Depression

Depression can range from mild to life-threatening. Mental health professionals define a major depressive episode as (a) having five or more of the following symptoms present during the same two-week period and (b) having the first and/or second symptom on the list.

1. Depressed mood lasting for most of the day, nearly every day
2. Markedly reduced interest or pleasure in all, or almost all, activities
3. Significant weight loss or weight gain
4. Sleeping too little or sleeping too much, relative to the person’s usual sleep pattern
5. High level of activity or lethargy
6. Fatigue or loss of energy
7. Feelings of worthlessness or excessive, inappropriate guilt
8. Diminished ability to think and concentrate, or indecisiveness
9. Recurrent thoughts of death or suicidal thoughts or attempted suicide.

You or others may notice these symptoms, or your loved one may make remarks about them. These symptoms cause significant distress or impairment of day-to-day functioning.

These symptoms are also side effects of some medications; therefore, it is wise to inform the prescribing physician about these symptoms, as a change in medication or dosage may improve the situation.

Depression can negatively affect health and may speed the progression of cognitive and motor symptoms in degenerative disorders, such as Parkinson’s disease. Because many symptoms of depression are also characteristics of degenerative disorders, depression may be mistaken for the progression of the disease and left unaddressed. One study of MS patients with major depression reported that 67% of them had not received treatment for depression.

Chronic pain can be both a cause and a consequence of depression. For example, self-neglect in depressed persons with spinal cord injury can lead to painful bed sores and urinary tract infections, which then may intensify depression. Therefore, pain management should be part of a plan to help prevent or reduce depression.

Sadly, despite their best intentions, caregivers can’t cure their loved ones’ depression by repeatedly stating all the positive things they have going for them. However, caregivers can do a number of things that help to replace their loved one’s negative thinking with positive coping strategies.

Prevent social isolation

While the loved one may not wish to be around others, social isolation tends to increase depression. Being around others can provide a distraction from the pattern of negative thoughts and feelings of hopelessness. Tell funny stories. Make plans together that include the loved one.

Focus on meaningful tasks

Depressed people with chronic disabilities may feel hopeless about their future and helpless to change their life path. Focus on the positive and the capabilities that the individual still has. Often people with chronic disabilities are depressed because they feel that they no longer have a sense of purpose. They may catastrophize their present or future, instead of having a balanced perspective. Seek out roles that the person can fulfill which contribute to others’ well-being.