macular degeneration, macular, diagnosis depression – My Macular Degeneration Journey/Journal

Sue’s Best Pages – Part 2

continued from page 1

Part 2 Dealing with the Emotional Reaction to Vision Loss

  • “AMD can lead you to question whether or not you have any value. It may lead you to feel unworthy and guilty about being dependent upon others for so much. These are symptoms of depression, too.”
  • “No sense getting peeved and denying it. It is what it is and I feel the way I feel. That is the way it is. Acceptance of what is important.”
  • “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.”
  • “Remember this journey is not a sprint, it is a marathon. In fact, it is a marathon that we don’t even know the course.”
  • “Many of us are facing limitations. These are limitations we don’t like and don’t want. Limitations that hit right at our independence and threaten who we are and how we interact with our worlds.”

Next: The Highest Rated Pages

 

Some of Yours

Just logged on to check my email and the first thing I found was another phishing attempt. Oh, for crying out loud! These things are coming faster and the ‘phishermen’ are getting bolder.

This one was ‘from’ my email provider. Not only did they want my username AND password but they were also trying for a credit card number. Good grief. Do I look like I just fell off the turnip truck?

The problem is, for every 999 people who have not just fallen off the turnip truck, there is one who has. That is all the scammers need to make a killing.

So, just in case we have a reader who is not ‘scam savvy’, a couple of tips: scammers are often non-English speakers but the messages are in English. Misspelled? Clumsy wording? Be aware. Ask for your password? Run the other way. Soliciting a credit card number from you? Contact customer service and ask them. Do not give a credit card number out to anyone who asks for it. Lastly, check the details on the email. If it come from Sylvester in Syracuse you probably have a scammer.

Anything suspicious can get forwarded to your service provider. I also label anything from that sender as spam so I don’t have to deal with him again.

Just another public service announcement.

Oh! And I just noticed something wild. My service provider lists as ‘tells’ for phishing attempts the following: asking for personal information, mass mailings and details (show details). That spells AMD. How about that? [Lin/Linda: ::groan:: you are REALLY stretching it!!!]

And after all that, I want to talk about pessimism/optimism. Another good grief. I know the shady morals of so many is not necessarily a reason to be upbeat and sunny. My delivery and timing stink. However, if you look at it another way, we are looking out for one another and that is positive. Yes? Yes!

Lin asked me to read Dan Roberts article about how so many of us see a more dismal future than others our age who do not have AMD. The piece says we expect health deterioration and Lord knows how many other bad things just because we have vision loss.

The first thing I thought about was why should vision loss lead to worse health than any other sensory or orthopedic or general health issue? Sounds like the depression talking to me.

Roberts emphasized there being so much reason for optimism with all the tools and medical breakthroughs. I agree with him totally on that. That is part of the reason we continually share news on research and ‘toys’.

However, what I think his real message was was this: the study did not differentiate between those actually getting the information, the training and the support and those who are not. Roberts asks what the differences would be. He also asks – about knowledge and skills training lapses – the question “why not?”.

You see things and ask “Why?” but I dream things and I say “Why not?” – George Bernard Shaw

(And, yes, JFK paraphrased it a bit but he took it from Shaw.)

Part of the reason for this website is to spread knowledge and to spread hope. Every day progress is being made. Every day things are happening to make our lives – as the visually impaired – easier.

Know someone without knowledge? Someone without hope? Give him some of yours. We want to be able to say “Dan, we hear you and we are trying to do our part.”

Written October 29th, 2017 Continue reading “Some of Yours”

An Exercise a Day

Hey. It is Sunday. I have changed bedding, mopped the bathroom floor, done dishes, done laundry and written most of a psych report (why don’t people look on the backs of checklists?). I have HAD IT. No mas. Break time. The sun is shining. It is around 75 degrees outside (screwy weather) and I am heading for the deck.

Sunday has become my work around the house day. Monday it is back to the real world and if I want to get anything done at home, it has to be done Sunday.

Heaven help me when I am no longer working and don’t have the press of deadlines. Nothing will ever get done!

Feeling good about getting a pup. We picked the lively and inquisitive one. I know she may be more of a handful than any of her sisters but I need a walking buddy. I have been “going to walk the dog” for more than 60 years and going to walk by myself feels wrong.

Bringing me to the promised topic, as well as the promised nagging ?. Exercising is great for avoiding depression!

We have talked about the crazy percent of older people who are depressed and the even crazier percent of older VIPs who are depressed.

Right now many of us are not going to improve our visual standing anytime in the near future. Gotta live with that. That leaves us with fighting the second dragon, depression.

Our friends whom we have not met yet in Nord-Trondelag county Norway have been participating in a huge, as in HUGE, longitudinal health study that started in 1984. One of the things they were measuring was the relationship between exercise and depression. To begin with they found an exercise a day keeps the psychiatrist away. Those who did not exercise at the start of the study were 44% more likely to develop depression than exercisers. Total amount of exercise and depression were negatively correlated (more exercise went with less depression). However, they also found as little as one hour of exercise a WEEK reduced chances of depression by 12%!

Similar studies in Sweden and the United Kingdom found similar results. The benefits of exercise were seen in everyone, including older folks, and the intensity of the exercise did not matter. Easy was OK. Small doses were OK. The idea was to move.

Of course – pushing my luck with some of you; I know – aerobic exercise and focused attention meditation twice a week has been found to improve depression in two months or less. That research comes out of Rutgers. The Rutgers study sequenced the two, one after the other, but it is possible to get both exercise and focused attention in one activity. I am talking about the Eastern practices such as yoga and tai chi.

OK. End of lecture. Just hoping to find one convert out there somewhere. It really does work. Any brave soul out there who wants to try it? All you have to lose is your depression.

October 22nd, 2017 Continue reading “An Exercise a Day”

Come Dance with Me – Again

End of a busy Saturday. The big news of the day is we met our puppy! She is all picked out and will be ready to come home to her new mommy and daddy on November 18th.

I also got back to my exercise classes. My routine will only be in place for about a week before I go running off on vacation but that is alright. Things will settle down soon after. I hope. No more ride snafus, food poisoning or adventures for a bit.

While I like a little adventure (but not ride snafus or illness!), sameness and predictable are really good. I like the familiar, too.

Such as the Eastern screech owl ‘whinnying’ outside the window. He has been there most nights for several weeks now. According to web sources, that is a territorial defense cry. Wonder what he is defending against? Apparently there is a hidden drama unfolding in the backyard!

One of the other things I got done today was going through some Healio and Medscape posts for articles. They are still publishing that Manchester, U.K. research saying eye shots cause anxiety and depression and my reaction is still “Duh! Ya think so?”

But the next things I came upon were actually related to that article – about depression and mental functioning – and gave me more reason to harp on exercise again.

I absolutely love it when things I enjoy doing are found to be good for not only physical health but cognitive and emotional health, too! It makes me feel so righteous to say I am doing it because it is recommended even though inside I know I would do it anyway. Like being told eating an entire chocolate cake with a half gallon of vanilla ice cream is a nutritious meal! Recommended at least three times a week!

Oh well, that might be a little extreme (a girl can dream; can’t she?). However, the Medscape article ‘Dancing Keeps Older Brains on the Ball’ gave me a rationale for being the ‘grand old lady’ at hip hop class as well as one of the ‘dowagers’ at Zumba.  The article talked about how the integration of info from multiple sensory sources such as hearing the music, watching the instructor and feeling how your own body is moving in space is good exercise for your brain. The researchers discovered the demands of learning new dances every week or so in addition to the balance demands of dancing literally beef up your hippocampus. The hippocampus (seahorse in Latin as I mentioned before) is your memory center and tends to shrink in old age. The researchers ended by saying “our study results suggest that social enrichment and a combination of physical and cognitive activities influences neuroprotection best”. So there!

And of course I got so excited about having a SCIENTIFIC rationale for putting on my boogie shoes a couple of times a week, I did not leave myself space to write about the other two articles I found. But good news: one of the articles on exercise and depression talks about the levels of exercise effective for battling depression and guess what? It was practically nuthin’. See? You can read the next page even if I am being a noodge!

October 22nd, 2017

Continue reading “Come Dance with Me – Again”

Looking for Answers

Lin gave me a preview of the page Nancy submitted as a guest writer. I am so glad Nancy took our invitation! Hoping that more of you do the same. [click here for Nancy’s page.]

Now, we all know I am a little ‘different’. Might as well embrace it. My immediate supervisor at school loves to tell me “You are such a psychologist!” She’s telling me I’m weird; right?

Anyway, even though I am not normal, I see parallels between Nancy’s experiences, my experiences and maybe even your experiences, too.

We are all “of a certain age”. At 64, I think of myself as a youngster with AMD but Lin tells me new Facebook members keep getting younger. What the hey is happening there?!?!? Anyway, this is not a disease of the young.

Most of us had parents or relatives with AMD. Nancy worried about developing it herself. I never did but Daddy was into his 80s when he lost his sight and his condition was never named for me. Since relatives were pretty few and far between on my father’s side, he was a sample of one for me. I never gave a thought to it being hereditary. Oops. Maybe you were not so obtuse and worried like Nancy.

Both Nancy and I have had the anxiety of waiting for things to go to hell in a proverbial handbag. One of the problems with a slowly developing condition is it lulls you into complacency and the next thing you know WHAM! No longer so complacent.

Many of us are facing limitations. These are limitations we don’t like and don’t want. Limitations that hit right at our independence and threaten who we are and how we interact with our worlds.

Then there are the attempts to combat this stuff. I went research and science. Fits me. Nancy went nutrition. Me? Not so much. Even though my ‘little’ nephew – 6’5” and possibly still growing – assures me food is the most important drug you can put in your body, I am not going there.

And in keeping with the season I just had a really excellent piece of pumpkin spice cake. What? Don’t give me grief; it was orange! Antioxidant color; right?

Back on track – but it was yummy cake! – we are all looking for answers. We are all hoping for the miracle cure. Is it coming? I truly believe so. Just don’t expect it by next Tuesday. In the age of great medical breakthroughs, you would think our little problem would be easy but it’s not. It is a frustration we all feel.

Then…the elephant in the room: depression. We have talked about it before and will talk about it again. We have all felt it. Some of us have the resources to help us bounce back. Some of us need help finding those resources. Lin said something about citing pages, etc. about depression so I am sure several of these words will be blue soon. [click here for an article about depression in people with AMD.]

What I learned from Nancy’s page? We are all having similar experiences. Nancy, probably you, me, too. So maybe I’m not so weird after all? Maybe?

written October 2nd, 2017 Continue reading “Looking for Answers”

No Brainer

I have not been able to get my act together all weekend. I have had low motivation and not a lot interests me. Depressed? Not exactly.

To ‘fess up’, I must admit what I have been doing all weekend is listening to an audiobook. I have been sort of ‘into’ Kellerman’s The Golem of Paris which I discovered is actually the second in a series. Now I have to listen to the first one!

My head has been full of the legend of the Golem of Prague and the Book of Enoch (weird, I know, but I kid you not. They are integral parts of the story line.) But what if my head were full of worries and hopelessness and dread?

I would not, by a long shot, be alone. PsychiatryAdvisor reports 57.2% of older people with vision impairment have depression. That is up from 43.5% of older people without vision loss. If those numbers are accurate, half of you folks are depressed. Crap. This is not good!

Some of this will be a recap, but I like to think it bears repeating. For example, I want to repeat gradual vision loss or loss in one eye but not the other is very anxiety producing! Where do you think the saying “waiting for the other shoe to drop” came from? Waiting for something bad to happen ain’t good.

Then there is the interaction between loss of everyday competence from vision loss combined with the loss of everyday competence from age-related cognitive decline. There is a one, two punch! Facing loss of independence from that combo is depressing.

This combo leads me right back to what I have preached and preached and preached some more. Exercise helps to keep you sharp. Learning and using low vision strategies and technology helps to keep you competent. Sharp, competent people keep their independence. Independent people are less likely to become depressed. End of lecture once again.

The second installment of the article starts with what I consider to be a ‘no brainer’. To wit, if you can save your vision, you can help save your mental health. Like I said, no brainer. Go for your shots. Investigate changes in your vision immediately. Hard to get more basic than this.

Next the article talked about using your low vision skills and technology and a little thing called behavioral activation. What behavioral activation basically is is getting back into life. Too bad transportation is a pain in your sweet, little tushie. If it gets you to your activities – even an hour and a half early – use it. Swallow your pride and ask for a ride. Remember Cabaret? “What good is sitting alone in your room?” Good for depression! Instead,”go taste the wine! Go hear the band!” I bet Liza Minnelli never realized she was a behavioral activation therapist?.

There are several paragraphs on what psychotropic medications NOT to use when you are depressed. I think those deserve more research and their own page. For here, just remember, question your doctor about the vision side effects of EVERY medication you are prescribed. You are your own best advocate.

OK, I have nagged you enough for one page. What did mother say? “I only do it for your own good.” Me, I’m going back to my book. Did you ever hear of the Golem of Prague?

written August 27th, 2017 Continue reading “No Brainer”

One Foot in Front of the Other

We recently had a reader ask how it is possible to maintain hope, faith and optimism, etc. when “everything” is slipping away. She stated she does not want this disease because she had watched it “destroy” others. Her friends do not want to associate with her because of the “doom” she is facing.

Oh, my…where to start. First of all, I guess I need to say “I’m with you! I don’t want the damn thing either.” But wanting it or not wanting it really does not make a bit of difference. We do not get to make decisions like that in our lives. We only get to accept (or reject, but if you fight reality, I can practically guarantee you will waste a whole lot of energy and in the end, still lose. To paraphrase “I fight reality, reality always wins!”). We also can find ways of coping.

That appears to be a magic word: cope. This is not a fatal disease. If you are still breathing and conscious, you are capable of dealing with things and trying to make them better. Your hope is in every breath you take. Breath.

Remember one of my favorite people whom I never met, Viktor Frankl, said “the last freedom left to any man is determining how he will react to his circumstances.” This disease will not destroy us. It may take things from us, but not destroy us. We destroy ourselves through our reactions to it.

Our reader may not realize it, but she IS coping. She reached out to this website. She has sought professional help and she is involved with the state services for the visually handicapped. She is doing what she can do.

We don’t have to like having AMD and losing sight. We don’t have to be happy about it. We just have to keep moving. I mentioned this before but another one of my favorite, never met people, Winston Churchill, said something like “when you are going through Hell, keep going!” It is in pouting and denying reality – in stopping in the middle of Hell – that we are destroyed.

To address the part about being hopeful, optimistic, etc, a bit more, there are times all of those pretty thoughts are going to desert us. Times there seems – as in appearances and impressions – there is no hope. Those are the times we simply put one foot in front of the other. Determine what is next and do it.

I have been told I am “in love” with DBT. I am, for the simple reason it works. Mindfulness and staying in the moment work.

For example, the Beastie Baby has been diagnosed with lung cancer, but right now she is sleeping peacefully on the floor next to me. Right now, life is good. We will take one day at a time, one hour, one moment if need be. We will not grieve (much) and ruin life when things are good. Lesson: stay in the moment. Deal with the now. By dealing with each moment as it comes, we can handle a scary future. Buying future grief and hardship is a bad investment.

I could address the absolutes – always, never, everything – but I won’t. Not much, at any rate. We just need to remember few things in life are truly that black and white, that cut and dry. Every dark cloud has a silver lining and every silver cloud has some dark inside.

This has been a little jumbled, but that, after all, is my mind. I guess in summary, what I want to say is:

Accept this is happening, Recognize you are not powerless, we all have choices we can make.

Understand if we take care of each moment as it comes, the future will take care of itself. Don’t get ahead of yourself.

We don’t need to be hopeful or optimistic all of the time (even though there is reason for hope). If you cannot muster any faith in your future, just put one foot in front of the other and move. You will be surprised where you end up.

Continue reading “One Foot in Front of the Other”

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”

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”

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.

written April 29th, 2017

Continue reading “Attitude Adjustment”

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!”

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”

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”

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”

I Vote for Tahiti

Greetings. Now that I have wandered around in prehistory for a while I guess I should get back on track. I did enjoy the wandering, though. I always liked anthropology. Too bad there are so few paying jobs in the field.

On track….Lin wanted me to talk about Seasonal Affective Disorder (SAD) and the holiday blues. SAD first.

SAD is an odd form of depression. As I said before, it probably has some deep roots in the species. It probably is endogenous (from the inside) rather than exogenous (happening as a result of something outside) in its causes.

Except for the season and/or the geography, you cannot point to something – an event – and say that is why you are depressed. No blaming SAD on your boss or your mother-in-law.

SAD occurs more often the farther you get from the equator. It happens more during the dark of winter. It is thought all that darkness messes with your biological clocks. They are still trying to figure out what actually goes on. However, the results of whatever it is include difficulty waking, decreased energy and lethargy, carbohydrate craving, weight gain, difficulty concentrating, decreased libido, withdrawal, depression, anxiety and irritability. Lovely.

Since SAD spontaneously goes away in the summer the thought became to either take the sufferer to the sun (I vote for Tahiti!?) or to bring the sun to her. Enter light therapy. (Apparently we can’t afford Tahiti. Dang.)

Light therapy works. It reduces depression, fatigue, sleepiness and all sorts of other things. Ready for the but? Light therapy is contraindicated for those with retinal disease. That is us. [Lin/Linda here: The problem with light therapy where you sit in front of a ‘light box’ with a bulb that simulates daylight is that it does contain blue light.  The topic of blue light & retina damage is controversial but why tempt fate? Click here for more information on this.]

Now what? Light therapy is pretty much out but there are other courses of action. Antidepressants have been found to be effective. However it normally takes several weeks for antidepressants to reach full effectiveness so you need to start taking them ahead of time. Psychotherapy has had successes. Ditto on the time lag for that, too.

Just to be on the safe side, if you are suffering from seasonal depression, or any depression, you should make sure everything else is in good working order. Thyroid problems can cause depression. Also low vitamin D is a culprit. Dr. Weil reported 70% of Americans are D deficient. Apparently nobody but me is drinking her milk!

Other sources such as Living Well With Low Vision suggest the judicious use of melatonin not only in supplement form but also by regulating its natural flow. Blocking blue light for several hours before bed moves the production of melatonin up in time so it is not still being produced and making you groggy and cranky in the morning.

I would think if you don’t have lenses that block the blue you could get similar results by nixing the screen and listening to BARD books in a dark room, but I have nothing to prove that hypothesis.

Then there are the really ‘radical’ depression fighters like getting up and taking a morning walk! Not only do you get the morning sun but somewhere I read 40% of all depressions respond to exercise. There are studies being done that suggest a rise in body temperature improves mood. I admit to being both a nature freak and an exercise nut, but my positions are being endorsed more and more by science.

That’s SAD. What is SAD? Depression. That’s SAD.

Next, the holiday blues, as requested. Continue reading “I Vote for Tahiti”

Time to Hibernate

Spring ahead. Fall back. In real-time we are one week past the return to standard time. It is dark out there.

Last week, one day after the clocks were turned back, there were only three students in hip hop! It was weird. Where was everyone?

My husband says I am eating red meat more than usual. I notice I can sleep ‘forever’. At 63 I recognize the symptoms. No big deal. I am getting ready to hibernate.

Wait. Hold on. Bears hibernate. Also skunks, groundhogs, chipmunks and some bats. And it would appear, some people, too.

NaturalNews.com reports there is a natural tendency to conserve energy in winter in their article Winter Hibernation and SAD May Be Normal Human Response. Researchers are just starting to think our evolutionary heritage contains the genes for hibernation. Less sunlight increases melatonin production. Melatonin is a sleep hormone; you know. There is even a decrease in the sex drive. If you do the math, a baby conceived in winter will be born in the fall, a time that resources are becoming scarce. Not a plan for infant survival.

Getting even more interesting, the article goes on to say fire was harnessed 400,000 years ago but the oldest human remains are a million years old. That means 600,000 very chilly years! Lots of natural selection time there. Those who were equipped to survive the cold survived.

Then, to add another interesting wrinkle, the article cites evidence Neanderthal DNA may have something to do with our ability to adapt to winter. (You didn’t really think they just went extinct; did you?)

There is historical evidence of cultural hibernation as well. Years ago entire villages in Russia would “close up shop”, only stirring enough to do what was absolutely necessary until the spring.

So, to get around to where I am supposed to be going with this, although it has been an interesting introduction to write, 20% of the people in those villages were said to suffer from some form of Seasonal Affective Disorder (SAD).

Catherine Zandonella writing for the Daily Mail (11/13/16) reported scientists are beginning to believe SAD is an atavistic form of hibernation. To translate that sentence a bit, atavistic means “relating to or characterized by reversion to something ancient or ancestral”. In other words, a throw back.

Seasonal affective disorder is a type of depression associated with the change in seasons.

There are major differences between SAD and other forms of depression. Those with SAD eat and may sleep excessively. Those with ‘traditional’ depression do the opposite.

The bottom line here is people who suffer from SAD may just be highly evolved and in tune with the natural world. They may be responding the way we were meant to respond in order to survive.

But there is a small problem. We are no longer expected to gather in our caves and sleep the winter away. Survival now involves a new set of skills. We are supposed to be bright-eyed and ready to go in all seasons.

Solution? Well, SAD responds to full spectrum lighting…. which can negatively affect AMD. Ooops.

Looks like I am back on topic. Continued next page.

written 11/14/2016

Continue reading “Time to Hibernate”

Bingo!

I just came from a three-hour, Bingo benefit for the teacher who has cancer. It was an excellent turn-out. 150 people. There were 75 items for the raffle. This is a good area with good people.

Comparison skill. Remember ACCEPTS of distress tolerance?  People do not have to help me pay my bills so I can concentrate on trying to save my life. I am a ‘mature’ (yeah, sure) adult who could retire on state teachers’ disability and social security now if needed. Life waited to bite me in the butt.

And compared to what she has going on, AMD is a little nip. Comparatively speaking, I am just great!

Second distress tolerance skill: contribute. I paid my $20 and played Bingo. I spent $10 on raffle tickets. The same raffle tickets I had actually purchased and donated. Contributing is a way of forgetting things are not so great for you either. It also makes you feel like you are in the fight, even if it is not your particular battle. In other words, I cannot cure my eye problems, but I can help this teacher get travel money and grocery money and whatever she might need to pursue her cure.

To quote from the Mental Health Foundation, altruism is associated with all sorts of positive things. They include a decreased sense of hopelessness, less depression, increased self-esteem and better physical health. Altruistic people even have better marriages.

Berkleywellness.com tells us altruistic people have longer lives than people who do not practice helping and giving. Some of the theorists thought this was due totally to the social engagement factor.  Not so. Just the interaction is helpful, yes, but at the end of day, being the one doing the helping has the greater benefit. Something to do with having a purpose in life. We circled back around to Viktor Frankl again. Remember “if you have a why, you can tolerate any how”?

So altruism is good stuff. Now moving on to perhaps more frivolous topics, I put an Ott light at the end of my ironing board. I think I am doing better in seeing colors with the increased illumination. At least I matched today. Hopefully this fix will work for a while. I hate being mismatched!

Bingo. I had not played in years but it went OK. Most of the time I was playing four cards at one time. My friend was sort of looking over my shoulder. In 20 games she corrected me one time. Not too bad.

We used the disposable, paper cards and dabbers. I could see the numbers with bare eyes but I experimented and my handheld reader would have been an option as well. Not so much the magnifier on the iPad. For that I would have had to bring the Justand. Too many wobbles over three hours.

One of the issues I had was dealing with the different layouts of each card. Having a few cards that were consistent game to game would have been nice. I looked guess where [Lin/Linda here: starts with an a, followed by amazon.com ::smile::] and large print Bingo cards are about $4 apiece. You can also avoid the Bingo chips sliding dilemma by paying significantly more and getting a plastic board with sliding panels on each number. I cannot believe anyone would object to your bringing your own cards. It is not cheating.

So how did I do? I did not go “Bingo!” but I did win a turkey fryer in the raffle. I brought it home to my husband but he doesn’t want it. Probably re-gift it to another raffle. Does THAT come under the heading of altruism? Maybe not. Continue reading “Bingo!”

I Have Macular Degeneration…Now What?

June 2023 There’s an announcement that since Sue has not written any new journal pages for some time, the site has been archived until we can decide if the work necessary to make sure all information is accurate and up-to-date can be made. In the meantime, you’ll get some pages ‘not found’ or ‘private’ until that decision has been made. The emphasis for several years has been on the Facebook group.

Where can I quickly find information about AMD?

One of the best resources available is from the Prevent Blindness organization’s website called Guide Me.  You answer a few questions and you will get a personalized guide with important aspects of AMD based on your answers:

Click here to go to Guide Me.

Click here to watch a 4-minute video that explains what AMD is, what causes it, and what can be done about it.

Click here for a good list of Frequently Asked Questions.

Click here to go to a great site maculardegeneration.net where you will find articles written by people with macular degeneration and caregivers. They also have a Facebook page.

What other websites are helpful?

Here are some of our favorites:

Click here to find out should I take the AREDS or AREDS2 supplements?

Click here for a video that covers important information about AMD

Click here for a description of dry vs. wet AMD (we are not recommending any products in this article, but be aware that the site may profit from some products they advertise.)

Click here for an explanation of the stages of AMD (we are not recommending any products in this article, but be aware that the site may profit from some products they advertise.)

Click here to read about what happens if you have AMD in only one eye

Click here for some answers to common questions about depression after diagnosis

Click here for an article about how vision rehabilitation helps prevent long-term depression

Click here for a very comprehensive page about wet AMD

Click here for a very comprehensive page about dry AMD

Click here for an article about how fast AMD progresses

Click here for 10 questions to ask your doctor

Click here to find a support group (I’ve been told that this site may not be up-to-date. Ask your eye specialist for a referral.)

Click here for eye-healthy foods including a Healthy Vision Grocery List (2/14/2022 site wasn’t formatting properly.) Click here to read the answer to the question ‘What should I be eating or not eating to hopefully slow the progression of my AMD?’

Click here to find out what vision changes/symptoms to look for (we are not recommending any products in this article, but be aware that the site may profit from some products they advertise.)

Click here to find out about the people who can help you (what are the differences between the types of eye doctors, do I need to see a specialist, etc)

Click here for tips on how to make the most of the vision you have (section toward the bottom of the page; lots of other good information on the whole page)

Click here for a FAQ (Frequently Asked Questions) from the Macular Disease Foundation Australia.

Click here for a FAQ (Frequently Asked Questions) from our Facebook group.

Where can I do more research?

You can do searches on the Internet – there is a LOT of information there.  We have done a lot of research and here’s how you can find it.

Click here to go to How to Navigate and Search Our Website.

Join our very active Facebook group Our Macular Degeneration Journey. There’s lots more information there as well as support whenever you need it.

How do I move around on the website?

Click here to go to How to Navigate and Search Our Website.

To find about more about me, about Sue, about our project, go to the menu at the top of the page.

Reviewed 02/14/2022

 

 

 

 

I Am Woman, Hear Me Roar!

Dependence: the state of reliance on or being controlled by someone or something else. What a pain in the posterior that is!

62 years – or at least from my early 20s to 62 – I was my own woman. Made my own decisions. Kept my own schedule. Went where I wanted to go. All of that is now changed.

Now there is ‘another country’ being heard from. Or maybe even two or three more. I hate it.

What gives these people the right to tell me – or try to tell me – what to do? My dependence does. I now need them.

I am being given opinions about what I ‘need’ and don’t need to do. I ‘need’ to go to work but I don’t need to go to exercise classes. Oh, really??? You may not feel the need to take me but I will get there even if I have to walk. Please don’t tell me what I need. You don’t live in here. I do.

I am having trouble finding anything much on the web about sudden dependence. The common parlance apparently considers dependence to be an addictions issue! However, one article contained the word ‘power’ and that word rang true.

I resent the loss of my power! I resent having power taken from me and I want it back!

Another phrase that rang true was ‘loss of identity’. This is not me. I have likes and dislikes. I have opinions. If I did not like something before I would get in my car and drive away. Why do I have to stay now? I don’t do things this way!

OK. My resentment can make me a bit of a witch. The people whom I am dependent upon have rights too. They don’t have to help me and, truth be told, they are not the ones taking away my independence. It is circumstance. However, if you don’t want or are unable to help me be myself and maintain my power, say so.

Lead, follow or get the hell out of my way. I want MY life and I want MY identity and I will do what I can to try to keep them. Don’t tell me what I ‘need’ to do! If I fail, I have failed on my own terms.

While I am not in the habit of citing people who have no last name, I found something related written by James D. for www.keepinspiring.me. James’s take on things is that lack of control in your life can lead to depression. I quote him because I have seen the same finding other places. James suggests you take steps to control those things in your life that you are capable of controlling. Even being able to control a few things is helpful.

So I keep on keeping on. I will find ways to be me as long as I can. I will find a way to keep at least some of my power. Dependence? It stinks! Continue reading “I Am Woman, Hear Me Roar!”

Boot Camp

Waiting for a ride here. Looking through the allaboutvision.com site. Some interesting articles.

All About Vision is a decent site. That is my first point. Second point? Never have nothing to do. Waiting for people can be deadly when you have nothing to do. Third point: be ready to jump up and run when they finally do get there. Make sure whatever you are doing can go away in 15 seconds or less.

So that is my visually impaired lady wisdom for the day. Back to all allaboutvision.com. They have an article saying physical health, cognitive ability and emotional health need to be considered when dealing with the visually impaired. I really want to say “no s***” and label it a no brainer, but maybe people really don’t realize how important those factors are to a good adjustment.

Total human being here. The days of believing in the separation of mind and body are long gone.

Sort of like PLEASE in DBT. Take care of your health. If you don’t maintain your ‘vehicle’ you are going nowhere. There are plenty of data about the benefits of staying fit and strong. Vision loss is plenty. I, for one, do not need to add heart failure or diabetes to the list.

There is not much you can do about exceeding the smarts God gave you, but you need to remember what was given to you is actually a range. Biology sets the range and the point on that range is determined by the environment.

The point you are at can be up to you. Try to function towards the top of that range.

Don’t quote me but I think I read something like 80% of what we learn comes through vision. The flow of knowledge has been blocked for us. We now have to actively work on learning and staying sharp.

Emotional health, read depression and anxiety, can be a serious factor when you are visually impaired. We talked about loss before. Don’t let anyone downplay it. Vision loss is a death. Grief is natural. Depression is not uncommon. The number I read was 30% of people with vision loss are depressed.

Anxiety is pretty natural, too. My panic attacks were not fun but they could have been predicted. The article said that people who only have AMD in one eye are often more anxious because they are waiting for the other eye to fail. Will today be the day? Will today be the end ?

So do these factors truly affect your resilience? Duh, yeah! Therefore, it is time to go walk that mile. Solve that puzzle. Accumulate positives by doing things that make you happy.

This is AMD boot camp. Let’s get prepared! There is a campaign ahead.

Continue reading “Boot Camp”

My First 100 Days: Part 1 Hopelessness?

Good afternoon! Got my exercise in – Zumba and a dog walk – and expecting a thunderstorm presently. I like storms. It may sound sort of crazy but I like knowing there is a powerful universe out there. I also like knowing Someone out there cares enough to shelter me.

But enough of weird philosophy. I really should not do it. I am a conscientious objector to people stepping too far out of their expertise. I once went to a Ricky Martin concert and he started talking about his vision for the world. No. We don’t ask the Dali Lama to shake his ass and we don’t ask rock stars about philosophy!

OK. Enough, but in a weird way that leads around to something I do want to talk about: hope. Lin wants me to do a retrospective. I am coming up on 100 days post vision loss and it seems appropriate. The thing is I don’t just want to do a chronicle. I do have half an idea. It will probably turn into several pages. (Half an idea turning into several pages? Yes, I can pile it up! ?) Let me try it and see if it flies.

According to my day planner all hell broke loose between January 31 and February 12. That is less than two weeks to go from totally functional, sighted person to hot mess. I was having MAJOR panic attacks. I knew what they were. Part of my brain very dispassionately identified them but my autonomic nervous system was off to the races. The girl was in a bad way.

I have had some people tell me quite candidly they would want to commit suicide if they were going blind. Well, thank you very much! Should I take that as a suggestion?

The thought of suicide never crossed my mind. Not that it is an uncommon thought. Not that it is not understandable. It is just that suicide and hopelessness are closely linked and so far I have not been hopeless.

To lecture a bit here, suicide.org says hopelessness is a feeling that conditions will never change. There is no solution to a problem.  Dying would be better than living. So far I have managed to skirt around that.

Why? To begin with, I had done my homework. You can say what you like about science and technology but, damn, they are doing incredible things. I had met Regillo and read what he and his team are doing. Not to put undue pressure on those folks, but my money is on them!

Being a special education professional, I was already aware of assistive technology. I knew there are people out there whose job it is to help people like us. I contacted them.

I also have had people who believe in me. How can things be hopeless if people I trust are telling me I can do it? They may have been delusional, but I probably owed them a try.

OK. Back to my lectern!

Again, thoughts of suicide happen. They are often a reaction to a feeling of hopelessness. They are not shameful but they are wrong. The old adage says “suicide is a permanent solution to a temporary problem”. Even if our vision loss is not temporary, even if science does not find a cure in time for us, even if we never have our vision restored, there is still hope for better functioning.

If you are feeling suicidal, get help. Tell a friend or family member.  In the US the number for the national suicide prevention hotline is 1-800-273-8255. In the UK it is +44(0)8457909192. I think. I never understand foreign telephone systems. Our friends in the UK, could you post the number, please?

I guess that is a start. Onward on the retrospective or maybe I should say “forward to the past!” Anyone own a DeLorean? [Have you seen the movie Back to the Future? The DeLorean is a car that is the time machine in the movie.]

Continue reading “My First 100 Days: Part 1 Hopelessness?”

Are You Depressed?

I have been stood up so I guess I should use my time wisely…..

In a recent post I  talked about the stages of loss and depression. The most recent Macular Degeneration Partnership (amd.org) bulletin has an article on depression. Seems like a hot topic recently. A lot of people getting depressed with Age-Related Macular Degeneration.

Thinking about it, I realized I had not defined depression. I don’t think the Partnership people did either. Could have missed it, but I don’t think so.

To start, I want to state plainly and simply, depression is not a dirty word. It is not a weakness. It is not something that has to be suffered and denied because ‘real men’ do not have mental illness.

 All right, so I am picking on you guys but the simple fact of the matter is that women are a lot more apt to seek treatment for mental health concerns than men are. You guys might as well own it. You think depression is a weakness and many of you would not be caught dead in a place like this, a counseling center.

So what is depression? We may say we know it if we see it, but maybe we don’t.

The DSM’s full name is Diagnostic and Statistical Manual of Mental Disorders. It’s the book professionals use to classify mental illnesses. We are up to number 5 of these manuals but what I have at my finger tips is my ratty, falling apart, well-loved copy of IV-TR. It’s sort of a revision of the fourth edition. My 5 is at home right now.

No matter which version you are using depression is defined as having some basic characteristics.  There is ‘depressed mood’ which is basically feelings of sadness. In children – and yes, in some men I have noticed  – you may get irritability and anger. OK, OK it can happen in women too, but I have not seen the foul, angry mood in women as often.

The second characteristic is ‘anhedonia’. That is a fancy name for nothing being fun any more. “Want to go fishing, Gramps?” “Nah, it is not that much fun any more. You go without me.”

Third we have ‘physical symptoms’. Changes in eating or sleeping habits can be signs of depression. It does not matter which way. Increases and decreases are both considered to be symptoms.

The same goes for ‘activity level’. Some of us get very lethargic and spend most of the day in bed or just sitting around. Others of us become agitated and always have to be moving. This moving around often does not get much done. Agitation, not goal-directed work.

‘Fatigue’ is a big symptom of depression. Everything is just too much effort.

AMD can lead you to question whether or not you have any value. It may lead you to feeling unworthy and guilty about being dependent upon others for so much. These are symptoms of depression, too.

Depression will really cloud your thinking. Thinking ‘straight’ and being ‘sharp’ become a lot more difficult when you are depressed. Some people chalk this up to senior moments and old age but that may not be it at all.

The last symptom listed in the DSM is ‘thoughts of death and suicide’. Thinking your family and the world would be better off if you were gone is wrong-headed thinking that can be brought about by depression.

If any of these symptoms sound like you or someone you know, it is time to seek help. Get to your doctor. He can help you find help.Medications, counseling and support groups are valuable in fighting depression. Feeling bad is not a requirement of AMD.

Which brings me to one more quick point before I quit. I have had clients tell me their situations are really terrible and it is unrealistic to try to look on the bright side. Hard, cold reality really is hard and cold. Normal people are delusional!

I tell these clients they are exactly right. Studies have proven depressed people often have a better handle on the facts. Their world view is often more realistic….but it is nowhere near as much fun. It also does not help you put one foot in front of the other as easily.

In any case, putting on rose-colored glasses and joining in the delusion is not a bad thing. So, let’s hear it for Pollyanna!

Continue reading “Are You Depressed?”