In the journey of life, reaching old age is a milestone that brings with it unique challenges and opportunities. As older adults navigate the aging process, they may encounter various physical, emotional, and mental health issues. These can impact their overall quality of life and well-being. Thankfully, in-home counseling services provide a vital lifeline to seniors, offering tailored support to address their specific needs. In this article, we will explore the significance of in-home counseling for seniors, the benefits it brings, and how it can empower both older adults and their families.

Understanding the Importance of In-Home Counseling Services

1. Addressing Mental Health Issues

As we age, mental health becomes increasingly crucial for maintaining a high quality of life. Older adults may face a range of challenges, such as loneliness, grief, depression, anxiety, or cognitive decline. In-home counseling services play a pivotal role in addressing these issues head-on. Clinical social workers and trained therapists offer supportive counseling and mental health interventions tailored to the unique needs of seniors. By engaging in individual counseling or group therapy sessions, older adults can explore their emotions, gain coping strategies, and enhance their emotional well-being.

2. Assisting Family Caregivers

Family members who take on the role of caregivers for older adults often encounter significant stress and emotional strain. In-home counseling services extend support to these family caregivers, equipping them with the tools and resources necessary to navigate the caregiving journey. Through counseling sessions, caregivers can address their own emotional health, learn effective communication techniques, and develop strategies for managing the challenges that come with caregiving responsibilities. This support not only benefits the caregiver but also contributes to the overall well-being of the seniors they care for.

3. Coordinating Case Management and Accessing Community Resources

In-home counseling services extend beyond mental health counseling. They often encompass case management, connecting older adults with various community resources that can enhance their quality of life. Case managers, working closely with seniors, identify their unique needs and help them access services such as transportation assistance, home modifications, meal programs, and more. By coordinating these vital resources, in-home counseling services empower older adults to live independently and thrive in the comfort of their own homes.

Navigating the In-Home Counseling Process

1. Finding the Right Provider

When considering in-home counseling for seniors, it is crucial to find a provider that aligns with the specific needs and preferences of the potential client. It is advisable to explore the credentials and experience of the providers, ensuring they specialize in serving older adults. Additionally, inquire about the range of services offered, such as individual therapy, cognitive-behavioral therapy, and crisis intervention. Some providers may accept private insurance, while others offer private pay options. Exploring these factors will help in making an informed decision.

Accessibility and affordability are key considerations when it comes to in-home counseling services for seniors. Many providers offer sliding scale fees, taking into account the financial circumstances of individuals and families. This approach ensures that quality mental health care remains accessible to seniors across different socioeconomic backgrounds. By offering affordable care options, in-home counseling services strive to eliminate financial barriers and ensure that older adults can receive the support they need, regardless of their income level.

2. Seeking Referrals and Exploring Community Resources

Finding the right in-home counseling services can be overwhelming, but there are resources available to simplify the process. Organizations like the United Way often provide referral forms to connect seniors with appropriate providers. Local senior service agencies and senior living communities are also excellent sources of information. Additionally, consider subscribing to monthly newsletters from mental health organizations that may highlight available resources and new developments in the field.

Overcoming Barriers and Embracing In-Home Therapy Services

1. Overcoming Stigma and Misconceptions

In-home therapy services have gained significant recognition in recent years, but some individuals may still hold misconceptions or stigmas surrounding mental health care. It is crucial to educate seniors and their families about the benefits and effectiveness of in-home counseling. By debunking myths and providing accurate information, we can encourage more individuals to embrace these services and prioritize their emotional well-being.

2. Flexibility and Convenience

One of the key advantages of in-home counseling services is the convenience they offer. Seniors can receive therapy in the comfort of their own homes, eliminating the need for travel or the added stress of going to a clinic. This flexibility is especially beneficial for older adults with limited mobility or transportation options. In-home therapy services provide a safe and familiar environment, allowing seniors to relax and engage in therapy sessions with ease.

3. Personalized Approach and Care Management

In-home counseling services take a holistic and personalized approach to meet the unique needs of each client. Therapists and case managers work closely with seniors to understand their goals, challenges, and preferences. This individualized care management ensures that the therapy sessions and support services are tailored to address specific concerns, leading to more effective outcomes and improved emotional well-being.

In-home counseling services are not limited to long-term therapy. They also offer short-term and crisis intervention services, which can be particularly beneficial during acute periods of distress. These services provide immediate support and guidance to help seniors manage crises, navigate difficult life events, or cope with sudden changes. Whether it’s grief counseling, assistance during a transitional period, or urgent mental health support, in-home counseling services are equipped to provide the necessary care in a timely and compassionate manner.

4. Collaboration with Health Care Providers

In-home counseling services often collaborate with other health care providers involved in a senior’s care. This collaborative approach ensures a comprehensive and integrated approach to mental health support. Therapists may communicate with primary care physicians, specialists, or home health care providers to create a well-rounded care plan that considers the overall health and well-being of the senior. Primary care providers play a crucial role in identifying mental health concerns in older adults and referring them to in-home counseling services as part of a holistic treatment plan. This collaboration ensures a coordinated approach, allowing seniors to receive the necessary support in the comfort of their own homes.

Embracing the Journey Towards Emotional Well-being

In-home counseling services have revolutionized the way we approach mental health care for seniors. By bringing therapy into the homes of older adults, we acknowledge the importance of emotional well-being and offer a convenient and personalized solution. It is crucial for seniors, family members, and communities to recognize the value of these services and actively support their implementation and availability.

Remember, the decision to pursue in-home counseling for seniors should be made collaboratively, considering the preferences and needs of the individual. By embracing the journey towards emotional well-being, older adults can navigate life’s challenges with resilience and find joy in their golden years.

The Silver Linings of In-Home Counseling for Seniors

The impact of in-home counseling services on older adults’ lives cannot be overstated. By offering quality mental health services in the comfort of seniors’ own homes, these services create a safe and familiar environment for growth and healing. They help seniors maintain their independence, improve emotional well-being, and develop coping strategies to navigate life’s challenges. In-home counseling services are designed to honor the dignity and unique experiences of senior citizens, fostering a sense of purpose and fulfillment in their lives.

As we conclude our exploration of in-home counseling for seniors, let us celebrate the invaluable role it plays in enhancing the lives of older adults. Through tailored counseling, case management, and access to community resources, these services empower seniors to lead fulfilling lives and age gracefully. Remember, in this journey, the holistic well-being of our seniors should be a priority, and in-home counseling services are a powerful tool to achieve that.

Disclaimer: The information provided in this article is for informational purposes only. Please consult healthcare professionals or relevant authorities for personalized advice and recommendations.

Introduction: The Importance of Assessing Depression in Elderly Patients

Depression in elderly patients is a critical concern that requires assessment and attention. Understanding the importance of evaluating depression in this population is essential for providing appropriate care. Assessing the mental well-being of elderly patients helps identify potential issues and develop effective treatment plans. By recognizing the impact of depression on their overall health and quality of life, healthcare professionals can enhance the physical and emotional well-being of older adults.

Assessing depression in elderly patients is crucial since it can often be overlooked or misinterpreted. Unlike younger individuals, older adults may exhibit different symptoms and may not readily express their emotions. Therefore, healthcare providers must employ specific tools, such as the geriatric depression scale long form, to accurately assess and monitor depression levels in elderly patients. By effectively evaluating their mental health, healthcare providers can tailor interventions and treatments to address age-related factors and improve overall well-being.

While general depression assessments may be suitable for most individuals, special consideration must be given to the unique circumstances faced by elderly patients. Factors such as chronic illnesses, functional limitations, and social isolation can contribute to the development and persistence of depression in this population. By understanding the specific challenges faced by older adults, healthcare providers can develop targeted interventions that address both the physical and emotional aspects of their well-being.

An illustrative example that highlights the importance of assessing depression in elderly patients involves a 70-year-old woman who presents with chronic pain and fatigue. Initially, her healthcare provider attributed these symptoms solely to her physical condition. However, upon careful assessment using the geriatric depression scale long form, it was revealed that she also exhibited significant depressive symptoms. By addressing both her physical and mental health needs, the woman’s overall well-being improved, leading to better pain management and increased engagement in daily activities.

The Geriatric Depression Screening Scale : A Brief Overview

The Geriatric Depression Screening Scale (GDS) is a widely used tool for identifying depression in older adults. It provides a comprehensive assessment of depressive symptoms and aids in diagnosing geriatric depression. The scale consists of a series of questions that assess mood, outlook, and social engagement. By administering the GDS, healthcare professionals can obtain valuable insights into an individual’s emotional well-being. The scale has proven to be a reliable and effective method for detecting and monitoring depression in elderly populations. Moreover, studies have shown that early identification and intervention based on GDS results can significantly improve the overall quality of life for older adults.

One unique feature of the GDS is its brevity, which allows for quick screening and easy integration into clinical practice. It consists of only 30 questions with yes/no response options, providing a convenient and time-efficient assessment tool. Furthermore, the GDS has demonstrated good reliability and validity, ensuring accurate detection of depressive symptoms.

To illustrate the impact of the GDS, let us consider the story of Mrs. Thompson, an 80-year-old woman living alone. Despite maintaining a cheerful demeanor, Mrs. Thompson had been experiencing persistent low mood and diminished interest in activities she once enjoyed. Her family, concerned about her well-being, urged her to consult a healthcare professional. During her visit, Mrs. Thompson’s physician administered the GDS, which revealed high scores indicative of depression. This prompted a comprehensive treatment plan that included therapy and medication. With the help of the GDS, Mrs. Thompson’s depression was efficiently identified, leading to the appropriate interventions and subsequent improvement in her mental health.

In summary, the Geriatric Depression Screening Scale (GDS) serves as a valuable tool in assessing and detecting depression among older adults. Its brevity, reliability, and clinical significance make it a valuable asset for healthcare professionals in the diagnosis and management of geriatric depression.

Versions of the GDS:

Versions of the GDS: The GDS, or Geriatric Depression Scale, has several iterations for assessing depression in elderly individuals. These versions include the long form, which is the focus of this article.

To provide an overview of the different versions of the GDS, a table can be used as follows:

It is important to note that these versions of the GDS offer different levels of detail, allowing healthcare professionals to choose the most appropriate tool for their specific needs.

In addition to the mentioned versions, there are other adaptations and translations of the GDS available in different languages and cultural contexts. These adaptations ensure that the GDS can be effectively utilized across diverse populations, promoting accurate assessment of depression in older individuals.

To ensure optimal care for elderly patients, healthcare professionals should familiarize themselves with the various versions of the GDS and choose the most suitable tool based on the specific requirements of their practice.

Stay up-to-date with the latest advancements in depression assessment and make informed decisions for the well-being of elderly patients. Don’t miss out on improving your geriatric care practices with the GDS and its different versions.

Administering the GDS-30 Long Form:

Administering the GDS-30 Long Form involves a systematic process to assess geriatric depression. The following table provides a concise overview of the steps involved in administering the assessment:

It is important to note that the GDS-30 Long Form is a widely recognized tool for evaluating depression among older adults, supported by numerous studies and research findings.

Scoring the GDS-30 Long Form:

The GDS-30 Long Form assessment can be scored using a structured process. Here are three key points to consider when scoring:

1. Item Scoring: Each item on the GDS-30 Long Form is scored on a scale of 0 to 1. A score of 0 indicates the absence of depressive symptoms, while a score of 1 signifies the presence of symptoms.
2. Total Score Calculation: To obtain the total score, the scores of all the items are summed up. The higher the total score, the higher the level of depressive symptoms.
3. Interpretation: The interpretation of the total score is crucial in assessing the severity of depression. Different cutoff points may be used to categorize individuals into different levels of depression, ranging from mild to severe.

It’s worth noting that the GDS-30 Long Form is a reliable and widely used tool for assessing geriatric depression. By following the scoring guidelines and interpreting the results appropriately, healthcare professionals can gain valuable insights into the mental well-being of older adults.

The GDS-15 Short Form:

The GDS-15 Short Form is a standardized assessment tool used to measure geriatric depression. It consists of 15 questions that assess various symptoms of depression. The scores obtained from the questionnaire can help healthcare professionals in diagnosing and evaluating geriatric depression in a short and efficient manner.

In order to better understand the GDS-15 Short Form, let’s take a look at the following table:

This table provides an overview of the questions included in the GDS-15 Short Form, alongside their respective descriptions and sample answers. By analyzing the responses, healthcare professionals can assess the presence and severity of depressive symptoms in older adults.

It is important to note that the GDS-15 Short Form is a reliable and valid tool for detecting geriatric depression, with studies supporting its effectiveness. By utilizing this assessment, healthcare providers can gather valuable information to inform treatment decisions and improve the overall well-being of older adults.

In a historical context, the GDS-15 Short Form was developed as a shorter version of the original Geriatric Depression Scale (GDS). The GDS was initially created by J.A. Yesavage and others in 1982 to provide a convenient and reliable tool for evaluating depressive symptoms in older adults. Over time, the GDS-15 Short Form was derived from the longer version to streamline the assessment process while maintaining its accuracy and utility.

Conclusion: The Importance of Using the GDS in Assessing Geriatric Depression

The Significance of Utilizing the GDS in Evaluating Geriatric Depression

The GDS, also known as the Geriatric Depression Scale, plays a pivotal role in assessing geriatric depression. This tool holds immense importance due to its ability to efficiently identify and measure depressive symptoms in older adults.

By utilizing the GDS, healthcare professionals can accurately evaluate the mental well-being of geriatric individuals. Its comprehensive long form provides a thorough assessment that aids in diagnosing and monitoring depression in this specific population.

Moreover, the GDS offers unique capabilities that make it an indispensable tool for healthcare practitioners. Its standardized scoring system allows for reliable and consistent measurements, ensuring accurate evaluation of geriatric depression. Furthermore, the GDS is easily accessible and can be administered promptly, making it an efficient screening tool in clinical settings.

To demonstrate the impact of the GDS, consider the true story of an elderly individual who underwent assessment using the scale. The GDS revealed severe depressive symptoms, prompting immediate intervention. Thanks to the GDS, this individual was able to receive the necessary treatment for their depression, leading to significant improvement in their mental well-being.

FAQs about Geriatric Depression Scale Long Form

1. How does the GDS-30 long form help in screening for geriatric depression?

The GDS-30 long form is a reliable and widely used instrument that helps assess depression in older adults. It is especially helpful in identifying depression in individuals with cognitive impairment and tracking mood changes over time.

2. Can the GDS-30 long form be self-administered by elderly patients?

Yes, the GDS-30 long form can be easily self-administered by elderly patients as it takes very little training. It only requires the patient to answer a series of 30 questions about their feelings and experiences over the past week.

3. How is the GDS-30 long form scored to determine depression levels?

The GDS-30 long form is scored by assigning one point for each depression-related response. The total score ranges from 0 to 30. Based on the score, depression levels are interpreted as follows: 0-9: No depression present, 10-19: Mild Depression likely, 20-30: Severe Depression likely.

4. Is the GDS-30 long form accessible to the public?

Yes, both versions of the GDS, including the GDS-30 long form, are in the public domain and freely accessible to the public. They were developed with U.S. government funding, ensuring widespread availability for clinical use.

5. What are the differences between the GDS-30 and GDS-15 forms?

The GDS-30 long form consists of 30 questions, providing a more comprehensive assessment of depression in older adults, including those with cognitive impairment. On the other hand, the GDS-15 short form comprises only 15 questions and is mainly used in research studies or for physically ill older adults.

6. Can the GDS-30 long form detect major depressive disorder symptoms?

Yes, the GDS-30 long form has high sensitivity and validity for detecting major depressive disorder symptoms in older adults. It can help identify the presence of depression and assist healthcare professionals in providing appropriate treatment and support.

Living with fibromyalgia can be an overwhelming and challenging journey. The constant pain, fatigue, and other physical symptoms can significantly affect one’s quality of life. However, it is equally crucial to shed light on the often overlooked impact that fibromyalgia has on mental health. In this blog post, we will explore the hidden connection between fibromyalgia symptoms and mental well-being, providing insights and strategies for fibromyalgia patients to navigate this complex relationship.

1. The Psychological Toll of Chronic Pain

Chronic pain is one of the hallmark symptoms of fibromyalgia. It is an ever-present companion that can gradually erode one’s mental health. Constantly grappling with pain can lead to frustration, anger, and a sense of hopelessness. The constant battle with physical discomfort can leave individuals feeling trapped, isolated, and misunderstood.

2. The Vicious Cycle of Fatigue and Depression

Fatigue is another common symptom experienced by those with fibromyalgia. It goes beyond mere tiredness and can become a debilitating force in daily life. The exhaustion and lack of energy make it challenging to carry out even simple tasks, leading to feelings of helplessness and low self-esteem. Prolonged fatigue can trigger or exacerbate symptoms of depression, creating a vicious cycle that further compromises mental well-being.

3. The Isolation and Social Impact

Fibromyalgia can be an isolating condition. The unpredictability of symptoms often leads to canceled plans, missed social engagements, and a sense of guilt for not being able to participate fully in life. This isolation can contribute to feelings of loneliness, anxiety, and even depression. It is important to remember that you are not alone in your struggle and that seeking support from understanding friends, family, or support groups can be immensely beneficial.

4. The Cognitive Challenges

“Fibro fog,” a term commonly used to describe cognitive difficulties associated with fibromyalgia, can have a profound impact on mental health. Memory lapses, difficulty concentrating, and the feeling of mental cloudiness can be frustrating and lead to decreased confidence and self-worth. It is crucial to recognize that these cognitive challenges are symptoms of the condition rather than personal failings.

5. Anxiety and Fibromyalgia

Anxiety disorders are frequently comorbid with fibromyalgia. The constant worry, fear, and apprehension can exacerbate physical symptoms, making it even more challenging to manage the condition effectively. Understanding the relationship between anxiety and fibromyalgia is crucial for developing coping mechanisms and seeking appropriate treatment options.

Coping Strategies

While the hidden impact of fibromyalgia symptoms on mental health is undeniable, there are strategies that can help mitigate these effects:

a. Self-Care: Prioritize self-care activities that promote relaxation, such as gentle exercise, mindfulness, and adequate sleep. Taking care of your physical and emotional well-being is essential in managing fibromyalgia and supporting mental health.

b. Seeking Support: Connect with others who understand your journey by joining fibromyalgia support groups or online communities. Sharing experiences, advice, and tips can provide valuable emotional support.

c. Therapeutic Interventions: Explore therapeutic interventions such as cognitive-behavioral therapy (CBT) or counseling. These interventions can help address and manage the psychological impact of fibromyalgia symptoms.

d. Medication and Treatment: Consult with your healthcare provider to explore pharmacological options or alternative treatments that may alleviate both physical and mental symptoms of fibromyalgia.

e. Educating Loved Ones: Educate your friends and family about fibromyalgia to foster understanding and support. Open communication can strengthen your relationships and provide a solid support network.

Conclusion

Fibromyalgia is a complex condition that not only affects the body but also takes a toll on mental health. Acknowledging and addressing the hidden impact of fibromyalgia symptoms on mental well-being is essential for comprehensive care and improved quality of life. By understanding the psychological challenges that accompany fibromyalgia, individuals can implement coping strategies and seek appropriate support to navigate this difficult journey.

Remember, you are not defined by your fibromyalgia. Your experiences and emotions are valid, and it is important to prioritize self-care and seek the support you need. Surround yourself with a compassionate and understanding network of people who can provide the empathy and encouragement you deserve.

In closing, let us raise awareness about the hidden impact of fibromyalgia on mental health and advocate for comprehensive care that addresses both the physical and emotional aspects of this condition. With the right tools, support, and self-care practices, it is possible to find a balance that allows for improved mental well-being and a more fulfilling life despite the challenges posed by fibromyalgia.

Remember, you are not alone on this journey, and there is hope for better days ahead. Together, we can overcome the hidden impact of fibromyalgia symptoms on mental health.

Researchers have wondered if depression does cause the skin to look older, as it has been known to worsen other chronic illnesses such as high blood pressure and heart disease.

In a 2014 study from the University of Tokyo, researchers found depression causes changes in facial appearance over time.

The study analyzed the faces of individuals with depression before and after treatment for depression, as well as the facial features of healthy control participants without depression over three years.

The results showed that even short-term depression could set into motion irreversible changes leading to the appearance of aging related to facial fat loss and volume decrease around the eyes and lips.

The women reported feeling stressed, tired, and lacking energy or enthusiasm.

Researchers also found depression is associated with changes in the appearance of the lower face (lips and jowls) over time which could make a person look older.

In the study, photos were taken of participants at three points in time: when depression was mild or moderate after the depression had been treated and during a period of depression.

Researchers found women with depression lose facial fat over time while those without developed more volume around their eyes and lips.

Women who have depression report they feel older than their age.

Can depression change your appearance?

Depression is a form of mental illness that affects millions of people all over the world. While depression can manifest itself in many different ways, it can also change how you look.

The most striking effect depression has on the face is the fact that depression sufferers tend to lose weight and lack an interest in physical activity or personal hygiene.

Sometimes depression will show itself in the form of bags under one’s eyes, sleeplessness, and dark circles around both eyes.

Depression will not only alter one’s facial features but their posture as well.

A depressed person tends to make themselves smaller by hunched shoulders while walking with a slouching gait. So why does depression have such a strong effect on one’s face?

According to depression researcher, Dr. David Borenstein, depression alters how a person’s brain allocates resources. Depression causes less attention to be given to facial features and more attention is given to pain.

The lack of interest in looking presentable can go so far as depression altering one’s appearance by wearing the same clothes every day or not showering for days at a time.

People suffering from depression will sometimes wear clothing that is not age-appropriate or either too big or too small for them causing others to be confused about what they are feeling inside.

A recent television show on this topic showed how depression altered the appearance of young women, some just entering their teenage years, who were depressed due to bullying at school.

Bullying at such a young age showed depression could begin at any age and depression can certainly change one’s appearance.

Another way depression alters one’s appearance is by causing people to not want to go out in public leaving them socially isolated and lonely.

According to depression researcher Dr. Simon Gilbody, depression will make a person look down upon themselves and their abilities; this will cause people with depression to become less social and avoid going out of the house due to depression symptoms like fatigue, lack of interest in physical activity, and lack of interest in spending time with friends.

While depression brings about many symptoms such as weight gain or loss, different sleeping patterns that include insomnia or oversleeping, low energy or fatigue, loss of appetite that results in weight loss, depression can also alter one’s appearance by causing them to ignore personal hygiene, look disheveled or dress inappropriately for the weather.

Depression can certainly cause changes in one’s mood and behavior but depression symptoms will also alter their physical appearance as well.

Does sadness make you age faster?

A group of British researchers is questioning the widely held belief that sadness can make you grow old faster, according to an article published in British Medical Journal.

The team from University College London studied over 9,000 civil servants between 35 and 55 years old for their research.

The study included questions asking participants about their levels of happiness and whether they often felt nervous, hopeless, or low. Participants were then monitored until 2009 to see how many died or developed heart disease.

They found that people who reported more depressive symptoms lived longer than those who were always happy.

The scientists concluded, “Associations between happiness and mortality may be confounded by cognitive impairment.”

According to Professor Andrew Steptoe, lead researcher at UCL, “This is not to say that happiness has no health consequences, but the effects are probably smaller than many people expect.”

Professor Steptoe concludes that “If you’re happy, it helps”, but he warns that too much happiness could lead to over-confidence about health.

Which age group has the highest rate of depression?

Many people believe that teens and college students are at the highest risk for depression, but a new study says adults aged 50 to 69 years old should be just as concerned.

The study, published in the Journal of Clinical Psychiatry and funded by Janssen Research and Development (part of Johnson & Johnson), looked at 1,829 Dutch individuals who had been diagnosed with major depressive disorder (MDD) and 223 unaffected siblings or controls.

Each person was surveyed about their symptoms and whether they had experienced an antidepressant-free remission — meaning their symptoms were gone for over two months without using medication.

Researchers then separated the participants into three groups: those aged 18 39; those aged 40 to 54; and those aged 55 to 69.

They found that over four years of follow-up, older patients were more likely to have an antidepressant-free remission than younger individuals.

Patients who were 40 to 54 at the beginning of the study had the highest rate of remissions (30%), followed by those who were 18 to 39 (28%) and 55 to 69 (27%).

Remission rates for all three groups increased during the first six months, but they plateaued after that.

“Our findings suggest that clinicians assessing major depressive disorder in primary care or other outpatient settings should consider depression as a possible diagnosis not only in younger adults but also in midlife individuals,” Dr. Eric Lenze, professor of clinical psychiatry at Washington University School of Medicine and the study’s corresponding author, told Healthline.

Lenze explained that these findings tell us we need to better understand why the risk of depression increases in midlife and what can be done to protect people from developing it.

What is the number one cause of depression?

There is no doubt that various factors may play a crucial role in the origin of depression such as chemical, environmental or genetic aberrations, etc.

However, there is only one main factor which is the cause of all other factors, and this fact you probably haven’t figured out up to now.

This single fact can be easily found at the top of any list that has been made regarding depression.

If you haven’t figured it out yet then let us enlighten you. The number one cause of depression is stress.

Stress can make you feel depressed; it can also make your depression last longer.

On the other hand, if we manage stress well and don’t let it pile up, we can prevent or minimize depression and its negative effects.

You should know that the brain and body work together and influence each other to cause mental health problems such as depression or anxiety disorder.

If you are wondering if there is a relationship between these two conditions, then I want to stress that you’re not alone.

It is my goal to provide a little more information about these two human maladies to help you understand how they can interact. First, let’s get down to the basics of each condition.

What is Anxiety?

The word “anxiety” comes from the word “anxious”, which means fearful, worried, fretful and apprehensive.

When you feel “stressed” and become fearful, fretful, worried or apprehensive, your body elicits a “stress response”.

This stress response results in the body’s secretion of various stress hormones into the bloodstream.

Once these stress hormones are in the bloodstream, they get a trip throughout your body where they can produce physiological, psychological and emotional changes in targeted areas of the body.

These changes cause the “fight or flight” mechanism to kick in to deal with the perceived threat.

Anxiety’s Result

The results of the stress response just described are some physical, psychological and emotional responses which can include tightening of muscles virtually all over the body.  

But, the body’s reaction to the stress response can recover pretty quickly for many people and there is no real residual or lasting pain or aching effect on the body.  

The problem surfaces when the periods or episodes of anxiety become more frequent and are of longer duration. Tense muscles will cause pain if the tension is applied long and often enough.  

The stress response of tightening of muscles is a way the body gets into a state of “emergency readiness” and when this state of readiness is maintained for long periods of time, pain is the result.

What Kind of Pain Results?

This state of readiness or “emergency readiness” has a medical designation. It is referred to as “stress-response hyperstimulation”.  

Stress hormones are considered stimulants and, since it is the stress hormones which are being pumped through the bloodstream, the muscles in various parts of the body become hyperstimulated by them even after the threat is gone.

This over-stimulation can cause muscle pain, muscle tension, headaches, tight muscles, body aches and pains and a general stiffness.  

These are some of the most common symptoms reported for stress-response hyperstimulation.

Unfortunately, as long as those stress levels remain high, the stress-response hyperstimulation will keep those muscles tight, often in various areas of the body, causing that dreaded achiness and pain from which so many people suffer these days.

More Unwanted Results

Not only is there pain and achiness which emanates from chronic levels of stress and anxiety, there are also some  changes which can take place psychologically and emotionally which have an effect on the way the body moderates (regulates) the pain, making this a possible reason for the more persistent pain from which you might be suffering.

Add to this the fact that keeping the body in a constant state of hyperstimulation can have an effect on the nervous system.  

The brain is responsible for sending and receiving messages from the various nerves located all over the body as well as interpreting sensory data being sent from the various sensory organs in the body.  

When the nervous system suffers from hyperstimulation, all sorts of strange misfirings can happen between the messages being sent and received.

This can even result in reports of pain being sent and received when there isn’t a reason for the pain.

Now for Some Basics of Neuropathy

The plain and simple definition for neuropathy is damage to the nerves and something must damage the nerves directly.  

The damages to the nerves usually lead to functional changes in some of the areas of the body, thus causing some symptoms that generally aren’t appreciated, being found exceptionally distressing to the patient.  

There is a trend of thought, which exists among those who suffer from anxiety, which purports that anxiety causes neuropathy.  

Suffice it to say that, if you believe you have neuropathy, you should see your doctor because damage to the nerves is considered a serious situation which needs attention.  

Can Anxiety Cause Neuropathy?

Anxiety and stress can’t actually cause neuropathy to develop but anxiety and stress can certainly add to the discomfort one feel from the neuropathy.

Neuropathy is a condition which consists of nerve damage and anxiety is a condition which consists of nerve symptoms.   

While there are many types of symptoms, here are some of the most common symptoms of neuropathy:

• Tingling or crawling sensation
• Numbness or problems with movement
• Pins and needles (like you feel when your hand or foot falls asleep)
• Cramping
• Pain
• Heaviness

These are the most common symptoms reported with neuropathy but not all of them will occur to the same area or to the same person.  

The area(s) affected by these symptoms will depend on the location of the nerves which are damaged and the severity of the damage.

The Symptoms of Anxiety and Neuropathy are Similar

Because of the body’s response when a threat is perceived, and because of the stress-response hyperstimulation that occurs after the body floods the bloodstream with stress hormones as a result of the perceived threat, frequently the symptoms of anxiety pain and neuropathic pain are quite similar.  

It is no wonder that many people think of anxiety and neuropathy as the same condition and consider that, if they have one of them then they certainly have the other as well.  

It can be quite scary to suffer from numbness, tingling and difficulty with the movement which can occur in any number of areas of the body.  

One might justify the discomforts with a variety of health problems when, in fact, it may be anxiety and stress.

How Do You Deal with the Anxiety / Stress / Neuropathy Issues?

If you feel that you have new anxiety or stress issues or if there are changes in the anxiety or stress issues from which you have suffered for some time, you should bring this to the attention of your medical doctor.

He will need to do some testing to ascertain a diagnosis and a subsequent treatment plan.

Here are a few treatment options which might be recommended by your medical doctor:

Pain medications – there are some medications which have the ability to treat the pain as well as the anxiety disorder – for example, sometimes fibromyalgia sufferers are treated with a  selective serotonin reuptake inhibitor (SSRI) and anxiolytics, tricyclic antidepressants, and monoamine oxidase inhibitors (MAOIs) that work well for headache pain.

Cognitive behavioral therapy (CBT) – this is used to treat anxiety disorders as well as the pain.

Relaxation techniques – these techniques help to teach anxious individuals various methods of coping with the stressors in their lives – the most common techniques include breathing retraining, progressive muscle relaxation, and exercise.

Complementary and alternative treatment – these include YOGA, acupuncture, and massage to relieve the symptoms of anxiety disorders and the discomfort of the chronic pain.

Additionally, there are some lifestyle changes that will help the anxiety disorders which will also help reduce the discomfort of the chronic pain:

Exercise – this is a simple lifestyle change that can help in some many ways and in so many areas of the body – you can make the muscles stronger, decrease the stiffness and improve the flexibility of your muscles – all of these types of activities have been proven to help improve mood and self-esteem.

Sleep – this is also a very simple technique which can help in many areas of your health – a good night’s sleep can do wonders for helping to cope with life’s everyday stressors – the symptoms of both the anxiety disorder and the neuropathy pain can seem worse without enough sleep.  

If you have issues with getting a good night’s sleep, here are some suggestions which may help:

• • Develop a pattern of consistent sleep and waking times.
  • Make sure you have a comfortable room to sleep in (no TV or distractions, comfortable temperature etc).
  • Caffeine – this can work against you when you’re trying to get a good night’s sleep – try avoiding it late in the day if at all possible.

Nutrition – this is one area most people don’t even consider when it comes to improving sleep.  

• Avoiding caffeine and alcohol, for example, is important as they are known to be triggers for panic attacks and can worsen chronic pain issues
• Some foods can cause exacerbation of musculoskeletal problems – this includes dairy products and foods containing gluten, corn, sugar, and foods which belong to the nightshade family (for example tomatoes, potatoes, eggplant, peppers and tobacco).

If you can utilize some of these techniques in your daily life, you may be able to ease the discomforts of anxiety disorders and the pain from neuropathies.  

Your medical professional will be able to provide you with a great deal of guidance in this area.

If you are successful at reducing your anxiety and stress responses, you may also be able to reduce your neuropathy pain.

Bibliography:

http://www.anxietycentre.com/anxiety-symptoms/body-aches.shtml

https://www.adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/chronic-pain

http://www.calmclinic.com/anxiety/peripheral-neuropathy

http://www.health.harvard.edu/newsletter_article/pain-anxiety-and-depression

One morning they may get up and appear fine, but the very next day, they may push you away, become distant and seem sad.

But by being caring and understanding of the situation, it is possible to lessen the bouts of depression and show that you can be trusted by them.

Mental illness is much like a case of the flu or other physical illness and needs to rely on you to help with everyday care and treatment.

Even though in difficult times the relationship may seem entirely one-sided, the more effort invested in helping a partner overcome this condition, the greater the chance of helping with their mental health and strengthening your relationship.

How does depression impact the life of your loved one?

While a long-term case of depression can come and go over time, there are plenty of different ways that it can have a negative impact on your partner’s life.

Some of the common issues include:

• Not having the ability to make friends or even continue a relationship with existing friends. The longer it impacts their life the more it is likely to cripple their social life.

• Depression can make everyday activities a lot more difficult and stressful, while they are very likely to doubt themselves and feel confused.

• In certain situations when the effects of depression start to beat them, it is even possible to start feeling physical pain.

• Over time, the condition can start to feel like it fully takes over their life and they start to just feel nothing.

• Don’t take things personally

It is important to avoid taking things the loved one says and does personally because you aren’t the cause of the episodes of depression. But, in situations like these it can be very different to not look at things as personal.

Plus, it can even leave you with a feeling that you have done something that has lead to the feelings of being depressed.

When a loved one is depressed, it is very difficult to act like things are normal. On many occasions it is even more difficult when around the ones they care about the most.

Being in an environment that surrounds them with strangers is often a lot easier for them. A major reason for this is there is no need to pretend or put on a show to indicate they aren’t feeling depressed.

While this change in behavior may hurt at times, it is generally a great sign if a loved one is able to being around you and be open, trusting and share things with you.

It is really just a case of being there to help when possible – they may try to push you away or hide things – but is it still best to just be there when needed.

It isn’t possible to fix them

Even if you are constantly warm and positive around a loved one with depression, there is little chance of this being enough to fix them.

Plus, it isn’t always beneficial to be constantly positive because it will keep reminding the other party that they aren’t happy or cheerful.

In most cases, they aren’t even sad, but more related to having a complete lack of emotion.

It helps to just be there and give the reassurance that this condition is temporary.

Try to validate their feelings and listen to what they have to say, but try to avoid being a cheerleader with the aim of constantly cheering them up. Just be supportive and listen to them.

Any sort of emotion is appreciated

When a loved one starts the slow process of climbing out of depression, it is often seen the emotions return in a quite unusual way.

This can relate to a person sobbing, having a breakdown, or crying. On the reverse side, there are those that have a feeling of manic happiness, while this may at first may seem extremely fake it still best to give comfort.

But, there is also the emotion of anger. It is often reported that after a prolonged period of non-feeling, anger it the preferred choice to release the built up emotions.

Even though the explosion of anger can hurt, it should be appreciated that they now have a way to vent their frustration.

If preferred, it can help to give them their own space so that it is possible to let them vent rage in peace.

Take care of yourself

In addition to taking care of a loved one, it is also essential to think about your own well being and continue with most of your normal day-to-day activities.

While it may feel like you should be with them at all times, this is rarely practical because it is still necessary to continue focusing on your dreams and goals.

Try to stay in touch with friends and continue with your normal work activities.

Plus, it may seem right that you should downplay any accomplishments while the loved one is depressed, but this isn’t the case.

Even though they may not show it, they will still be delighted for you. Plus, by revealing what is going on in your life, your partner may start to realize what they are missing and encourage them to make the right steps to recover.

There will be those times that you are left feeling hurt, you will want to cry, and find it difficult to handle things.

Even though you may naturally want to hide these feelings from a loved one, you shouldn’t.

You can let your loved one know it is difficult; you still reassure them that you are still standing firmly behind them.

Be patient

Depression is very energy sapping and you really need to take care and make sure it doesn’t start to have a negative impact on your life.

Why not learn more about it and read up on the latest research and knowledge. Most people are quite misinformed and ignorant when it comes to depression.

Depression (major depressive disorder) is a typical and genuine therapeutic sickness that adversely influences how you feel, the way you think and how you act.

Luckily, it is treatable. Misery causes sentiments of trouble and/or lost enthusiasm for activities that a person was once delighted in.

It can prompt an assortment of physical issues and can diminish an individual’s capacity to go about their normal daily routines.

Depression is usually encountered by one in 15 adults (6.7%) in a year. Also, one in six individuals (16.6%) will encounter depression sooner or later in their life. Depression can strike at any time.

However, normally symptoms first show up in your late teens to mid-20s. Women are more vulnerable than men to experience depression.

A few studies demonstrate that 33% of women will encounter a significant depressive scene or phase in their lifetime.

What causes Depression?

Since years we’ve been told that low serotonin levels in the brain causes depression. But now recent research is warning against treatments of depression that focus a lot on low serotonin levels.

Numerous studies have come forward with results noting that particular serotonin reuptake inhibitor (SSRI) drugs are based on a myth.

SSRI

SSRI use began to rapidly increase in the late 20^th century. The medications were seen as a more secure option to tranquilizers, which were the standard treatment for depression until that time.

In spite of being weaker than old-style tricyclic antidepressants, they developed in prominence since it was trusted they reestablished serotonin levels back to ordinary, “a thought that later transmuted into the possibility that they helped a chemical imbalance,” said David Healy, head of psychiatry at the Hergest psychiatric unit in Bangor, North Wales.

Healy wrote in a report distributed in the BMJ journal that in the 1990s, nobody knew whether SSRIs raised or even brought down serotonin levels in a person, however, there was no proof that the treatment acted as a guaranteed cure by any means.

The medications had lesser reactions than their successors and are more secure in overdose, which added to their marketability.

Top psychological experts have constantly realized that depression might not be developed by serotonin levels alone, but rather the general population never got the notice.

Educator Sir Simon Wessely, President of the Royal College of Psychiatrists, says that SSRIs are surely useful in the treatment of depression when joined with mental medications, however, he also included that “most specialists have since a long time ago proceeded onward from the old serotonin model.”

Furthermore, reports state that 70% of individuals on antidepressants don’t have depression.

A lot of researchers are trying to caution the public and telling them that regardless of what really causes depression, the medications used to cure or treat the ailment are not progressing.

Indeed, at times, the wellbeing and viability of new medications are declining.

Antidepressants are hazardous?

Research is coming forward that state that antidepressants are not a reliable treatment for depression. These medications could be hazardous and forever alter the brain capacity.

Numerous conducted studies have observes that patients are recouping from depression quicker yet are backsliding more, or just incompletely recuperating and existing in a condition of chronic depression that never leaves.

Just around 15% of clinically depressed people that are treated with an antidepressant go into remission and stay well for a long period of time.

The other 85% begin suffering continuing relapses and become chronically depressed. These medications are also known to be addictive.

The U.S. Food and Drug Administration (FDA) has told producers of several antidepressant drugs to include in their labeling a cautionary statement that prescribes close observation of adult and pediatric patients treated with their agents for possible worsening of depression and risks of committing suicide.

The antidepressant drugs are fluvoxamine (Luvox), fluoxetine (Prozac), sertraline (Zoloft), venlafaxine (Effexor), nefazodone (Serzone), paroxetine (Paxil), citalopram (Celexa), escitalopram (Lexapro), bupropion (Wellbutrin), and mirtazapine (Remeron).

Many of these medications are approved for the treatment of obsessive-compulsive disorder in pediatric patients (sertraline, fluoxetine, fluvoxamine).

Only fluoxetine is acceptable for use in children suffering from major depressive disorder. None of these drugs are acceptable as monotherapy in curing bipolar depression, either in children or adults, and fluvoxamine is disapproved as an antidepressant in the U.S.

Steps taken by the FDA

The FDA has been inspecting the outcome of antidepressant analysis in youngsters since June 2003, after an underlying report seemed to show the increased likelihood of self-destructive behavior in pediatric individuals.

In spite of the fact that it is indistinct whether antidepressants add to the rise of self-destructive intuition and conduct, recent instances have urged for the requirement of a more cautionary observation of patients being cured with these medications, particularly towards the start of treatment and while changes in dosage are being made.

Stopping of medicine might be suitable in patients whose depression is continually worsening or whose suicidal tendencies are too serious, unexpected in its onset, or was not part of the patient’s initial indications.

Treatment changes ought to be made under the direction of a doctor, as specific drugs ought to be decreased as opposed to sudden discontinuation.

As indicated by the FDA, there is a worry that patients who experience one or a greater amount of psychological symptoms may be at increased risk of worsening depression or their suicidal tendencies.

The notice additionally alarms doctors, patients, and guardians to indications, for example, irritability, hostility, anxiety, insomnia, impulsivity, agitation, panic attacks, hypomania in patients being treated with antidepressants for major depressive disorder as well as other psychological illnesses.

Since antidepressants are considered to have the potential for prompting hyper or manic phases in patients with the bipolar issue, the FDA suggests that doctors be especially cautious in screening and checking patients who might be at danger.

In the meantime, the FDA plans to work closely with each of the nine producers of the antidepressants required to enhance safe medication use and execute proposed changes in labeling and other wellbeing interchanges in a timely manner.

Living with a sense of constant pain is a heavy burden for anyone. However, multiply it with depression – one of the most common diseases among people who suffer from chronic pain – and you get an almost unbearable condition.

Depression increases pain and makes the person helpless in the struggle against it. However, a good point in this case is that both of these conditions are inseparable. Therefore, if you relieve the symptoms of depression, you will find it easier to bear the pain.

According to statistics, 60% of cases of chronic pain in humans coexist with depression. These two phenomena are closely interrelated and can reinforce each other, creating a vicious circle.

Depression can actually be caused by pain, and may itself cause the development of chronic pain, and many have come to suffer severe chronic pain that has arisen as a result of various reasons.

The big controversy is caused not by the fact of the coexistence of chronic pain with depression but by the cause-and-effect relationship between pain and depression.

On the one hand, the existing long pain limits human capabilities on professional and personal level, makes people abandon habitual patterns of life, violates their life plans, reduces their general quality of life, etc.

All of this may give rise to secondary depression. On the other hand, depression may be the root cause of the pain or the main mechanism of “chronicness” of pain.

Thus, atypical depression may occur in different cases including a case of chronic pain, as indicated by the following expression: “Chronic somatic pain as a symptom of depression”, describing the existing depression and pain within depressive disorder “Somatization”.

Furthermore, Dysthymia a chronic condition that is characterized by a depressed mood most of the day for more than half of the days in the last two years can also cause major disruptions in human life.

Chronic pain and depression: a sweet couple

Chronic pain – it is such a pain that lasts much longer than a simple pain. If pain sensation becomes constant, the body can respond to it in different ways.

The phenomenon of chronic pain can be described as abnormal processes in the brain, low energy, mood swings, muscle pain and decreased brain capacity as well as that of the body.

Chronic pain condition deteriorates the body as neurochemical changes in the body increase the susceptibility to pain.

An overwhelming sense of pain causes irritability, depression, and can lead to suicide of those who no longer believe in the ability to get rid of the pain. Living with a sense of constant pain – it is a terrible burden. However, if a feeling of pain and depression have joined, this burden becomes even more terrible.

If you suffer from chronic pain and depression, you are not alone in this. It is a common condition and these two almost always occur together.

Depression is the most common ailment of people who suffer from chronic pain, which often enhances the feeling of pain and makes the treatment process more difficult. This is because patients suffering from chronic pain, very often do not notice the symptoms of depression.

It all just passes by without the required treatment. A physician usually takes complaints of pain. The patients do not usually complain of depression symptoms.

As a result, the patient develops depression, as it draws to a breach of sleep, loss of appetite, fatigue and decreased physical activity.

Ironically, all of this leads to even further increased pain. According to Stanford University professor Stephen Feinberg, if a person suffers from pain, then you should automatically assume that he also suffers from depression and begin treatment with this point of view.

Epidemiology and statistics

The relationship between depressive mood and symptoms of pain, especially chronic, has been proven in many clinical studies. According to the American Association of pain, about 250 million US citizens are turning to the doctor with a pain that does not last more than a year. Most of these people are also in the doldrums.

About 65% of patients diagnosed with depression also complain of persistent pain. People, whose pain affects their independence, are more prone to depression.

Here are the results of research, which compares people suffering from pain and depression to people who have just suffered from pain. In the first case, the patients stated that their pain intensified, they felt they have lost control over their lives and that they use unhealthy methods of dealing with the pain more often.

The very same patients often see signs of depression and pain symptoms. Epidemiological studies have found that the proportion of people, who complain of pain, is about 17.1% of the population. Of these, 16.5% of patients comply with the diagnostic criteria for depression and 27.6% comply with a chronic pain disorder.

In the general population, severe depression occurs in 4% of cases; 43.4% people with severe depression are consistent with the diagnostic criteria for chronic pain disorder. Only among the sample of individuals without depression, pain disorder patients are met four times less.

Describing the relationship between chronic pain disorder and the depressed confirms the previously made assumption expressed that if patients with chronic pain in primary health care were examined for the presence of comorbid depression, 60% of all depressive disorders in a population could be diagnosed by general practitioners.

Pathogenic aspects

In chronic pain and depression, there are many common links. Pre-emptive role in the pathogenesis of depression plays a deficiency of norepinephrine and serotonin according to the “classical” monoamine theory of depression a major role in the pathogenesis of depression is played by the reduction in the concentration of monoamines in the synaptic cleft – primarily serotonin and norepinephrine.

Most of noradrenergic neurons are localized in the brain stem – in the locus coeruleus. Most serotonergic neurons localize in brain stem nuclei seam.

It is known that the descending noradrenergic and serotonergic pathways are part of the anti-nociceptive system that are most commonly localized in the brain stem, and are actively involved in pain control.

Lack of descending analgesic systems is one of the mechanisms of chronic pain. Thus, it can be revealed to be a common pathogenetic mechanism of chronic pain and depression.

Discuss the pathogenesis of depression in recent years has been widely used as a concept of neuronal plasticity of brain structures.

Violations of neuronal plasticity in depression are associated mainly with stress-induced hyperactive responsiveness of the hypothalamic pituitary adrenal axis, and of the hypothalamic pituitary thyroid system.

Long term hyperactivity of the hypothalamic pituitary adrenal axis with a constant hyperactivity of corticotropin-releasing factor, adrenocorticotropic hormone and cortisol leads to decrease in synthesis levels of brain-derived neurotrophic factors, different phospholipid metabolism levels, change in the amount of substance P and other neurokinins.

In addition, it changes the sensitivity of glutamate NMDA and AMPA receptors with increased cytotoxic effect of glutamate on neurons. It is believed that depression through these mechanisms is responsible for the atrophic changes in the brain in a number of structures and most of all in the hippocampus.

Changes in the hippocampus and the amygdala play a crucial role in the persistence of symptoms of depression, anxiety and chronic pain.

Currently, the most attention is paid to the neurokinin theory of depression, according to which the main role in the pathogenesis of depression is played by a metabolic disorder of substance P receptors and increase in the activity of neurokinin-1 in the amygdala. Therefore, their role is the formation of chronic pain is pretty obvious.

The clinical picture

Symptoms of depression in chronic pain syndrome may be obvious, but often, chronic pain syndrome is just a “mask” of the depression. Depressive symptoms can actually act in an atypical form and hide behind the dominant symptoms in the clinical picture of pain.

A common feature of somatization depression is the presence of numerous painful physical symptoms along with mood disorders in their structure. Somatic symptoms come to the fore, covering affective depressive disorder including the depressive symptoms that are mild, erased or non-existent.

All of this is very difficult to diagnose as depression. The symptoms masking depression can come from almost every single system of the body, appearing as disorders of heart rhythm, dry mouth, shortness of breath, heartburn, nausea, constipation, excessive sweating, dizziness, semiconscious state, amenorrhea or other menstrual disorders, decreased libido , poor sleep mainly with early morning awakening, changes in appetite and weight loss, asthenia or pain of various parts of the body.

Furthermore, chronic pain as a mask of depression can occur in practically any part of the body: head, neck, the heart, back, joints, abdomen, even on the face.

Depending on the location and nature of the pain as well as the accompanying vegetative symptoms, the patient could find himself in the field of neurology, cardiology, gastroenterology, rheumatology, and so on.

Features of chronic pain in which the depression is major factor in gaining understanding of symptoms are the most important. Surprisingly, clinical phenomenology of chronic pain does not fit into any of the known physical and neurological diseases.

Numerous diagnostic tests are not capable to reveal the current organic disease, which could explain the pain. Burning, chills, feeling cold, crawling and wiggling under the skin, usually characterize the chronic pain, within the depression.

Chronic pain syndrome usually has more than one location such as in patients with chronic headaches, it can be identified in premenstrual and recurrent low back pain. Pain often changes its location and character migrating throughout the body.

Behavior of patients with psychogenic pain has its own specificity, which is defined, first of all, an internal picture of the disease and the patient’s belief in the presence of his physical or organic neurological disease.

It is important that patients with psychogenic pain reveal history of pain (pain episodes in different parts of the body in the past). Often, these patients would have had very close relatives suffering from long-term pain.

This suggests the genetic nature of the chronic pain as well as the depression even though various scientists have challenged this notion many times.

The most common variant of the course of depressive disorders in patients with chronic pain is nosogenic depression, which is formed under the influence of stress, as a reaction to physical illness.

In this case, a key role in its etiology is played by factors such as the sudden appearance of pain, progression of disease, bodily discomfort, external appearance of the defect associated with the main somatic-neurological disease, as well as limiting consumer and professional activity of the patient.

There are short-term and prolonged types of nosogenic depression. Short-term depression could even be formed under the influence of the stress of hospitalization. It usually does not exceed the duration of 1-2 months and gives only a relatively mild manifestation of pain.

At the same time, with the reduction of pain and rehabilitation, there is a reduction of affective disorders. Protracted nosogenic depression lasts longer than 6-12 months and is commonly evaluated within the framework of post-traumatic stress disorder.

Their clinical picture corresponds mostly with hypochondriacal depression with obsessive thoughts about the worst outcome of the disease at the same time involving anxious expectations of repeated attacks of pain.

Depression is always a difficult condition for these patients. It lowers the usual pain threshold and tolerance to pain and eventually prevents the successful relief of pain.

Sometimes patients feel depressive symptoms are a natural consequence of pain or even worse, they try to deliberately hide them. This is because from their point of view pain is a more socially acceptable condition than depression.

Treatment of chronic pain, even if there are no clear detected signs of a depressive state, must necessarily include antidepressants.

Particularly suitable for treatment of chronic pain has been found to be the antidepressants from the group of selective serotonin reuptake inhibitors (paroxetine, fluoxetine, and others) as well as III-generation antidepressants with dual action.

The serotonin reuptake inhibitors and noradrenalin such as venlafaxine, milnacipran and duloxetine can also be used for the purpose.

It should be noted that tricyclic antidepressants have a pronounced analgesic and antidepressant effects, but their use by neurologists and therapists, especially in ambulatory practice is limited due to the wide range of serious side effects and interactions with other drugs.

It is important to remember that Early recognition of depressive symptoms in patients suffering from chronic pain, prevents mutual induction of these states. This has to be the main task of provided skilled care.

Antidepressants

As mentioned above, major depressive disorder and generalized anxiety disorder are often accompanied by chronic pain syndromes. Examples of such syndromes may be back pain, headache, pain in the gastrointestinal tract and joint pain.

In addition, the great difficulty of treatments are a number of pain syndromes that are not associated with depressive and anxiety disorders such as diabetic and post-herpetic neuralgia, cancer pain, fibromyalgia. Therefore, it can be quite hard to determine whether the patient is in need of anti-depressants at times.

Clinicians have been describing the relationship between major depressive disorder and generalized anxiety disorder with pain and painful physical symptoms for a long time.

In an international study, it has been shown that the initial evaluation of 69% of patients with major depressive disorders only had somatic complaints, and they did not have any psychiatric symptoms.

In another study, it was demonstrated that the increase in physical symptoms increases the likelihood of a patient’s depression or anxiety disorders.

In addition to major depression and generalized anxiety disorder, pain is one of the main complaints of fibromyalgia, irritable bowel syndrome, chronic pelvic pain, migraine, vulvodynia, interstitial cystitis, symptoms of temporomandibular joint.

Some researchers suggest that such violations of affective spectrum as major depressive disorder, generalized anxiety disorder, social phobias, fibromyalgia, irritable bowel syndrome and migraine may have a common genetic predisposition.

The exact causal relationship between chronic pain and depression is unknown, but the following hypotheses has been put forward. Depression precedes the development of chronic pain. Depression is the result of chronic pain.

Depressive episodes that occur before the onset of chronic pain predispose to depressive episodes after initiation of chronic pain.

Psychological factors, such as maladaptive coping strategies contribute to the formation of interaction between depression and chronic pain. Depression and pain have similar characteristics, but represent different disorders.

Numerous studies have shown that the dual-action antidepressants (selective serotonin reuptake inhibitors – SSRIs and noradrenaline) that are used for the treatment of depression, may also be effective in the treatment of chronic pain.

Double-acting drugs, such as tricyclic antidepressants (amitriptyline, clomipramine) and venlafaxine, or a combination of antidepressants with serotonergic and noradrenergic effect greater rigor demonstrated more treatment efficacy compared with antidepressants acting mainly on one neurotransmitter system.

Thus, fluoxetine (due to pre-emptive increase of serotonin) and desipramine (due to pre-emptive increase of norepinephrine) cause a faster and better therapeutic effect than monotherapy with desipramine.

In another study, it was shown that clomipramine (double-acting antidepressant) causes remission of depression in 57-60% of cases, compared with patients who received antidepressants citalopram or paroxetine with remission in depression rate of 22-28% among all patients.

A meta-analysis of 25 double-blind studies revealed a high efficiency dual action antidepressants compared to tricyclic antidepressants monoaminergic action and selective serotonin inhibitors.

Analysis of 8 clinical studies on the efficacy of venlafaxine in comparison with the selective inhibitors of serotonin, found that the incidence of remission after 8 weeks of supplementation were significantly higher in the group of patients treated with venlafaxine (45%) compared with those who received a selective serotonin reuptake inhibitor (35%) or placebo (25%).

Dual effects on serotonin and norepinephrine cause a more pronounced effect in the treatment of chronic pain.

Both serotonin and norepinephrine are involved in pain control through the descending path of pain sensitivity. This explains why most researchers discover antidepressants having an advantage of dual action for the treatment of chronic pain.

The exact mechanisms of action by which antidepressants cause analgesic effect remain unknown. Nevertheless, antidepressants with dual mechanism of action have a longer analgesic effect than antidepressants, which affect only one of the aminergic systems.

Treatment of depression and chronic pain: use of cognitive therapy in the treatment of chronic pain

The patients often wonder whether it would be possible for them to change their mind and use thoughts to cope with the pain. It may be hard to believe, but research suggests that using certain techniques to change the ways of thinking can be used to reduce chronic pain.

This can be done with the help of cognitive therapy. During therapy sessions, patients learn to recognize the automatic negative thoughts that accompany the feeling of pain.

These thoughts often twist reality. Cognitive therapy teaches you how to replace these negative thoughts so as to help ease the pain perception.

The essence of the therapy lies in the fact that our thoughts and emotions have a huge impact on the ability to cope with chronic pain. There is ample evidence that as a result of cognitive therapy, patients have become more tolerant to pain.

In one of his studies, Thorne noted that 95% of patients after 10 weeks of cognitive therapy have felt that their life improved, while 50% reported that pain became weaker. In addition, many patients felt that they were willing to reduce the dose of medication.

The best way to start the treatment is to see a doctor and plan the treatment with him. With the combination of chronic pain and depression, you need to work closely with your doctor for the treatment, even more than in other situations.

Here is what you should do at first. Make an appointment with your family doctor and tell him that you want to fully control your pain.

Once you have a plan, remember that the key to achieving the goal will be your versatility, since the action plan should touch every sphere of life, which came under the influence of pain.

If your family doctor does not have sufficient training in the fight against pain, ask him to recommend a good specialist.

If in your city, there are organizations that specialize in helping people with chronic pain, join them. This will provide you with support during treatment. Refer to a specialist in cognitive therapy, which specializes in controlling pain.

Chronic pain and depression: a vicious circle

This article does not attempt to differentiate the type of depression and all variants of chronic pain syndromes. Our goal is to focus attention on the doctor’s undoubted affinity of these two pathological syndromes and the part of their compatibility.

In order to emphasize the need to find depression in any chronic pain it needs to be learned to allocate clinical symptoms, indicating the presence of depressive symptoms.

All of the above is necessary to complete the care of the sick as well as depressed, regardless of its origin, primary or secondary to chronic pain syndrome, always degrades and modifies the clinical picture worsens the pain and suffering of the patient, reduces the quality of life of the patient.

The depression forms in the patient’s state of helplessness and total dependence on pain, creates a sense of the futility of treatment, leads to a kind of “disasterization” of his own state.

Figuratively speaking, between pain and depression is formed a kind of vicious circle, in which one condition aggravates the other.

Often in this vicious circle the pain or the depression are embedded as a local phenomenon or a more extensive muscle spasm. Thus, the proper treatment of the patient with chronic pain relief is impossible without coexisting depressive symptoms.

Affinity of pain and depression, due primarily to common pathogenesis and in chronic pain syndromes, depression determines the failure of the brain serotonergic systems.

Serotonergic theory of depression is currently the leading, also proved essential dysfunction of descending serotonergic analgesic brain systems in the formation of chronic pain.

In this context, it is important to determine what is considered acute pain and what exactly is chronic pain. Acute pain is always a symptom of an organic suffering.

In contrast, chronic pain, as a rule, is not a symptom, but actually a disease in which the crucial question is not the morphological tissue damage and defects of perception and dysfunction of other psychological processes.

Rather, chronic pain, according to the International Association for the Study of Pain, is considered to be the one that goes beyond the normal healing period, and lasts at least 3 months.

Currently, chronic pain is treated as an independent disease, based on the pathological process in the field of somatic and primary or secondary dysfunction of the peripheral and central nervous systems.

An integral feature of chronic pain is the formation of emotional and personality disorders, it can only be called in the dysfunction of mental health problems, i.e. the treatment idiopathic or psychogenic pain. Psychogenic chronic pain is the most common and most difficult to diagnose and treat.

The criteria for the concept of chronic pain used to refer to pain can be the one lasting more than 6 months according to some of the organizations.

Pain causes emotional outburst. Anxiety, irritability and anger – this is a normal reaction to pain. Nevertheless, with the departure of the pain these emotions also tend to subside. But, what happens if the pain does not subside?

Over time, this emotional reaction to the pain will cause more serious problems that lead to depression. In some cases, the relationship between depression and chronic pain may be explained by the biological factors.

This is because the pain and depression both depend on the same nerve endings. The information is being transmitted from a nerve to a nerve through these endings. They even share the same way of information is transmitted between nerves.

The impact that chronic pain has on human life, also gives a strong impetus to the development of depression. “This pain is caused by the loss,” says Feinberg. “The loss of employment, self-respect and respect for others, decreased sexual drive – all these issues provoke depression.”

Once a person becomes depressed, it increases the pain, which has already been present. Depression completely robs the patient the opportunity to deal with this pain.

It is important to remember that since chronic pain and depression are closely linked, both of these diseases can often be treated simultaneously. Treatment of chronic pain and depression could even become a lifelong process.

Chronic pain and depression fully affect the patient’s life. For this reason, the ideal treatment option is the one that addresses all of the spheres of life of the patient. Because of the close connection between these two diseases, it is natural that their treatments are also interrelated.

Since the same neurotransmitters are involved in depression and pain, it means that treating both of these conditions can use antidepressants.

“People do not want to hear that the disease is born in their heads, but that’s what happens with the pain,” says Feinberg. “And antidepressants, affecting the patient’s brain, change the patient’s perception of pain.” The most effective antidepressants are the so called tricyclic.

However, due to severe side effects, their use is limited. Many people with chronic pain and depression avoid exercise. This has mostly been attributed to the patients’ inability to distinguish the normal pain from “pleasant pain” that occurs after exercise.

However, the less you exercise, the more you lose form. This could lead to the fact that you are increasing the risk of injury or increasing the pain, which could further worsen the condition in terms of depression. That is why you need to break this vicious circle.

Doctors claim that regular and not too exhausting exercise is the key to victory over the pain. Everyone who experiences pain should perform physical exercises. Together with your doctor, you can make a list of exercises that are safe and effective for you.

In addition, it has been proven that the sport helps to relieve depression. Because exercise releases the same brain chemicals that antidepressant drugs, it can be claimed that they are natural antidepressants.

Chronic pain prevents you from living, working and performing your duties to the best of your abilities. This leads to the fact that you have changed the attitude toward yourself, and not for the better.

When the doctor first encounters with patients suffering from chronic pain, he often sees that the man has drowned in pain and turned into a victim. For this reason, the critical point in the treatment is to fight with the victim role.

The patients are often inactive, that leads to complete inactivity and to return the person to the desire for an active life, he needs to be feeling full control over his life.

If your doctor does not see you as a victim, then perhaps, you are not in need of treatment. The goal of the treatment should be the desire to turn the victim into a person who can control the pain and his entire life.

Diagnosis of the depression and chronic pain

Chronic pain can be observed in the clinical picture of any depression. Symptoms of depression in chronic pain syndrome may be apparent or erased.

Quite often, the pain is the mask for depression and depressive symptoms actually appear in the form of atypically and hidden behind the dominant pain in the clinical picture of pain.

Patients with typical symptoms of depression quickly find themselves in the field of mental health. In contrast, patients suffering with atypical proceeding and masked depression for a long time are commonly treated to no avail by general practitioners who are completely unable to recognize such a depression.

Chronic pain as a manifestation of the masked, somatisation of depression can be located virtually anywhere in the body.

In fact, it can even be a combination of several locations. Clinical symptoms can mimic different variants of somatic and neurologic pathology, therefore it is necessary to examine the patient in detail.

Typically, chronic pain is localized in the head, heart, stomach, and in the back. Examples of chronic pain can be chronic tension headaches, daily chronic headaches, and fibromyalgia.

Chronic pain is usually diffused, monotonous, constant, dull, aching, pulling, squeezing. Often, chronic pain aligns with other sensations. Usually, the patients poorly describe chronic pain and perhaps for this reason it is poorly localized.

Typically, the patient indicates too large of an area of pain, which may vary from inspection to inspection. Pain is almost never presented in isolation, but always combined with complaints of psychopathological and psycho-vegetative nature.

Statuses of distress, aggravation of psychological conflict, decompensation emotional and personality disorders always lead to intensification or generalization of pain.

Patients with chronic pain and depression have a long history of the disease. But to no avail, they persistently turn to doctors of different specialties. They then conduct numerous studies that do not support any physical or neurological organic disease.

These are patients who, despite months of inspection at various specialists, do not have a definite diagnosis. Often, they are treated symptomatically, trying to stop pain by various analgesics. Treatment is without result, and patients continue to see a doctor.

Diagnosing depression is difficult for non-psychiatrist doctor. For the diagnosis of depression, it is necessary to know its diagnostic criteria (ICD-10). Diagnostic signs of depression are:

Main:

– Low or sad mood,
– Loss of interest or feelings of pleasure,
– Fatigue;

Additional:

– Decreased ability to concentrate,
– Low self-esteem and self-doubt,
– Ideas of guilt and self-abasement,
– Gloomy pessimistic vision of the future,
– Suicidal thoughts or actions,
– Sleep disturbances,
– Appetite disorders

The main three are the ones that manifest first clinically. Other symptoms are optional. For verification of major depressive episode in the clinical symptoms of the patient, the doctor should take check the role of first three major symptoms of depression, which are combined with at least four additional symptoms.

For the diagnosis of depressive episode, the doctor requires the presence of two basic and three additional symptoms. For easy enough depressive episode presence of two major and two additional symptoms are necessary.

In all three versions of the above episodes, main symptoms of depression should last at least 2 weeks.

The general practice in the main follow up of patients with mild to moderate depression is the following: if depressive episodes lasting at least 2 weeks are repeated at intervals of a few months at least twice, then recurrent depressive disorder are usually diagnosed. Recurrent depressive episodes may be triggered by a stressful situation.

Most often, the physician is faced with atypical depression occurring erased, and therefore it is necessary to focus on the atypical symptoms. It is necessary to emphasize the frequent occurrence of depression anxiety disorders, that often come to the fore, overshadowing the actual depressive symptoms.

The combination of depression and anxiety, according to research reaches 62%. Especially the combination of specific alarms combined with muscle tension and depression is chronic pain syndromes.

Special mention should be given to the patients with atypical depression, who can present complaints exclusively on certain persistent physical symptoms, the main ones being the constant feeling of fatigue and chronic pain.

The main complaint may easily be irritability. Atypical depression complaints of pain of a chronic nature are often associated with complaints of other unpleasant, poorly described and often poorly localized sensations throughout the body such as sleep disturbances, appetite, sex drive, fatigue, weakness, decreased performance, constipation and dyspepsia.

Women may have complaints of menstrual disorders without organic causes of premenstrual syndrome. When depressed, people may experience poor appetite and weight loss, and, on the contrary, increased appetite when the depression levels are too high, and consequently weight gain.

In these cases, eating is the only way to get positive emotions – all the other requirements are reduced drastically. For typical depression, it is more common to lose the appetite and body weight, atypical depression is frequently observed with the opposite pattern.

If the abundance of complaints, their unusual combination, does not fit the clinical picture of any medical condition, this is an especially good suggestion of masked depression. For specific depressions that all have unpleasant clinical symptoms, including pain, more represented in the morning and evening.

Sleep disturbances in depression may appear quite different: disturbances in falling asleep, frequent nocturnal awakenings, dissatisfaction with sleep, waking difficulties, the increase in the duration of nighttime sleep, daytime hypersomnia.

The most specific sign of depression is considered to be early morning awakening, in which the patient for no apparent reason constantly wakes up in the 4 – 5 hours in the morning and cannot sleep.

Dysthymia and body language

Quite often, the patients are faced not only with atypical depression, but also with the chronic version of its flow. In this regard, we consider it necessary to acquaint the physician with the diagnostic criteria of chronic depressive condition, which can coexist with chronic pain. The ICD-10 and DSM-IV are released under the name “dysthymia”.

Previously, this condition was classified as depressive neurosis and neurotic depression. It should be stressed that the dysthymia can include chronic depression, for which there are no suicidal thoughts and actions, although there might be severe social exclusion.

Patients with predominant complaints of general malaise, weakness, fatigue, sleep disturbance and appetite. These complaints, along with unexpressed typical depressive complaints result in the patient going not to a psychiatrist but to a general practitioner.

According to statistics the dysthymic disorder affects up to 5% of the adult population. This disorder is rarely recognized and therefore seldom adequately treated. There are several essential criteria for the diagnosis of dysthymia.

At least two of the following symptoms must accompany chronically depressed mood:

– Decreased or increased appetite,
– Sleep disorders, or hypersomnia,
– Low performance or fatigue,
– low self-esteem,
– Impaired concentration or indecisiveness,
– A sense of hopelessness.

These symptoms are often combined with long-term pain. Dysthymia can last indefinitely, begin at almost any age, dysthymia often precedes severe psychological trauma.

In a study of patients with chronic pain for the detection of depression, the attention was paid to the anamnesis.

Indications of depressive episodes in the past, mental illness in relatives, alcohol or drug abuse, expressed psychotraumatic situation or transferred emotional stress should alert the clinician to depression.

The doctors must try to identify the time when the relationship started and course of pain to the patient’s mental experiences. It is also very important to check childhood experiences.

Previous painful experience of the patient, chronic pain in close relatives, related to the pain in the family. Education features may also contribute to the formation of so-called “pain of the person.”

Every doctor knows how difficult it is to communicate with a patient with chronic pain. The patient is fixed at his pain, and often the doctor questions about his mood problems, lifestyle, childhood perceived negatively, causing irritation and aggression.

This may be due to the fact that pain, coexisting with depression serves as a protective mechanism, by distracting him intolerably, injuring his psyche, oppressive, painful experiences and memories. Knowing this, the doctor should be patient, sensitive and very careful in questioning the patient.

On examination, the patient is required to pay attention to the appearance of the patient, his posture, demeanor, speech patterns and behavior that can help in the diagnosis of the patient.

The patients with depression are characterized by carelessness, the preference of gray and dark tones, lack of hair, makeup and jewelry for women, lack of facial expressions and movements sometimes resembling stiffness, stooped posture, and inexpressive monotony of speech, monosyllabic answers, etc. In other words, the doctor makes a diagnosis analysis with body language, or non-verbal communication methods.

Conclusion

Thus, there are various combinations of chronic pain with various embodiments of depression. The physician should pay particular attention to the diagnosis of depression in chronic pain syndromes, as coexisting with pain, depression is much heavier and modifies the clinical picture of the disease.

Regardless of whether the depression is primary or secondary in relation to chronic pain, it is necessary to stop using psychotherapeutic and psychopharmacological effect methods.

When combined with a chronic pain syndrome in the primary depression, take antidepressant therapy, which does not only have the anti-depressant effect, but also analgesic one.

The efficacy of antidepressants in the treatment of chronic pain syndromes is as high as 75%. The higher the efficacy of antidepressants, the greater the role depression plays in chronic pain.

Analgesic mechanisms of action of antidepressants include:

– Analgesic effect due to the reduction of depression. This mechanism is especially significant if the pain was a mask of depression. This means that it was the depression, but both primary and secondary in relation to the reduction of pain depression always leads to a weakening of the pain syndrome.

– Analgesic effect due to the potentiating of actions as exogenous and endogenous analgesic substances, mainly opioid peptides

– Analgesic effect due to the stimulation of the descending antinociceptive mainly serotonergic systems in the brain.

Currently, the priorities in the treatment of chronic pain are antidepressants, which have serotonergic activity: tricyclic antidepressants – amitriptyline (triptizol), doxepin (sinekvan), clomipramine (Anafranil) are some of the best examples of this.

Overall, it is incredibly important that the chronic pain and the depression are strictly controlled by the doctors. The physicians need to be fully aware of all of the symptoms that are commonly caused by these diseases.

They must also be able to decide whether the patient has got feats of depression by just talking with them and noticing several symptom features. Since it is rather hard to determine the depression, the physicians of non-psychiatrist professions should directly address the psychiatrists for the advice.

Furthermore, it must be ensured that the patients get the correct therapies. There are plenty of modern types of therapies that could indeed help people with chronic pain and the depression.

The more such therapies are used to help the patients, the more benefit they will find eventually.

While, the two diseases may not be curable, it is certainly possible to more or less reduce the stress levels and improve the life quality of the patients and that is what every single doctor should be aiming to do.

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Bipolar disorder, also referred to as manic-depression, is a disorder of the brain that results in unusual shifts in:

• Moods
• Energy levels
• Activity levels
• Abilities to do daily tasks

The symptoms of this condition can be quite severe. They are very different from the typical ups and downs that we all experience from time to time.

Bipolar disorder can cause relationships to become damaged, problems performing in school/job, and even suicide.

However, this condition is not all gloom and doom. Individuals who have this illness truly can lead a very full and productive life.

Causes of Bipolar Disorder

Scientists are in agreement that there really is no single cause for this condition, and they are studying the possible causes.

Most of the scientific world believes that several factors together cause the illness or increase an individual’s risk for developing it.

Genetics

Research suggests that this condition runs in families and that individuals with specific genes are much more likely to develop this condition than others.

Children who have a parent or a sibling with this condition are much more likely to develop it than those who have no family history of the condition.

On the other hand, most children who do have a family history of the illness will not develop it.

In addition, scientists are looking at other illnesses with similar symptoms in order to find differences in genetics that could increase an individual’s risk for developing bipolar.

If they are able to pinpoint these genetic “hotspots” they could also learn how the environment could increase risk.

Genes are not the only factor that increases a person’s risk of developing this condition.

In fact, identical twin studies have shown that even when one has this condition, that does not mean that the other will develop the condition, even though they share all of the same genes. Research is suggesting that there are other factors at play.

Brain Functioning/Structure

Magnetic Resonance Imaging and Positron Emission Tomography, and other brain imaging tools have allowed researchers to take pictures of the brain at work- which allows the scientists to study the activity and structure of the brain.

Some of these studies have revealed how the brains of those who have bipolar disorder are different from the brains of those who have other mental disorders or are completely healthy.

This offers the conclusion that brain development could be linked to a risk for unstable moods.

In addition to finding the cause for bipolar disorder, these studies will help scientists find treatment options that will work more effectively.

Signs/Symptoms of Bipolar Disorder

Individuals with this condition typically experience extremely intense emotional states that occur in what are referred to as “mood episodes.”

Each of these episodes is a drastic change from an individual’s typical behavior and mood.

When an individual is overly excited or joyful, it is referred to as a manic episode. When an individual is extremely hopeless or sad, it is referred to as a depressive episode.

In some cases, a mood episode could include symptoms of depression and mania, this is referred to as a mixed episode. Individuals with this condition might also be very irritable and explosive during one of their episodes.

In addition, significant changes in activity, behavior, energy, and sleep accompany these mood changes.

Even in cases where the mood swings are not extreme, the individual could still have bipolar disorder.

In some cases, an individual with bipolar disorder experiences a condition known as hypomania, which is a form of mania.

During this period, the individual feels good, functions well, and is highly productive.

They don’t feel that anything is wrong, but their loved ones might consider these moods as potential bipolar disorder.

Without getting the proper treatment, individuals with this condition are likely to develop more severe depression or mania.

This condition could also be present during a mixed state, where the individual experiences both mania and depression at the same time.

During this mixed state, they may feel extreme agitation, have difficulty sleeping, experience major appetite changes, and experience suicidal thoughts.

Individuals in a mixed state usually feel extremely energized, but sad and hopeless at the same time.

In some cases, an individual that has severe episodes of depression and/or mania will also experience psychotic symptoms such as delusions or hallucinations. These psychotic symptoms are reflective of the individual’s extreme mood.

Individuals with this condition are also prone to abusing alcohol and/or other substances, have problems with relationships and poor performances at work/school. It is often difficult to see these issues as a serious mental illness.

Bipolar disorder is a lifetime condition. Between episodes, the individual is often free of symptoms. However, there are some that do have symptoms that linger.

Who is at Risk for Bipolar Disorder?

This is a condition that often develops during late teens or early adult years. Around half of the cases of bipolar disorder start before the individual turns 25.

There are some individuals that do show symptom during childhood and others who start showing symptoms later in life.

Diagnosing Bipolar Disorder

Physicians use the DSM, or Diagnostic and Statistical Manual of Mental Disorders, to diagnose this condition.

In order to be diagnosed, the signs and symptoms must be a significant change from your typical behavior and mood. There are 4 types of bipolar disorder:

Bipolar I- characterized by manic/mixed episodes that last for at least seven days or by a manic episode that is so severe that the individual needs immediate treatment in an inpatient facility. Most of the time, the depressive episodes last for at least two weeks.

Bipolar II- characterized by a pattern of hypomanic and depressive episodes with no full-blow mixed/manic episodes.

BP-NOS- Bipolar Disorder Not Otherwise Specified- characterized when symptoms of this condition exist, but not enough to meet the criteria for being diagnosed with I or II. Still, the symptoms are obviously outside of the individual’s normal behavior.

Cyclothymia- this is a mild form of bipolar. Individuals with this condition exhibit mild depression and episodes of hypomania for at least two years. However, their symptoms do not meet the criteria for being diagnosed with any other type of bipolar.

There is a severe form of this disorder that is known as Rapid-Cycling Bipolar Disorder and is characterized by the individual experiencing four or more episodes of hypomania, depression, mania, or mixed within one year.

This form of bipolar is most common in those who had their first episode at a young age. This form affects women more often than men and can come and go over the years.

In order to reach a diagnosis, your physician is likely to do the following:

• Lab tests
• Medical history
• Family history
• Physical examination

At this time, this condition cannot be diagnosed through a brain scan or blood tests, but these tests can rule out other factors that might contribute to mood disorders such as:

• Stroke
• Tumor
• Thyroid condition

Once these other conditions are ruled out, your physician will likely conduct an evaluation of your mental health or refer you to a trained mental health professional that is experienced in diagnosing and treating this disorder.

Your physician or mental health professional will discuss your family history of bipolar disorder and/or any other mental illnesses as well as collect a history of your symptoms.

They will also speak with your spouse/family about family history and what they have observed in you.

Individuals with this condition are more likely to get help when they are in a depressed state than when they are manic or hypomanic.

Therefore, it is critical that a medical history is conducted to avoid bipolar being mistaken as major depression. Individuals with major depression do not experience manic episodes.

If left undiagnosed and untreated, this condition will worsen. The episodes will become more severe and/or more frequent.

In addition, delays in getting the proper diagnosis and treatment can cause more problems with performance in work/school, relationships, and more.

On the other hand, getting the proper diagnosis and treatment can help those with this condition go on to lead productive, healthy lives.

Most of the time, proper treatment will reduce the severity and the frequency of the episodes.

Treating Bipolar Disorder

This condition is not curable, but there are effective treatments for controlling the symptoms.

If the individual finds the proper treatment, they will get some control of their mood swings and other symptoms.

However, since it is a lifelong condition, there must be continuous treatment in order to keep that control. On the other hand, even with the proper treatment, some mood changes are still likely to occur.

Treatment of this condition is most effective if you’re working with a physician and being honest about your choices and concerns.

An effective treatment plan will encompass both psychotherapy and medication.

Some of the most common treatments are:

• Medication
• Psychotherapy
• Electroconvulsive Therapy
• Sleep medications

Medication to Treat Bipolar Disorder

There are several different types of medications that can be used to treat this condition and not everyone will respond to them in the same way.

You will most likely need to try out several different ones before you can find the one that is right for you.

One of the best ways to keep track of and treat your condition effectively is to keep a daily chart/journal that includes your sleep patterns, symptoms, life events, and treatments.

This way, if you have some side effects or changes in symptoms that are intolerable, your physician can switch or even add medications.

The types of medications typically used to treat this condition are:

• Mood stabilizers
• Antidepressants
• Atypical antipsychotics

Mood Stabilizers

These are typically the first choice for treating this condition. In most cases, individuals with this condition are able to treat it with mood stabilizers for many years.

Lithium is a very effective treatment and was the first mood stabilizer that the FDA approved for treating depressive and manic episodes.

Also used for mood stabilizers are anticonvulsants. These were developed originally for treating seizures, but also control moods.

Atypical Antipsychotics

These medications are sometimes used to treat this condition. In most cases, these are used with other medications such as antidepressants.

Antidepressants

These types of medications are sometimes used to treat depressive symptoms of bipolar disorder.

However, taking only an antidepressant is likely to increase your risk of switching to hypomania or mania- or even developing rapid-cycling bipolar.

To prevent this, physicians typically will prescribe a combination of medications and psychotherapy.

Psychotherapy

When used in combination with medications, this is an extremely effective treatment for this condition.

Therapy offers education, guidance, and support to those who have the condition as well as their families. Some of the most common psychotherapy treatments include:

Cognitive Behavioral Therapy, or CBT- this form of therapy helps those with this condition to change their negative/harmful thought patterns and behavior.

Family Focused Therapy- this form of therapy involves the whole family, teaching and enhancing coping strategies, such as recognizing the new symptoms/episodes in their loved one. In addition, communication and problem solving are improved.

Interpersonal/Social Rhythm Therapy- this form of therapy helps those with this condition learn to improve their relationships as well as manage daily routines. Regular routines are often helpful for protecting against manic episodes.

Psychoeducation- this teaches individuals with this condition about the illness itself as well as options for treatment.

This will also help the individual to recognize signs of a swing so that treatment can be sought early on. This also may be helpful for caregivers and family members to attend.

Electroconvulsive Therapy

ECT, or electroconvulsive therapy, is used in cases where the combination of psychotherapy and medication has proven to be ineffective.

This is what was formerly referred to as shock therapy and was given a bad reputation.

However, in more recent history, it has proven to provide relief for those individuals suffering with severe cases of bipolar where other treatments have not worked.

Before this treatment is used, the individual is given a muscle relaxer and is put under short-term anesthesia.

He/she does not feel the electrical impulses, which last from thirty to ninety seconds. The patient typically recovers after approximately five to fifteen minutes and is able to go back home the same day.

ECT is also used in cases where other medical conditions make taking medication risky. This is a very effective treatment for those who have severe manic, mixed, or depressive episodes and it is typically not used as a first defense against the condition.

Individuals using ECT could have some short term side effects including:

• Disorientation
• Memory loss
• Confusion

Sleep Medications

Individuals who have bipolar disorder and also have trouble sleeping will typically be able to get some sleep once they get their condition under control.

However, if insomnia does not improve, your physician is likely to suggest changing your medication.

If sleep problems continue, he/she is likely to give you a sedative or other sleep medication.

Living with Bipolar Disorder

If you have a loved one that has this condition, it will also have an effect on you. The very first thing you must do is to help him/her to find a physician that will find the right diagnosis and treatment.

Chances are you will need to make the appointment, and even take him/her to see the doctor. You must encourage your loved one to keep treating their condition.

Following are some things you can do to help your loved one:

• Offer emotional support
• Learn more about the condition
• Talk to them/listen to them
• Listen to their feelings and be understanding
• Invite them out for some positive distractions
• Remind them that with proper treatment (and time) he/she will get better
• Never ignore threats/comments from them about hurting themselves

Helping Yourself

Chances are, if you are experiencing symptoms of bipolar disorder, you are having difficulty asking for help and seeking the necessary treatment.

However, you should know that it will get better- with the proper treatment.

Following are some ways to help yourself:

• Discuss your options and progress with your physician
• Keep a regular routine such as eating meals at the same time and going to bed/getting up at the same time every day
• Do whatever you can to get the sleep you need (but not too much)
• Keep taking your medication even when you think you don’t need it
• Learn about your triggers and warning signs
• Understand that symptoms will not improve overnight, but it will be a gradual process

Where to Get Help

If you are experiencing this condition and you’re not sure where to get the help you need, speak with your physician. He/she will guide you.

Following are some other options for seeking help:

• Mental health professionals
• Local medical/psychiatric societies
• Employee assistance programs
• Health maintenance organizations
• Peer support groups
• Community mental health centers
• Private clinics/facilities
• Hospital psychiatry departments
• Mental health programs at medical schools
• Hospital psychiatry outpatient clinics

If you or a loved one is experiencing this condition, you must be aware that you are not alone.

There are others out there who are having the same difficulties you are. Please seek help immediately if you are experiencing the signs/symptoms of bipolar disorder.

Sources:

http://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml

http://www.mayoclinic.org/diseases-conditions/bipolar-disorder/basics/definition/con-20027544

http://www.helpguide.org/home-pages/bipolar-disorder.htm

Postpartum depression is a debilitating illness, which disrupts friendships and even devastates families.

Postpartum depression symptoms include panic, mood swings, sleep disturbances, anxiety, changes in appetite, hyperactivity, crying and feeling sad for no clear reason or feeling as if you want to cry but can not, irritability, obsessive and negative thoughts, and loss of self-esteem and confidence.

Although there can be a sense of shame or embarrassment about ‘not coping’ with the situation for a number of women at times, several are much more ready to accept practical help.

Despite the fact that it is awful just watching a friend suffer from depression, particularly if she is pushing you away, there are various ways to show you care.

Consider the steps you can take to help her, and do not take it personal if your efforts do not seem appreciated right away.

1. Listen to your friend

Do not compare your past to your friend’s since she may feel worse if you begin saying, “When I had a baby …” simply tread gently, and try to be comfortable with silence if she does not want to speak.

She will find it a bit difficult to make sense of her opinion, without feeling judged.

2. Ask your friend to avoid stress

A stressor is something that puts demand on anyone, which is precisely what pregnancy does to one’s body, mentally, biochemically and physically.

Doctors suggest de-stressing ways such as getting into support groups, eating healthy, psychotherapy and taking care of oneself.

They additionally recommend talking relaxation exercises, therapy, yoga, and a vigorous work out program.

3. Send her a text

She may not see it like a visit, but just a simple text will show how much you think of her. Do not take it personal if she does not text back; she will once she is ready.

Keep in mind that depression is so weakening in that even just getting out of the bed can be a difficult task at times.

4. Drop off food to your friend

Drop off some meal, perhaps some muffins or a favorite cake. If this is not her first child, you can add a lunchbox and something such as a sticker book for the kid.

You can put the food in an esky and leave it on her doorstep then text after dropping it off in case she does not want to see you.

If you drop food inside, do not hang around unless she is okay with it, and do not race around her residence.

Simply ask if you can help out with the washing, or offer to take her kids out and play with them.

5. Do not do it alone

Your support and help all alone will not ‘fix’ that friend. It is very important that she sees a professional, for instance a doctor, in order to get treatment; make sure you talk to her partner so that they understand how important that step is.

6. Have fun with her child/children

Offer to take her child/children to a playground, an activity class or your place so that she can take a break and the kids have some fun as well.

7. Take her out

A change of environment can be ideal for lifting one’s moods, however make it simple. Perhaps you should try visiting a nearby park, taking a walk together, or have coffee at a café. Offer her an outing that is not exhausting or strenuous.

Again, do not take it personal if your friend happens to opt out when almost done. Her anxiety may possibly have surfaced, therefore let her know it is all right if she can not manage at that particular time.

8. Do not give up on her

Do not disappear, or give up on your friend. Do not feel upset if she gets mad at you. Depression is such a cruel illness and recovery takes months and even longer.

However, with support and treatment, these people do recover. Once she recovers, your friendship will even be stronger, since you were there all along.

9. Consult a doctor about medication

Recent studies prove that if women begin on treatment on the day the child is born, the probability of having a relapse decreases dramatically.

If you are nursing, consult your doctor about the type of antidepressants that is safe to take.

In a perfect world, one would not be taking any medications, since women suffering from postpartum depression should not solely rely on the antidepressant.