Mi Depression, Su Depression

We all know adjusting to sight loss is stressful. We are well aware of the times it has freaked us out but how aware are we of the impact our loss has on those around us? How often does anyone notice the stress on family members ?

Back in 2009 – that is 8 years ago, guys. Long enough this report could be in the third grade! – there was published an article entitled Family Function and Low Vision: A Systematic Review. The authors lamented they had not had many appropriate articles to review and – guess what – I found pretty much next to nothing since then. Families of the visually impaired are being ignored!

But yet families are a huge support to those who are losing their sight. Adequate support – both practical and emotional – protects against distress and other negative health concerns. The way we stay functional and sane is by having people there for us.

The problem is sometimes family members go through all of the stages of adjustment we do. Shock, denial and mourning are not just for us. But since we are the identified clients, we (hopefully) get the services and the attention. They don’t.

Visual impairment is related to separation and divorce. (Or at least it was in 1993. THAT study is old enough to vote.) There have also been more recent studies on emotion contagion.

Yep, mi depression, su depression*. And if that is not bad enough, the spouses of the visually impaired even have worse physical well-being than controls. Jeez.

The suggestions from the authors were pretty basic: education and mental health counseling. Family members need to know about visual impairment so they know how and how much to help. Overprotection can be nearly as damaging as neglect. Mental health support is pretty self-explanatory. Find and investigate the negative belief systems and see what you can do to refute them. Provide emotional support.

In short, the fight can be as hard on the guy who holds your coat as it is on you. Family members need to know about your vision loss and be told the level of support you need. They need to have time to do things for themselves and they need someone to support them as well. None of this is easy on anybody but it is easier when we do it together.

*translation of title is “My Depression, Your Depression” as in the phrase “Mi Casa, Su Casa” which literally translated means “My House, Your House”.

Continue reading “Mi Depression, Su Depression”

Ratings

  • Rate this
  • Summary
Current Average Ratings
Overall quality
Avg: 5.00/5
Applies to topic
Avg: 5.00/5
Helpful to me
Avg: 5.00/5
Mi Depression, Su Depression
Total Avg Rating: 5.00 out of 5 with based on 2 rating(s)
Overall quality
Applies to topic
Helpful to me

Improving Communication: Part 1

TGIF! Greetings from the land of organized chaos, aka my life!

I have not been writing as regularly as I would like. For one thing, as I keep pointing out, there are lulls in the action with AMD. You adapt to a certain level of loss and things are calm until the next loss of vision occurs.

Crank up the magnification and soldier on until the yet next disaster. Lulls are not all that page worthy…and I don’t need a disaster right now.

The other reason is my days have been flying! I am taking more counseling clients and my days are jam packed. Nothing like being busy to make the time fly!

All of this by way of saying, I am sliding into a holiday weekend (Happy Memorial Day!) and I am going to try to pound out a few pages over the next few days.

We stopped for deep dish pizza on the way home. (The new comfort food!) I walked the Beastie Baby in the neighborhood and the field. She drank from every rain puddle (mud flavor! Yum!) and we investigated what looked to me like bear scat (poop, no bear. Life is good). Well fortified and with the ‘adventure’ out of the way, I guess I am ready to go.

The topic was suggested by one of our readers. She is located in Massachusetts and has just helped to launch a new, vision loss support group. (Kudos!) The topic had come up in her support group: vision loss and social isolation.

The short answer is “yep”. Problem is, I rather doubt I can make a page out of that. In trying to flesh things out a bit, I came upon a publication by the Thomas Pocklington Trust. Published in 2013, this literature review contained 44 pages on the topic. Good resource. [Lin/Linda: it’s 44 pages if you download the Word version; 8 pages for the PDF version which is what I’ve linked to.]

The review starts by pointing out loneliness is not part of natural aging. Loneliness and social isolation are also not inevitable for the elderly, visually impaired population. (So maybe “yep” is not the short answer?)

That said, however, it is easy to see how vision loss, loss of function and depression can lead to social isolation and how social isolation can loop back around and cause more depression, etc. People with vision loss can really end up in a nasty downward spiral.

The review acknowledges the problems that can come from not recognizing faces and facial expressions. Without nonverbal cues to go by, communications can easily breakdown.

Lack of good social communication can break down social relations and lead to a drop in feelings of self-efficacy. Feeling you are not able to adapt and cope with your loss once again leads to all sorts of issues and perpetuates the downhill slide.

I think I mentioned before that feelings of self-efficacy are exceptionally important to mental health. The “I can do it myself” attitude can be reinforced by success in using assistive devices. In another page I believe I quoted something that said one of the best predictors of life satisfaction is access and use of assistive technology, both high and low tech.

OK. To be continued. Since some of us have trouble reading long text, I will stop here for now.

Continue reading “Improving Communication: Part 1”

Ratings

  • Rate this
  • Summary
Current Average Ratings
Overall quality
Avg: 0/5
Applies to topic
Avg: 0/5
Helpful to me
Avg: 0/5
Improving Communication: Part 1
Total Avg Rating: 0.00 out of 5 with based on 0 rating(s)
Overall quality
Applies to topic
Helpful to me

Attitude Adjustment

Alrightee then. End of feeling sorry for myself…for now. When the horse throws you off, you get back on and all that. It is attitude adjustment time.

Counting my ‘positive pennies’ the first half of today has been good. I tried my gown on this morning and it fit. That is a positive. I picked it up for $25 two years ago at the thrift store. It is actually a pretty gown for $25. This evening my gown and I go to the Mom Prom.

My husband dropped me off on the other side of those two, scary main roads and I rode my bike the rest of the way in to Zumba at the Y. Then I rode into town, chained my bike at the library and went to the street fair.

Since my class was putting on a demonstration, I participated. Participation is often a good thing. Afterwards I wandered around, ate fresh-cut fries and a chocolate brownie (we have discussed my dietary shortcomings; haven’t we?) Also ran into several people I know.

Back on the bike for the ride home. Coming home I passed a whole hedge of lilac bushes. I could have stood there all day and taken in the fragrance.

All told not at all bad start to my day. I may have age-related macular degeneration and central vision loss but I can still savor chocolate brownies and smell the lilacs. Oh, and they had this great group that does Chicago and Al Jarreau and all sort of music from our youth (assuming you are also on the upward side of 60!) The lead singer is excellent. I enjoyed their performance.

Attitude adjustment. Just like the three most important things in real estate are location, location, location, it appears the three most important things in keeping yourself mentally healthy with AMD are attitude, attitude, attitude.

I found a 2005 study by Jennifer Tolman et al. The study was on psychosocial adaptation to vision loss. Also on adaptation’s relationship to depression. Tolman and her people discovered it really is basically a matter of acceptance and compensation for vision loss. It is the internal experience that really counts. You know: if you believe you can’t, you can’t. If you believe you won’t, you won’t. Ya gotta believe in the possibilities in your life.

Tolman published the Adaptation to Vision Loss Scale (AVL) in her article. It consists of about 24 yes/no questions. Many of them have to do with self and personal power. It is interesting to look through. If you take it and find yourself answering as if you are powerless and/or have lost yourself, you might want to consider getting some help. Depression is a possibility.

Another thing she found related to depression was making use of services and adaptive technology, etc. I see that as a chicken and the egg sort of thing. Services make you less depressed but you have to have the motivation to go look first.

So that is pretty much it. We all have our setbacks. We just cannot wallow too long. Sometimes it is time for an attitude adjustment.

Continue reading “Attitude Adjustment”

Ratings

  • Rate this
  • Summary
Current Average Ratings
Overall quality
Avg: 0/5
Applies to topic
Avg: 0/5
Helpful to me
Avg: 0/5
Attitude Adjustment
Total Avg Rating: 0.00 out of 5 with based on 0 rating(s)
Overall quality
Applies to topic
Helpful to me

No Kidding!

I pulled a ‘dumb, blind’ chick trick yesterday. I read the time on my phone wrong and was waiting for my ride an hour ahead of time. That was bad enough but when I thought she was late, I got worried about her and started texting her. Pretty sure she was not the one with the problem!

Moral of the story would appear to be you should double-check what you think you know before acting on the ‘information’. Fortunately she thought it was amusing. I decided to laugh, too. Rule 62.

I have finally found time to go to the vision support group run by my low vision specialist. That is tomorrow afternoon. Work is in a temporary (I hope) lull and I could rearrange things a bit.

Not sure how that is going to go. My low vision person had said she wanted me to attend so some people could see you can survive and adapt with vision loss. Not sure I want to be exhibit A. I would like to help but some people get resentful when you try. See how it goes.

We all know the support of others is so important when you lose your sight. I find it sort of amusing – but sad – the medical community is just awakening to that reality. Literally yesterday in real-time, April 10, 2017 they published an article entitled Communication from Doctors Could Reduce Anxiety for Macular Degeneration Patients. Excuse me, but “no shit”. Do you think they joined our Facebook group and figured that one out?

The good folks at Manchester Eye did a study that found large levels of depression and anxiety in people getting shots for wet AMD. No…ahhhh. Never mind.

But don’t you think having a needle stuck in your eye would be a really good reason to be anxious????? Just saying, ya know.

Manchester went on to say there is “value in human interactions between clinician and patient” in offering reassurance about the treatments…..I’ll just bite my tongue and be quiet now.

Better yet, Hugo Senra, clinical psychologist, suggested there is value in specialized counseling with certain patients. All rightee, then. Cognitive behavioral therapy, dialectic behavioral therapy? How about trauma therapy? Not like they are not available most places yet the study indicated 89% of the patients showing anxiety and 91% of the ones showing depression were getting no therapy at all! Someone – actually a large number of someones – appears to be dropping the ball here.

So, yes, it does appear the anxiety and depression you are feeling about your AMD and the treatments really do exist. And yes, we are a grossly underserved population. And yes, we might actually benefit from treatment.

If you are one of those thousands and thousands of underserved folks and want psychological treatment, turn your insurance card over and call the customer service number. They should be able to provide you with a list of therapists who take your insurance. If you have no insurance, call your local mental health agency. In Pennsylvania they are called base service units. Elsewhere I have no clue about the nomenclature but if you search for public mental health providers, they should come up.

In short?……..

AMD? Depressed? Anxious? There is help. No shit. Continue reading “No Kidding!”

Ratings

  • Rate this
  • Summary
Current Average Ratings
Overall quality
Avg: 0/5
Applies to topic
Avg: 0/5
Helpful to me
Avg: 0/5
No Kidding!
Total Avg Rating: 0.00 out of 5 with based on 0 rating(s)
Overall quality
Applies to topic
Helpful to me

Fake It Till You Make It

Depression. We have hit this topic from several angles before. We are going to come at it again. Lin said there are a number of new people coming on and they are suffering.

These people are suffering with helplessness and hopelessness. Feelings of helplessness and hopelessness are closely aligned with depression. In fact, back in the 1960s Martin Seligman proposed the theory that depression is actually the result of helplessness. Beck has published a scale that measures hopelessness. The Beck Hopelessness Scale is a good measure of depression and also suicidality.

Hopelessness is the feeling that all hope has been destroyed. You are facing a dilemma that cannot be solved. Hopeless people see nothing positive in their future. They believe they are bereft of skills and options for getting themselves out of the mess they are in.

Ain’t they happy thoughts?

Anyway, some people feel that way when they get a life-altering diagnosis like age-related macular degeneration. They see nothing at all good in their future.

Beck Depression Inventory-click photo for larger image.

The Beck Hopelessness Scale is available online sans scoring. Take a look at it and if you agree with a fair number of the negative statements on it run, do not walk, to your doctor and ask him/her to help you get medication and counseling. You do NOT need to feel this way.

A good therapist should be able to help you deal better with what is ahead. Your therapist should help you to build positives and successes in life. Remember the old chestnut: nothing succeeds like success! What have you accomplished this far? What else can you expect to accomplish now? Go for it! Remember you are a survivor with many battles behind you. This is just one more.

If you don’t feel very accomplished or brave? Fake it! There are people watching. Be the person they will emulate during tough times in their lives. Show them what grace under fire really looks like.

It may be that your greatest accomplishment in life will be being a positive model for others. Show them how it is done.

It doesn’t matter if you feel like a fraud. It is the brave front they will remember. Besides, fake it until you make it works, so you will get benefits from your award-winning performance!

I am going to refer you back to all of the pages on DBT distress tolerance for more therapy ideas. DBT ‘borrows’ from some of the finest therapies there are and puts them all in a neat package, so I suspect you will find something useful.

Beyond that, find a way to build hope in your life. Speak with your religious adviser. Pray. Plan a party or a trip. Encourage others along their roads. Save an animal from the shelter. Plant a tree. Invest somehow in a positive future.

Other ways of investing in a positive future? Volunteer for a clinical study. Write your story for this webpage. Help others in the same fix we are in! Believe.

Progress is being made every day. The Audacious Goals Initiative project is alive and well, as are similar projects in other countries around the world, and funding research. Individual drug companies battle each other to bring new treatments to the market. It will happen eventually. The breakthroughs are coming. Believe. There is hope. Instill it in yourself. Instill it in others.

Continue reading “Fake It Till You Make It”

Ratings

  • Rate this
  • Summary
Current Average Ratings
Overall quality
Avg: 0/5
Applies to topic
Avg: 0/5
Helpful to me
Avg: 0/5
Fake It Till You Make It
Total Avg Rating: 0.00 out of 5 with based on 0 rating(s)
Overall quality
Applies to topic
Helpful to me

The A in AMD

I attended a seminar yesterday. This one actually gave us tables. Doesn’t sound like much but when you are balancing half a dozen things at one time, a table is a big thing.

That was six more credit hours. 12 down and 18 more to get in the next calendar year. Some of those can be home study.

A colleague gave me a web address for a company that sells continuing education training cheap. Since I was in student mode, I went on the site and downloaded several one credit hour courses.

(I said student mode, not martyr mode. Remember we AMD folks read more slowly now. If I can accomplish my goal – getting 30 continuing education hours – by ‘nibbling’ at them one hour at a time, I will. There is more than one way to skin a proverbial cat. There are no brownie points for doing things the hard way!)

Anyway, off track again but I thought it was a valid point. No one is going to ask how you got there, as long as you get there. Be kind to yourself.

Where I was REALLY going was to tell you I downloaded a presentation on depression in older people. [Lin/Linda: this was part of her course which is password protected so we don’t have access to it.] Now I know we are all 35 or less in our minds, but we also all know what the A in AMD stands for. This is not a condition for kids.

I actually read the article and answered the questions for my one hour of credit. The article said a lot of stuff we already know. Loss of sensory and physical functioning as well as personal/emotional loss and financial problems can all lead to depression. Been there? Done that? Got the t-shirt, huh?

It also gave some statistics I was not aware of.  Although the article (from Knowledge Informing Transformation) said depression is not a part of normal aging, it also said up to a quarter of seniors living in the community have depressive symptoms. Those numbers increase as living arrangement become more restrictive and as the people get older. In other words, if you think you are the only one suffering with depression, think again.

One of the big problems with depression is everything goes to hell right along with your mood. Depression in older people can lead to vague physical complaints, sleep disturbance, confusion, memory loss and agitation. Depression can lead to a significant reduction in the quality of life and even death. Health costs for depressed oldsters are twice those of non-depressed people of similar age.

So that is the bad news. The good news is it is possible to fight depression and win. 60 to 80% of older people see improvement with appropriate treatment.

In addition to finding a mental health profession you are comfortable with, I would just suggest you push back! Depression trying to take your positive attitude? Take it back through things like humor or altruism. Keeping you away from friends and support network? Call them! How about health and wellness? Make a date to walk with a friend. Cook a nourishing meal and actually eat it even if you have to choke it down. Fake it until you make it.

OK. Gotta get ready for bed. Remember good sleep is important too. G’night! Continue reading “The A in AMD”

Ratings

  • Rate this
  • Summary
Current Average Ratings
Overall quality
Avg: 0/5
Applies to topic
Avg: 0/5
Helpful to me
Avg: 0/5
The A in AMD
Total Avg Rating: 0.00 out of 5 with based on 0 rating(s)
Overall quality
Applies to topic
Helpful to me

The Holiday Blues

My assignment is to talk about depression, specifically the ‘holiday blues’. I am going to go in the back door on this one, so bear with me.

My 25th birthday was the worst birthday I have ever had. I had it in my head successful people had it all together by age 25. Successful 25 year olds have jobs, spouses, houses. I had none of these things. In my head, I was a failure.

Relevance? I would suspect every one of you who is down about the holidays like I was down about my birthday is operating under a whole slew of myths.

Myths in DBT parlance are stories we have come to believe simply because it seems they have always been there. We assume they are valid because they are part of us. They are the ways we think things are. Period. The end.

So what are you telling yourself about the holidays that is getting you so down? My first guess would be something to do with holidays and family, yes? The traditional meaning of family is a bunch of people related by blood. If you don’t have blood relatives surrounding you, you cannot have a holiday; right?

I don’t think so. I have no siblings and no children. I have no cousins on one side and I am estranged from cousins on the other. Some people would call that tragic. For me, forgive me if I offend, it has been liberating.

I have been able to build my ‘family’ with the people I want. I spend my time with people I enjoy. You don’t have to have blood relatives to have family.

Thanksgiving day I have a dinner engagement with a friend. (Hubby is having a tooth pulled the day before. Ouch.) Whom could you have time with? It does not have to be on the actual holiday. That is just an arbitrary date on the calendar.

This person does not even have to be an established friend. You could go to an activity you enjoy. The day after Thanksgiving the Y is having back-to-back classes. I will be there for two or three of those, along with my fitness ‘family’. We are looking forward to it. What could you plan that you can look forward to?

There are as many myths out there as there are people to entertain them. What are some of the myths you entertain? How about “I need to do everything I always have done for my family! It won’t be a holiday unless I prepare a four course meal!” or how about “we can’t  have a real holiday on a fixed income!”

CNN has an article about 4 things you can do about the holiday blues. They are pretty basic but they work:

Seek social support, exercise, don’t compare yourself to others, and reframe your thinking. There’s more about these in the CNN article.

Finally, I would not be a DBT instructor if I did not remind you of the distress tolerance skills. Refer back to ACCEPTS in the archives. It does work. Continue reading “The Holiday Blues”

Ratings

  • Rate this
  • Summary
Current Average Ratings
Overall quality
Avg: 0/5
Applies to topic
Avg: 0/5
Helpful to me
Avg: 0/5
The Holiday Blues
Total Avg Rating: 0.00 out of 5 with based on 0 rating(s)
Overall quality
Applies to topic
Helpful to me