How do I know when to see a professional about my depression?

Everyone has blue periods in their life. The fact that life has ups and downs is not news. But if you try strategies to lift your depression and if the symptoms of depression last for more than a few weeks, you will want to get professional help. Ask your doctor for a referral to a psychologist[1] or psychiatrist[2] so that you can be evaluated for depression. A good mental health professional will be able to determine whether your depression is biological, situational, or both, and guide you in choosing treatment options. And, as it is with chronic disease, the treatment of depression may involve some trial-and-error attempts on the part of patient and practitioner. For some people, there is a stigma attached to mental health counseling. They think it is only for those who are weak and crazy. Depression is just as real a disorder as insulin-dependent diabetes or a broken bone. You wouldn't try to treat those on your own, would you? It is the strong person, not the weak person, who has the courage to ask for help when needed. It is the sane person, not the crazy one, who makes a decision to relieve his own suffering.

Why am I having trouble thinking and remembering?

Difficulty thinking and remembering can have several causes. There may be a biological cause for your cognitive problems that is based in the disease itself. The medications that you take to manage the disease or its symptoms may be the cause. Or the cause may be situational, brought on by the many stresses of living with a chronic medical condition. More than likely it is a combination of all three.

Autoimmune diseases[3] can cause inflammation in the brain, affecting the ability to think clearly. Neurological disorders[4] can skew the messages that travel from nerve to nerve. A quick search on the Internet turned up 371 diseases that can cause people to have problems with forgetfulness, trouble concentrating, confusion, and disorientation.

Medications that carry a warning that they may cause drowsiness and that you should avoid operating machinery after taking them can cause cognitive impairment, too. Pain medications, beta blockers, and steroids can all be culprits, among many others.

The constant stress of living with the uncertainty of chronic illness, pain, fatigue, and depression can all interfere with your ability to think clearly. If you add the challenges of loss of income, inability to pay for medical care, and changes in relationships resulting from chronic illness, is it any wonder that you have a hard time concentrating?

Why don't my prayers work?

Whether or not people profess faith in God or follow a spiritual path, they find themselves trying to bargain their way out of desperate situations. The old adage, "There are no atheists in foxholes" could easily apply to chronic illness. One of the stages of grieving—and remember we are grieving for our own losses—is bargaining. Whether it is bargaining with God as we know God or bargaining with something as vague as the cosmos, people will try to bargain their way out of

Instead of spending your energy figuring out what constitutes an enticing offer, put your energy into something you know will pay off and make a plan to manage your disease.

the illness. The process starts when the patient looks back at his or her life and decides that his less-than-perfect lifestyle or attitude is the cause of the sickness. The next step is making promises about future behavior in return for relief from the sickness. Bargaining sounds something like this, "If I get better (or You make me better) I promise I will (eat more vegetables, be nice to my neighbor, be a pleasant person, etc.). Bargaining makes some faulty assumptions. The first is that we did something to deserve our illness. The second is that our illness was inflicted on us as some kind of religious or cosmic punishment. The third is that whoever we are bargaining with will remove our sickness the same way that it was "given" it to us.

Whether or not you contributed to your illness is only important in that you have learned to change your behavior. What happened has happened, and nothing can change it. While prayer and meditation can be very helpful in managing chronic illness, playing "Let's Make a Deal" is not. Fortunately, the bargaining stage usually doesn't last very long. Instead of spending your energy figuring out what constitutes an enticing offer, put your energy into something you know will pay off and make a plan to manage your disease.

  • [1] A mental health professional who uses talk therapy and other techniques but does not prescribe medication.
  • [2] A mental health professional who can prescribe medication to treat mental and emotional problems.
  • [3] Any disease in which a person's immune system cannot tell the difference between viruses, bacteria, or parasites and the healthy self.
  • [4] Problems affecting the nervous system.
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