Editor’s note: With the holidays approaching, Audrey Demmitt, R.N., and VisionAware peer, discusses managing depression during the holidays. In her post, she provides excellent tips for coping and information about treatment.
The holiday season is tough on those who are struggling with depression, anxiety and stress. Let’s face it–for many of us the family gatherings, endless shopping, and chaotic parties can leave us feeling down and exhausted. It’s a time that may be particularly difficult for someone new to vision loss. Many people who are blind or low vision find it stressful to go shopping, attend social functions, navigate crowds and manage family relationships. And that is just what the holidays are all about. Vision loss will certainly change the experience and may even trigger depression.
Loneliness and Social Isolation Predict Depression
Social isolation is one of the biggest predictors of depression—especially during the holidays. Many people who are blind or low vision are isolated because of lack of transportation, unemployment, and the anxiety of going out in public places. This can lead to loneliness and depression. In fact, research shows that up to one third of adults with age-related macular degeneration will also have depression, which can be further debilitating. Depressed people withdraw and avoid social interactions, often worsening the feelings of loneliness and symptoms of depression.
Holidays are also hard on those who are grieving a loss such as the death of a loved one, the end of a relationship or even the loss of one’s vision. You are reminded of what used to be and may feel sad or anxious about the future. This grief saps our energy, distracts us, and makes it impossible to celebrate. Though it is natural to grieve over a loss and there is no timetable for grief, it can become prolonged and turn into depression.
Holiday Blues or Depression?
It is normal to feel down and sad at times, but if the low mood lasts for more than two weeks, is accompanied by other symptoms and is severe enough to disrupt daily life, it may be depression.
- Loss of interest in life or apathy
- Loss of pleasure in things you used to enjoy
- Feelings of worthlessness, guilt or shame
- Lack of hope
- Fatigue and decreased energy
- Insomnia, especially early-morning waking
- Excessive sleep
- Persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
- Increased or decreased appetite
- Weight gain or weight loss
Depression Affects All Aspects of Life
The physical and emotional pain brought on by depression can affect a person’s work, relationships, and hobbies. It causes problems with concentration and decision-making. Left untreated, depression can get more severe and become life threatening.
Depression is not a sign of weakness or a negative personality trait; it is a medical condition, and it is treatable.
Who Is At Risk?
People who have a family history of depression are at higher risk as it is believed genetics play a role. Women are twice as likely to have depression as men. Depression is triggered by the stress of major life changes such as a death in the family, divorce, major illness or disability. Many experts believe it is caused by a difference in brain structure and chemical function which is biologically determined.
Treatments for Depression
Talk therapy is effective in treating mild to moderate depression. Cognitive behavioral therapy focuses on changing the thoughts and behaviors which lead to depression. Often, a few weeks or months of therapy is all it takes to alleviate the depression.
Antidepressant medications affect the levels of serotonin and norepinephrine, chemicals in the brain that regulate mood. They can take a few weeks to reach full effectiveness and dosages may need to be adjusted. There are many options so if one medication does not work, chances are another will. Research has shown that the combination of talk therapy with medication is the most effective treatment for depression.
Because loneliness goes hand-in-hand with depression, it is important to develop a social support network. This may include joining a support group, finding an online support community, or making a plan to see friends and family more often. Even joining a book club or taking classes at your gym can help you connect with people and avoid isolation.
Other treatments include regular exercise and pet therapy which have been shown to improve mild to moderate symptoms. Exercise releases brain chemicals that lift the mood and can promote increased self-esteem, better sleep, stress relief, and improved energy. Pets and even service animals have positive effects on our mood and health. Petting our animals lowers stress hormones, lowers blood pressure, and releases oxytocin which gives a sense of well-being and bonding. Our animals offer unconditional love and companionship which also has a therapeutic effect.
Don’t Wait to Seek Help
Depression leaves you feeling helpless and hopeless. As it worsens, it can be a slippery slope, so it is important to seek treatment as soon as it is recognized. Depression is not a dirty word, and there is no shame in getting help for it. The good news is that it is highly treatable and more than 80% of people get better with medication, talk therapy, or a combination of the two.
If you or someone you love is experiencing symptoms of depression, please talk about it and seek medical attention. You may want to take an on-line screening for depression to determine if you are depressed.
Don’t go it alone. Visit your primary care doctor to share your screening results and discuss diagnosis and treatment. If there are thoughts of suicide or you have a plan to harm yourself or others, go to the nearest emergency room or call 911. Or call a help line: Free confidential help is available any time at 800.273.8255. With treatment, you can feel better and handle life again, even beyond the holidays.
What to Do When the Holidays Are Not So Jolly
Surviving the Holidays and Vision Loss
Macular Degeneration and Depression | MacularDegeneration.net