illness and some challenges associated with your mental illness symptoms, you still have many strengths and abilities that help you move forward in life to achieve your goals and dreams. There is nothing to be ashamed of for having a mental illness. Having a mental illness is like having a medical problem. It is your body’s way of telling you something is off, and it is time to do something about it by seeking help.

 

Mental illness is treatable! Most people with mental illness continue to function in their daily lives and are able to live a fulfilling life. If you feel you are unable to manage your mental illness, experiencing significant symptoms that cause significant distress or impairment in social, work, or other important areas of functioning, then seek professional support. There is nothing to be ashamed of for seeking support. When you get the flu and a high fever for a couple of days, you will seek medical attention, so when you are feeling mentally exhausted and sick, then make sure to seek mental health attention.

 

Reprinted with permission from Cherry Health

What would you do for good grades? Indie film explores the length one person goes

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The dean of Stratford Wellington sells his school to potential students.

Stratford Wellington defines prestigious with its top-notch professors, some of whom have earned Noble Prizes and more than 3,000 activities from birdwatching to the debate team. And with only 13,000 attendees, anyone should feel honored to be accepted.

 

However freshman Calvin feels only the pressure to not only to succeed but to do so exceptionally. And to Calvin, he could possible do that if he didn’t have to deal with his drugged out roommate Trevor.

 

Thus is the basis of Indie producer Matt Whitney’s film “4.0” or “How I Killed My Roommate for Better Grades” which will be the featured film at WKTV’s Midnite Movie on Saturday, May 27.

 

“Darkly funny and full of twists and turns, ‘4.0’ explores the struggle of depression, the rigors of higher education, and the dangers of secrets,” Whitney said.

 

“4.0” started as a project pitch by Whitney and some college friends. Time constraints did produce what the group wanted and the concept sat until last year, when Whitney was able to write a script he felt conveyed the message he wanted to share.

 

“It’s both a commentary on the sometimes sorry state of higher education, and a study of the different ways depression manifests in people,” Whitney said a 2016 Kickstarter description. “This is a story I need to tell. It deals with issues very personal to me. Depression is a daily issue for me, and far from this film being an exotic form of therapy, it is a way to show those who have never struggled with depression what it really is, and to give a voice to people who struggle with it now.”

Chin Up! It’s the Holidays: A Depressive’s Guide to Surviving the Ho-Ho-Ho

Community Health, Education, Holidays, How-To's,

12-federico-castellon-remorse-1940By Victoria Mullen

 

Does the holiday season weigh heavily upon your tender psyche? Depression get you down? Cold comfort in knowing that there are millions of people like you out there, right? No safety in numbers with this thing.

 

Many familiar with depression will agree: Sunny days are the worst. Yeah, sure, birds are chirping, kids are playing, and in the summer, you can hear the drone of lawnmowers in the distance. But with sunny days come obligations. You’re expected to be productive and enjoy the day. Let’s be real: Birds poop on your car, kids are loud and annoying, and freshly cut grass unleashes your hay fever. Yes, sunny days put a lot of pressure on a person.

 

Conversely, cold, rainy or snowy days are the best because you have a good excuse to stay in bed and cuddle up under the covers with cats sleeping by your feet. But someone has to feed them, and guess what? That someone is you. Only under threat of feline mutiny or family banishment will you venture out to the store to get cat food and holiday gifts, and that’s pure torture because the holiday season brings those awful chipper, happy people out in droves. I don’t know about you, but I’m ready to bitch-slap the next beaming face.

coll_250_castellon13

 

It could be that you have a perfectly fine, supportive family. I know I do. They’re great folks. But in the throes of depression, it’s hard to see or appreciate that. And if you don’t have family or friends close by, the loneliness can be unbearable.

 

Depression is a many-faceted beast, and this article isn’t meant to be a cure-all. What we can offer here are some tips to help get you through the endless drudge of holiday parties, workplace gatherings and caroling, depression be damned. Twenty-five tips, one per day–think of it as a sort of depression advent calendar. If I had the energy, I’d paint a lovely picture for each day. Instead, Federico Castellon has captured the feelings of depression admirably. Learn more about the artist here.

 

  1. Keep it real. Don’t compare your holidays to those portrayed in overly cheerful greeting cards; that’s just not reality. Greeting card companies have to make money somehow, and their business model requires selling never-ending tidings of joy. But you’re smart, and you know better. Life is not a bowl of cherries. And that’s OK.
  2. Do something different. Don’t settle for being a sheep in the herd. Break out from the bahs. Who says you have to make an eight-course dinner for 15 family members? That’s the greeting card industry brainwashing you. Have Thanksgiving at a restaurant instead–yes, let someone else do the cooking. Spend Christmas day at the moviesFederico_Castellon,_Self_Portrait_with_H,_1942. Skip the traditional gift-giving and donate the money to a charity. Screw those greeting cards. What a bunch of hooey!
  3. Reach out to friends and family. People who care about you want to know when you’re having a tough time. Your instinct may be to isolate yourself, but resist the urge to do so. At least keep in touch by phone. A friendly, empathic voice can work wonders. (Admittedly, I have a tough time with this one, but it is highly recommended anyway.)
  4. Life isn’t perfect, and that’s OK. It’s easy to let your imagination run wild, but don’t automatically anticipate disaster. Take the holidays as they come. The greeting card industry has bestowed special powers upon some perfectly ordinary days to make a few fast bucks. It means nothing! Surely you can see through all that. (I’m not being paranoid. Am I? Wait.)
  5. Don’t sweat the small stuff. Now, here’s a cliche for you! But, guess what–it’s good advice. Don’t feel obligated to compete with that idiot down the street. You know the one: Decorations up the wazoo, holiday music blasting at all hours of the day and night. The one whose house sticks out like a sore thumb with all those stinking–er, blinking–lights. Sure, he’s crazy, but don’t let him get to you. (That’s exactly what he wants.) Instead, think of how high his electric bill will be. On another note, so what if you don’t crack open that box of St. Nicholas figurines your grandma left you in her will. Yes, you promised her you’d display them proudly each year. But, guess what? They’re nice and cozy tucked in their box down in thcastellon.maskofthereddeathe basement (or up in the attic), and they won’t mind waiting another year. Seriously.
  6. Help someone less fortunate than you. Maybe your life seems crappy, but just remember that someone always has it worse than you. That is not to discount what you’re feeling, but making a difference in someone else’s life can make you feel better about yourself. It takes your mind off its focus on you.
  7. Don’t stress over seeing Uncle Bob (or other annoying family member). Don’t want to see him (or her)? Then don’t. Just don’t go there. Why put up with the stress of seeing someone you don’t like? Life’s too short. Go to the movies instead.
  8. Ask for help. But be specific. Need help cooking or shopping? Ask a friend or family member. Tell them what sort of help you need. People aren’t mind readers, you know. We’re not that highly evolved yet.
  9. Some things are beyond your control. Do Dad and Uncle Frank always fight over who gets to carve the turkey? Remember, it’s them, not you. First things first: If you can safely take away the sharp fork and carving knife, then do so. Next, go to another room, sit down and breathe deeply. Don’t worry. They’ll work it out. They always do, right? It’s impossible to control every situation or person (nor would you want to). Your own reaction–now that’s something you can control.
  10. Create new family traditions. Maybe finding the pickle in the Christmas tree has reached its expiration date. It’s not fun anymore, is it? If you don’t enjoy the ritual, why keep doing it? ‘Tis the season to create a new one. As an example, my ex-husband and I used to celebrate LEON (NOEL, spelled backwards–we’re clever folk). Worked for us. Tfc-12-the-dark-angelshe kids, not so much. After years of therapy, they’re fine–proof positive that kids can bounce back from just about anything. (Your healthcare insurance may provide coverage for just such an emergency. Read the fine print.)
  11. Celebrate the memory of loved ones. Holidays can be tough when you’re reminded of someone who isn’t around anymore, but think of it as an opportunity to celebrate them in spirit. Toast grandma. Bring her photo with you when you go out to dinner at her favorite restaurant. Prop her photo up against the salt shaker, facing you. She’ll be smiling down upon you, that’s for sure. (Well, at least from across the table.)
  12. Be picky. Don’t get overwhelmed by weeks and weeks of holiday festivities. Think about which parties you really want to attend. You don’t have to go to them all. Postscript: If you haven’t been invited to any parties, throw one for yourself and Puff. Living well is the best revenge. (Besides, who needs those people anyway?)
  13. Leave when you want. If that means stopping in for just a few minutes to say hello, then so be it. Giving yourself permission to leave at any time helps curb the anxiety.Castellon
  14. Safety in numbers. Arrange to arrive and leave with a friend, and that office party won’t seem so utterly awful. Having an ally and an escape plan can make all the difference.
  15. The ‘perfect gift’ is a myth. Don’t stress over finding the best gift ever. If you don’t know what to get someone, get a gift certificate. That’s what those things are for. The greeting card industry got one thing right.
  16. Shop online. One of my all-time favorite sports, shopping online is a godsend for people with depression. You don’t have to fight the crowds or waste time finding a parking spot. Best of all, you don’t have to put up with rude people and loud, smelly toddlers.
  17. Follow thy budget. Know how much you have to spend before starting to shop. And stick to it. Nothing is more depressing than overspending.
  18. Your normal routine is your best friend. Now is not the time to stay out late at parties or pull an all-nighter cooking or wrapping presents. The psyche can be a fragile thing. Remember, Rome wasn’t built in a day. Somehow that analogy fits here. I just know it.castellon_hilda_thefloweredhat
  19. Exercise. If you’re like me, then you hate even the thought of exercising. Unfortunately, exercise is often the best way to banish anxiety or depression, at least for a while. Walk instead of driving. Take a few extra laps around the mall (assuming anxiety doesn’t prevent you from getting there). Chase the cats around your apartment. Be creative!
  20. Eat sensibly. Ha! Easier said than done, but it’s worth striving for anyway. All those holiday treats may be tempting, but overloading on sugar won’t help your mood, and you’ll only hate yourself more if you pack on the pounds. Having said that, don’t beat yourself up if you’ve just raided and emptied the cookie jar. Just get back on track tomorrow. Or wait until Lent (assuming you’re Catholic). That’s what Lent is for.
  21. Holiday substances won’t lift your spirits. People over-imbibe during the holidays, but that doesn’t mean you should. Alcohol is itself a depressant and drinking too much will make you feel worse. And it may not be safe if you’re taking antidepressant meds. Just don’t go there. (If you do, certainly don’t drive.)
  22. Sun lamps are golden. Seasonal affective disorder (SAD) plagues millions of people during the shorter winter days. Consider getting a sun lamp. It could improve your mood.1
  23. Don’t miss your meds. Do not miss your meds. Do NOT miss your meds. If you’re like me and take antidepressant or bipolar meds–or both–don’t miss doses. Sure, it’s tempting, but that’s just another place you shouldn’t go. (Trust me on this one.) While you’re at it, make sure your refills are up to date, too. Now is not the time to run out.
  24. Have extra sessions with your therapist (if you see one). The holiday season is tough on people. (Now, there’s a “duh” statement, if I ever saw one. But I wrote it, and I stand by it.)
  25. Be kind to yourself. ‘Tis the season we dwell on our imperfections, mistakes, things we’re not proud of. Guess what? You’re human. Cut yourself some slack. Kindness and forgiveness goes a long way. Don’t forget to save some for yourself.

When all else fails, here’s the Suicide Hotline number: 1.800.SUICIDE (1.800.784.2433). I’ve called it myself. That’s what it’s there for.

Images copyright Federico Castellón (1914-1971).

Help Save a Life: September is Suicide Prevention Month

Community Health, , , , ,

depressed-womanSo far this year, 47 suicides have been completed in Kent County. Six of those who died so far in 2015 were 19 years of age or less, the same number of suicides for that age group in all of 2014. We can work now to prevent another lost life. September is Suicide Prevention Month, and Thursday, September 10 is World Suicide Prevention Day. The Kent County Health Department wants you to know there is help available.

People considering suicide will sometimes talk or write about death or dying. Some will actually look for items to use in a suicide attempt, such as weapons and drugs. You may note dramatic mood swings or personality changes in someone who is suicidal, a loss of interest in daily activities, and/or hopelessness. The American Foundation for Suicide Prevention suggests if you suspect someone needs help:

– Begin by telling the suicidal person you are concerned about him or her.

– Tell them specifically what they have said or done that makes you feel concerned about suicide.

– Ask if the person is considering suicide, and whether he or she have a particular plan or method in mind. (These questions will not push them toward suicide if they were not considering it.)

– Ask if they are seeing a clinician or are taking medication so the treating person can be contacted.

– Do not try to argue someone out of suicide. Let them know you care, that they are not alone and that

If you think someone is considering suicide, call 911 or take the person to the nearest emergency department for professional help. “There are many professionals in Kent County committed to helping people who are struggling with depression and suicidal thoughts,” said Adam London, Administrative Health Officer of the Kent County Health Department. “We need to be sure that people can easily find these important resources.”

The National Suicide Prevention Hotline is available at 1-800-273-TALK (8255) and one call connects you to local resources. This line is available to anyone in suicidal crisis or emotional distress 24 hours a day, and your call is free.

The moment one life ends from suicide, the pain and struggles begin for those left behind. The Healthy Kent Suicide Prevention Coalition is teamed up with Network180 for a “Survivor Outreach Program.” Trained volunteers offer support to family members and friends who are struggling with loss. The hotline—which can be reached at 616.336.3909—will put you in touch with a coordinator, who will contact the family in person or over the phone in the next 3-5 days.

*There will be a free screening of a new movie that follows a boy’s journey after he finds out his father died by suicide. The movie Hope Bridge begins at 6:30 p.m. at Celebration! Cinema South in Grand Rapids. Seating is based on a first come, first serve basis. If you can’t make Thursday night’s event, there are several other screenings happening throughout September for Suicide Prevention Month.