When Caregivers Are Left With Nothing More To Give

Writer Sandra Tsing Loh spoke last week on the NPR national call-in show Talk of the Nation about a provocative piece she had written for The Atlantic Magazine. It was about the heavy financial and emotional cost of caring for her elderly father and stepmother. It was already a pretty sobering conversation, which is what you might expect since her piece was subtitled "Why Caring for My Aging Father Has Me Wishing He Would Die."

Then Yvonne called in and said:

"In 2000, my mother's heart suddenly stopped. And I took care of her for 10 years, and that was total care. That means bathing, making all of her meals, changing her diapers. I also work in long-term care. I'm a registered nurse. And on top of that, my youngest daughter gave birth to a child that she really couldn't take care of herself. So I was doing, wow, all of that. And I got to tell you: There were times I thought I was going to lose it. I could not — I felt so angry, and I'm ashamed of that."

Trauma and Adversity in Childhood: History Need Not Be Destiny from Huffington Post

Once again, the American Academy of Pediatrics is demonstrating its clinical leadership. Two recent, groundbreaking reports -- "The Lifelong Effects of Early Childhood Adversity and Toxic Stress" and "Early Childhood Adversity, Toxic Stress, and the Role of the Pediatrician: Translating Developmental Science Into Lifelong Health" -- by the Academy boldly declare what has been known but too hidden from sight: Namely, that brain and emotional development is profoundly disrupted by childhood adversity and trauma.

The pediatric academy quotes Frederick Douglass who said "It is easier to build strong children than to repair broken men."

Should grief be treated like depression? from CNN

Editor's note: Dr. Charles Raison, CNNhealth's mental health expert, is an associate professor of psychiatry at the University of Arizona in Tucson.

(CNN) -- I am starting to think that there are no answers to the issues most worth writing about, at least in psychiatry.

Consider the following scenario: A woman who has been mostly happy in her marriage for 30 years comes home to find her husband dead on the floor, the victim of a heart attack.

At first, she is numb with shock. Slowly, as the days pass, she becomes more and more upset. She cries at any mention of her husband. She can't sleep. She can't eat. Nothing seems worth doing, and even if it was, she wouldn't be able to concentrate enough to get it done.

The Benefits of Tears from Huffington Post

Something extraordinary happened at Candlestick Park in San Francisco two Saturdays ago, Jan. 14. Sure, it was an amazing ending to an NFL playoff game between the San Francisco 49ers and the New Orleans Saints (which the Niners won in dramatic fashion, making all of us fans here in the Bay Area very happy); but the monumental win wasn't what made it so remarkable to me.

As Vernon Davis, the tight end for the Niners who caught the game-winning touchdown, came running off the field, tears were streaming down his face. He came to the sidelines and was embraced by his head coach, Jim Harbaugh, in a huge bear hug. Coach Harbaugh hugged him for quite a while and spoke into his ear in what I can only imagine was an expression of authentic appreciation and celebration. It was a beautiful and moving moment that transcended football and even sports -- it was about courageous triumph, raw human emotion and vulnerable self expression.

Don't Confuse Grief With Depression from Huffington Post

A front page story by Ben Carey in January 24th's New York Times carries the poetic title: 'When does a broken heart become a diagnosis?' It describes a puzzling proposal by D.S.M. 5 to transform what is now considered normal grief into Major Depressive Disorder.

D.S.M. IV already recognizes that some people respond to loss with severe problems that warrant immediate attention. It therefore encourages the diagnosis of major depression whenever bereavement is persistent or is associated with severe, impairing, delusional, or suicidal symptoms. D.S.M. IV thus makes a crucial distinction between the transient pain of expectable grief and the severe and/or persistent symptoms of major depression. D.S.M. 5 proposes to eliminate this distinction. It would allow the diagnosis of major depressive disorder after only two weeks of fairly mild symptoms.

10 Things Not to Say to a Cancer Patient from Huffington post

When I was diagnosed with leukemia last May, I couldn't imagine what lay ahead for me. The last eight months may have well been eight years. It's been a blur of blood tests and bone marrow biopsies, fevers and infections. Any cancer patient can tell you that the disease turns you into an ersatz medical student, whether you like it or not. But navigating the social dynamics of living with cancer -- communicating with family and friends about my diagnosis, symptoms, fears and hopes -- was a challenge I did not expect.

The oncology world is overdue for an etiquette guide. As a commenter noted on my blog, unless you're Seth Rogen in 50/50, there's no script for what to say to someone with a life-threatening illness. But if you can avoid saying these 10 things, you're off to a good start:

I Hear You: Responding to Cries for Emotional Help from Huffington Post

Cries for emotional help come in all forms. We witness these cries in ways direct and indirect: from outright requests to help me stay alive to the less direct but no less obvious self-starvation of anorexia or leaving empty pill bottles or illegal drugs in plain sight.

We recently witnessed a modern-age cry for help when Sinead O'Connor declared on Twitter: "does any1 know a psychiatrist in dublin or wicklow who could urgently see me today please? im really un-well... and in danger." Why a celebrity needs Twitter to find a psychiatrist is beyond me. Sure, we can all quip about how hard it is to get an appointment with a doctor, but I suspect that is not what this was about.

Nor can I know since I am not personally familiar with this celebrity, her medical community or resources, or for that matter her state of mind when she turned to such a ubiquitous form of social media for help. But as a psychiatrist I understand how people reach out in ways that we need to listen to: The ultimate fear is that they will find no one there, which is the saddest situation of all. Suicide, as has been said, is not just the product of hopelessness; it is the result of believing that you are all alone, with no one to turn to and no means of exiting from the psychic pain that is crushing your soul.

For more please press the link.

Healing With Hurt Feelings from Huffington Post

Hurt Feelings. They're like noses. We all have them. They come in all shapes and sizes. They can come suddenly like a cloud and bring the rain or build up slowly and then consume us like a tornado. They can be so powerful that they can make us lose complete perspective of our reality. You overhear your colleagues are having a get together at the end of the day, but you haven't been invited. You feel excluded. Hurt feelings show up. You find out that someone you thought was a good friend has been talking about you behind your back. You feel betrayed. Hurt feelings show up. You're having dinner with your girlfriend, and she says she wants more space and wants to date other men. Clunk. Couldn't she at least have waited 'til after dessert? You leave dinner feeling hurt and abandoned.

Wouldn't life be so much easier without hurt feelings? Well, maybe. But I believe that hurt feelings can also provide a powerful opportunity for self-awareness and healing. If outer reality is a reflection of inner reality, then when hurt feelings show up, we can take the opportunity to ask ourselves what has been suppressed and unexpressed. If in my outer world there is something that produces hurt and pain, then there must be something inside me that is still unresolved. The question then becomes what to do with hurt feelings when they show up, and what can we learn from them. The theme of this blog series and of my new book is how to use everything that life puts on our path as a way to unbind our hearts. Hurt feelings can then serve as a tunnel, through which we can come to the other side to the freedom of our heart.

How Grief Can Break Your Heart from Time

Grief is a powerful emotion, and the latest research shows just how damaging it can be, especially for the heart.

The sobering results, appearing in the journal Circulation, are the first to compare how grief affects an individual’s heart-disease risk within a period of time. Previous studies have documented that people losing loved ones tend to have more heart problems than those who aren’t bereaved. In the current analysis, lead author Elizabeth Mostofsky and her colleagues took a unique approach by calculating an individual’s “average loss” of loved ones over a year, by asking how many people study participants had lost in the past year and comparing that figure to the number of loved ones that same person lost during the study period in question, which included the most recent day and week preceding a heart attack. Because all the participants were heart-attack patients, that allowed her to calculate the effect that losing a loved one had on each individual’s heart-attack risk.

Depression and Complementary Health Practices from NCCAM

Depression is a medical condition that affects nearly 21 million American adults each year, according to the National Institute of Mental Health. Mood, thoughts, physical health, and behavior all may be affected. Among the common symptoms of depression are persistent sad, anxious, or "empty" feelings; feelings of hopelessness, guilt, and/or worthlessness; restlessness or irritability; fatigue; difficulty concentrating; insomnia; overeating, or loss of appetite; and/or thoughts of suicide.

Many people with a depressive illness never seek treatment. But the majority, even those with the most severe depression, can get better with treatment. Depression can be treated effectively with conventional medicine, including antidepressants and certain types of psychotherapy.

A New Year, a New Yesterday from Nurse Together

Yesterday was what it was. Or was it?

If your memory is like mine, I can’t remember where I parked my car an hour ago. How can I possibly think that my memories from a year ago - or a decade ago - are accurate?

Next question: How much weight do memories of past events color your present relationships and viewpoints?

I don’t know about you, but as I thought about that for myself, something inside me went... flooop.

The Will and Ways of Hope from Huffington Post

Talent, skill, ability -- whatever you want to call it -- will not get you there. Sure, it helps. But a wealth of psychological research over the past few decades show loud and clear that it's the psychological vehicles that really get you there. You can have the best engine in the world, but if you can't be bothered to drive it, you won't get anywhere.

Psychologists have proposed lots of different vehicles over the years: grit, conscientiousness, self-efficacy, optimism, passion, inspiration, etc. They are all important. One vehicle, however, is -- I believe -- particularly undervalued and under-appreciated in psychology and society. That's hope.

Got The Post-Holiday Blues? Here's How To Beat 'Em from Huffington Post

Wait ... hear that? That's our collective sigh marking the fact that the great holiday season of 2011 has finally come to a close.

And while for many of us, that is indeed a relief -- there's no more cooking, no more cleaning, no more forced New Year's revelry -- the post-holiday period can represent a real time of sadness and readjustment, too.

Each of us has our own personal blend of apres-holidays feelings, but there are many issues and emotions that crop up again, and again and again. So we went to a team of experts to ask for some advice on what you can do -- right now -- to help beat those post-holiday blues.

10 Signs Death Is Near from Caring.com

By Paula Spencer Scott, Caring.com senior editor

No one can predict the moment of death. But physicians and nurses involved in end-of-life care know that certain symptoms are usually associated with the body's shutting down. These signs of approaching death are specific to the natural dying process (apart from the effects of particular illnesses the person may have).

Not all dying symptoms show up in every person, but most people experience some combination of the following in the final days or hours:

Survivors' Stories Featured in Lifeline Gallery from SAVE

Survivors of suicide loss might want to visit the Lifeline Gallery, where they can listen to everyday people's stories about coping after suicide -- as well as tell their own story of being bereaved by suicide.

Stories in the "Loss" section are for anyone who has lost a loved one to suicide.
Stories in the "Turning Points" section are for people who have survived a suicide attempt or have struggled with thoughts of suicide.
Stories in the "Helpers" section are for caregivers, advocates, or supporters working on behalf of suicide prevention.

When it was launched in 2008, the Lifeline Gallery was described in a Los Angeles Times health blog as a place where...

12 signs of depression in men. from Health.com

By Lisa Zamosky

More than 5 million men in the U.S. experience depression each year.

Clinical depression—in women or men—can cause sadness and a loss of interest in once pleasurable activities. But depression can sometimes manifest in different ways in different people.

"While the symptoms used to diagnose depression are the same regardless of gender, often the chief complaint can be different among men and women," says Ian A. Cook, MD, the Miller Family professor of psychiatry at the University of California–Los Angeles.

Women and depression: Factors that contribute to depression via Yahoo News

Depression is a major health problem in today's troubled world. Thousands of women each day struggle to get up, go to work, and take care of themselves and their children. Antidepressant drugs are prescribed by the thousands each day. What is contributing to the climbing rate of depression in this country?

There have been a number of research studies focused on trying to understand the factors responsible for the increased cases of serious depression. One group of researchers studied 92, 539 postmenopausal women from different income, cultural, and religious backgrounds. They published their findings in the Women's Health Initiative. Another research study conducted by Michel Lucas, Harvard School of Public Health, Nurse's Health Study, followed 49.821 women by questionnaires from 1993 until 2000. These women were depression-free when the research project began. These and other research studies point to several factors that increase the risk for women to develop depression.

Recognizing Signs of Depression in Our Patients from Nursing Together

In nursing school, we all likely studied mental health/psychiatric nursing, at least to some extent. We also likely did our clinical experiences in patient units specifically devoted to the care of those with mental health issues. We know, however, that we encounter the same kinds of issues no matter what type of patient population we serve. We take care of patients with these diagnoses on Medical-Surgical units, in long term care, in the Emergency Room, etc. In these settings, we may tend to focus more on the physical symptoms, but what about emotional symptoms, specifically depression?

Physical illness causes stress. Patients often feel a loss of control over their bodies, functions, and treatment. They may be experiencing a loss of income or worry about other financial issues. They may feel guilty for burdening their families with not only the financial cost of their illness, but the emotional issues that the family experiences. They grieve for their loss of independence in some cases and are fearful about the future. These factors are true not only in elderly patients, but in other age groups as well.

For the full article please press on the link.

Why Antidepressants Don’t Work for Treating Depression

HERE’S SOME DEPRESSING RECENT medical news: Antidepressants don’t work. What’s even more depressing is that the pharmaceutical industry and Food and Drug Administration (FDA) have deliberately deceived us into believing that they DO work. As a physician, this is frightening to me. Depression is among the most common problems seen in primary-care medicine and soon will be the second leading cause of disability in this country.

The study I’m talking about was published in The New England Journal of Medicine. It found that drug companies selectively publish studies on antidepressants. They have published nearly all the studies that show benefit — but almost none of the studies that show these drugs are ineffective. (1)

That warps our view of antidepressants, leading us to think that they do work. And it has fueled the tremendous growth in the use of psychiatric medications, which are now the second leading class of drugs sold, after cholesterol-lowering drugs.

The problem is even worse than it sounds, because the positive studies hardly showed benefit in the first place. For example, 40 percent of people taking a placebo (sugar pill) got better, while only 60 percent taking the actual drug had improvement in their symptoms. Looking at it another way, 80 percent of people get better with just a placebo.

Mind Control: How Your Body Can Automatically Improve Depression from Dr. Mark Hyman

CAN YOUR BODY AFFECT your mind?

By making different food and lifestyle choices, can you rid yourself of depression, boost your mood or even improve more serious conditions such as ADHD, autism and more?

In my experience, the answer is YES and I’ll show you precisely how in just a second.

But first, let me tell you about one of my patients, Sarah.

She’s a very vibrant, smart young woman of 18 who had just finished high school with honors and was admitted to a top university.

Even more exciting, her passion for theater and acting had recently landed her the lead role in a real movie.

The future ahead of her was bright and full of possibilities.

So why had Sarah’s distraught mother brought her to see me?

Well, over the previous few weeks, she had sunk into a debilitating depression.

It had gotten so bad that she wouldn’t go out, didn’t respond to friends’ calls, and couldn’t even get out of bed to watch television — which is pretty bad for a teenager!