Chronically Living and how to make the most of it

Depression & Chronic Illness

March 29, 2021 Kelsey Season 1 Episode 40
Chronically Living and how to make the most of it
Depression & Chronic Illness
Chapters
Chronically Living and how to make the most of it
Depression & Chronic Illness
Mar 29, 2021 Season 1 Episode 40
Kelsey

There is so much overlap between mental health problems and chronic illness. In a previous episode we talked about anxiety, and this week we get into depression because it is very common in Spoonies.
In this episode we talk about:

  • contributing factors to depression in people with chronic illness
  • symptoms of depression
  • psychological treatments for depression
  • coping with chronic illness and depression

If you are in crisis, please reach out for support.
Crisis Hot Line Canada: 1-833-456-4566
Crisis Text Line Canada: text HOME to 686868
USA: 1-800-273-8255

Find me on Instagram @janeversuspain, on Twitter @janevspain, on FaceBook @janeversuspain, on TikTok @kelseyleighharris, and my blog is janeversuspain.com

Show Notes Transcript

There is so much overlap between mental health problems and chronic illness. In a previous episode we talked about anxiety, and this week we get into depression because it is very common in Spoonies.
In this episode we talk about:

  • contributing factors to depression in people with chronic illness
  • symptoms of depression
  • psychological treatments for depression
  • coping with chronic illness and depression

If you are in crisis, please reach out for support.
Crisis Hot Line Canada: 1-833-456-4566
Crisis Text Line Canada: text HOME to 686868
USA: 1-800-273-8255

Find me on Instagram @janeversuspain, on Twitter @janevspain, on FaceBook @janeversuspain, on TikTok @kelseyleighharris, and my blog is janeversuspain.com

Kelsey Harris:

Welcome to the chronically living and how to make the most of it podcast. I'm Kelsey Harris, a chronic pain warrior here to inspire hope and strength to the spooni community, get ready to lif each other up and find ways t live the best life possible Good morning, everyone, o afternoon or evening, whateve it is for you. Welcome back t chronically living and how t make the most of it. Um, so yo know, I find myself talkin about mental health a lot, bot on here and in real life. An depression and anxiety affec the lives of so many people. An I've had my own struggles, whic I've shared previously. And yo know, realistically so of a least half the people I know And I see at least, becaus there are obviously a lot o people who still don't tal about it, because there is stil stigma I also work in menta health. Well, I mean, by work, mean work for free, because I' still student, but I think yo know what I mean. So I do spen much of my days talking abou depression and anxiety, th really sad things that my fello human beings go through. really wanted to do an episod on depression, especially afte having done one on anxiety anxiety, because like anxiety depression is so common i people with chronic illness. An about a third of my caseload a a psychotherapist is with peopl with chronic pain or chroni illness. And the mental healt struggles that they deal with These are really overlappin issues. So if you're thinkin yourself that you're alone you're not. However, I'm als aware that me telling you tha may not change your mind Regardless, I really hope yo stay tuned for the rest of thi episode, because I hope to giv you some ideas later on for ho to kind of start to cope o manage your depression as wel as chronic illness. So first let's look at some contributin factors to depression and thos of us with a chronic illness. S one of these is the feeling o isolation many people have whe they're first diagnosed, you'r very likely the only person o maybe one of few that you kno in real life with your illness Let's makes it really importan to find ways to connect wit others. Online is a fabulous wa literally just type in hashtag whatever your illnesses, an you'll find people ready an willing to share with you. Th end of the day isolation i tough, and it can take a lot o effort to reach out, especiall when you're depressed. Just kee in mind that is possible to eve if you're not quite ready yet you can just have that in you brain for the future. Anothe factor is lack of medica support, also known as medica gaslighting, like how depressin realistically is it to not hav people believe you when you'r telling them that you kno things are wrong. So I found ou recently that one of my mom' friends was just recentl diagnosed cancer after havin been written off for months an months when he tried to tell hi problems to his doctor. Thi story just seems too familiar t me. Because many of us have bee in a very similar situation Most recently, for m personally, my rheumatologis told me just to go to physio when I explained to her that was having problems with my kne because it's, quote unquote weird for my knees, like jus your neidhart. For the record, had already told her that i wasn't just my knee that hurt It was just the most painfu area right now. Because sh literally always asks me wha the worst area is right now. S for a long time was my hip. It' been my hand previously like it it's not, you know, like, You'r asking me to pick something yo kind of got to go with what pick. All I can say is for th medical professionals, thi thing, please don't write of your what your patients ar saying. We know our bodies th best. That being said, it can b really easy to feel depresse after this type of conversation The one thing I can reall suggest is just to keep pushing push for tests, push fo diagnosis, push for yourself i general. And then I would sa probably debrief with someon afterwards. That is going t understand because a ver difficult situation. On a sid note, I recently found out tha there's a lot of people wh actually don't know what th term medical gaslighting means I think I've just explained i pretty well here. But you migh run into others who don't know So for example, one of m supervisors that my practicu didn't know. So just be prepare to explain what you're goin through Another contributing factor between chronic illness and depression is illness grief. Now I'm not really going to go into this here because I did a whole episode on this Previously, which was Episode 13. So for anybody who wants to go back into listen that again or if you haven't listened to it yet, I would suggest that it's a good one to listen to, especially if you're having some grief about having an illness. Just take a listen to that one. I will say right now that grieving is totally normal, and definitely part of the process. But if you're really struggling to make sure that really struggling just make sure you have the support, support network of people to talk to loss of independence, and self efficacy is another factor. So I think that really ties in with illness grief Alliance, it can also just be hard to see the positives, when there's so much less you can do physically, it really takes a toll. I think gratitude can be helpful here, but it's definitely not a cure all. And it can also be harder to find things to be grateful for, when you're really struggling. adjusting to a new reality does take some time. So I think that patience is also important. And by patients, I mean with yourself. Yeah, another potential contributing factor is emotional abuse. So it's interesting because I read somewhere online that people with chronic illness or like X amount of times more likely to experience abuse of like all types, particularly emotional abuse. However, when I like was doing my research search, I didn't find any scientific research from the past 10 years on this, so I really can't verify the accuracy of that statement. However, I'm just going to lay out some aspects of emotional abuse that I've actually even reviewed my clients before, so that you can kind of, I guess, assess for yourself if this is happening to you. So the first is the use of humiliation, including making patronizing comments, making jokes, belittling, belittling you, insults put downs, and acting as if they know what's best for you. The next is gaslighting and manipulation, which includes undermining your reality, defining how you should feel or dismissing your feelings, refusing to take responsibility for their actions. Then we have isolation and control. And this includes wanting to know where you are at all times, monitoring your communication, making decisions for you withholding affection, the use of a coercion and isolating you from your family and friends. And then finally, we have erratic or chaotic behavior. And this includes threatening you blackmail, mood swings, or outbursts and picking fights. So if you said yes to a bunch of things on this list, for any one of your relationships, romantic or otherwise, then be aware that there is potential abuse there. It's not a guaranteed every relationships different but I would just keep an eye out, especially if you said yes to a lot of those. The last contributing factor is that there is some research that sees the inflammation can make depression worse, and people with chronic illnesses. So there is a theory of depression that indicates that depression itself is an inflammatory disease, inflammation in the brain. And then there are also specific links to things like heart disease and autoimmune disorders. So for example, there is research by used in at all from 2017. That indicates a bi directional relationship between depression and autoimmune disease. And then there are also some of this relationship is some shared environmental and genetic factors. I think it's really interesting. It's something I'd definitely heard before, but as it was, there's seems to be quite a bit of research on this topic. Okay, so it occurred to me that some people may not actually know what the symptoms of depression are. So I'm gonna give you what the DSM five so that's the Diagnostic and Statistical Manual of Mental Disorders, says for major depressive disorder, I do want to preface this, that these are just the symptom criteria. So even if you meet the threshold for what I'm going to lay out here, it doesn't necessarily mean that you have depression, because the DSM doesn't really account for all the other environmental factors in your life, that could be causing symptoms. And it doesn't specifically account for cultural factors either. That being said, clinicians when they make their judgment calls are supposed to look at the whole big picture. But yeah, so the DSM also does have a diagnosis reserved for depression caused by a medical condition, which I think is very interesting, but it's also less likely to be diagnosed. And because you really have to know that it is the medical condition for sure that's causing the depression and that it's not a bi directional relationship or anything like that. So basically, what I'm saying If you were to be diagnosed, you'd most likely to be diagnosed with MDD major depressive disorder. Okay, so here are the symptoms. So having five or more of these symptoms in a two week period, when the symptoms are not caused by another condition such as like a physical or mental or substance use condition. So they are depressed mood, most of the day nearly every day, loss of interest or pleasure in all or almost all activities most of the day nearly every day weight loss or gain that is unintentional, or a decrease in appetite, insomnia or hypersomnia, nearly every day, psychomotor agitation or retardation nearly every day. fatigue or loss of energy nearly every day. feeling worse, worthless, or excessive or inappropriate guilt nearly every day, decreased concentration nearly every day, and recurrent thoughts of death or suicidal ideation. So I'm going to tell you a bit about my approach to treatment for depression, which is very similar to my approach treatment for anxiety. So you might if you listen to that episode, you might notice some overlap. So in that episode, the anxiety episode, I mentioned that I practice acceptance and Commitment Therapy, which is also called act or aect, depending on who you talk to. There are six elements to this. So the first is contacting the present moment. So in this we use a lot of mindfulness exercises. And I don't strictly mean like meditation. It's more about getting present and focused. So there's a lot of other mindfulness activities that we can do. Like do a brief run at the end, actually, if this episode, the second is self is context. So this is the part of ourselves that notices what we're thinking, feeling and doing. So something I often ask my clients is, what are you noticing as we talk about this? Or what are you what did you notice as we did this exercise together? diffusion. And this means separating ourselves from our thoughts. There are a lot of weird techniques here. But one of the easiest ones to use is just to notice when your mind is bullying you and to call it out as bullying. So an example would be, you know, you get this really negative thought or really thought of, you know, that was really hurting you and you just say mind, you're just being a bully right now. Then we make something acceptance. So this would be the pain, we're having both physical and emotional. If you want more in this, I would say there's a really cute video on YouTube called the struggle switch by Dr. Russ Russ Harris, who is of no relation to me. And some people find this really helps them with kind of the acceptance piece or understanding this concept a bit more. Then there is values, which means figuring out who and what is important to us. So that we can kind of find a way to get ourselves to continue to have those things important to us and actually do things that help foster those relationships and, and behaviors. And then finally, we have committed action. And this is sometimes called behavioral activation. And this involves setting aside time each day or a few times a week to do things that you enjoy, and then actually doing them to make yourself feel better. So for example, if you notice that you're most depressed at 5pm, and you also knows that, you know, walking, something that really helps you or you just like to walk, then the idea would be to go for a walk, regardless of how you're feeling emotionally, or even physically. Like even if you're really tired, you'd still go for this walk at 5pm X number of times per week. So I try to encourage people to do at least three times a week, but obviously more can be a lot better. There's actually a ton of research supporting that this helps people like overcome depression, like there's so much research on this. So I know it sounds like like it's going to be either really hard to do or like it might not work but they have done like 1000s and 1000s of studies. So doing things that you like to do, even if you don't want to do them will help you just feel better. And then I want to say that there are lots This is my approach to treatment. Like I said, there are lots of similar approaches to treatment. So anyone who uses any type of cognitive behavioral approach will kind of include their versions of diffusion and behavioral activation. That being said, All therapies have similar efficacy. So it does Doesn't really matter so much what your therapists specializes in. So there'll be outcomes technique, or theory only counts protect for 10% of the outcome, the therapists themselves, count for about 20%. And then the rest really comes down to your therapeutic relationship with your therapist, and most importantly, your effort in treatment. My quote this week is from the Dalai Lama, who says, happiness is the highest form of health. Now, I like this quote, because I think there's some truth to it. Even people like are very sick, but are happy, they tend to have better qualities of life. And all that said, when you're sick, or if you encounter other life, stressors and circumstances that are really difficult, it can be hard to achieve happiness. And as I've kind of said, throughout this episode, easy to find despair. And treatment for depression is real, though. And, actually, I'm going to do a blog post this week as well on a newly approved treatment for treatment resistant depression in Canada. So if you want to check out my blog, it's Shane vs. Pain, calm. I also want to say like, if you're struggling with depression, or there any other mental health problems, please make sure that you have a therapist on your healthcare team. And if you're struggling with suicidal thoughts, in particular, please make sure you reach out to our crisis line as needed. I'm going to link some of those for you, specifically for Canada, us in the show notes. But obviously, if you live in another country, please find your local one. Usually, you can just google them. Okay, if you're interested in more healing journeys with mental illness, please check out Episode 18, which was my interview with Ryan Phillips, who shared his very inspirational story though he'd naess, inspirational, of having complex PTSD, and kind of where he's at in his life right now. The only other thing I can really say for this topic this week, is that it's really important to learn how to cope with your illness, physical or mental. There are tons of coping strategies available. If you're interested in having specific episodes on some of these coping strategies, please let me know by writing a review and or tagging me or DM me on Instagram. My handle is at gene versus pain. Reviews actually do go a long way, in helping this show reach more people. I'm also always willing to answer listener questions on air. So DM me if you have those as well. So we're gonna do a quick mindfulness exercise, it's called drop the anchor. And if you want to think of it, like, if you're boating, and you're coming into port, and you see a huge storm swelling in behind you, what's the first thing you're going to do when you get to port, you're probably going to drop the anchor. And the same thing goes, when you're feeling a huge emotional storm coming on, it's good to just drop an anchor, get yourself grounded present. And that's one of the reasons that we use it in, in therapy so much. So you can keep your eyes open for this. And I want you to just take a few moments, and acknowledge any thoughts, feelings, physical, emotional pain that you have currently. Just really let yourself feel it. The same time I want you to press your feet into the ground. And just notice the ground beneath you. And then just notice what it feels like to have your back against the chair. What's like to sit on a chair. And at the same time, just keep acknowledging that you have these thoughts and feelings and physical sensations are still there. Now I want you to take a few moments and look around the room and find five things that you see. And now maybe three, maybe four things that you can hear. And then just acknowledge again that you still have thoughts, feelings and sensations that are really difficult. Now I just continue to notice what the ground feels like beneath you that you've got these thoughts and feelings, but you've got a body surrounding these thoughts and feelings. And you've got a whole room of sounds and sights that are surrounding your body. Just take a breath, notice what that feels like to come in to go out. When you're ready, just come back to the moment. The idea is not to get rid of all those thoughts and feelings. It's just to be present to everything, not just those. Alright, for now, my fellow warriors, keep on making the most of it. Thank you so much for joining me today on the chronically living podcast. If you love this week's podcast, please subscribe, rate and leave a review. Until next week, stay strong