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Guest Article
Ed Freeman, MD
[This article first appeared in the PAGER newsletter, Reflux Digest, April 2004]

I want to talk to those of you who are dealing with the stresses and strains of a loved one with a chronic illness. This is a very frustrating and draining situation that can rob you of your energy, patientice, creativity, joy, love, sexuality, and relationships. Getting the message? Good. Besides, most of you already knew this.

The goal of this article is to give you some understanding, guidance and hopefully answers to help you get through this chapter of your lives stronger and better than before. No promises, but a sincere desire to help is why I’m writing this. If you haven’t learned anything new by the end of this article, you may already have the tools you need.

Since I’m a psychiatrist (surprise!), I often focus on the medical aspects of what goes on in individuals, couples and families dealing with chronic illnesses. The first thing to know is that depression is a biological alteration of neurochemical transmitters in the brain and is very common consequence of long term stress be it physical, mental or emotional. In the case of long-term caretakers, all three stresses are likely to be involved. Many caregivers end up depressed and burned out at some point.

Depression isn’t always sadness. It can show up in lots of different ways such as anger, fear, pain, fatigue, anxiety, increased or decreased sleep/appetite, just to name a few symptoms. The diagnosis can be tricky and is better left to a qualified professional.

Depression is a very real illness just like high blood pressure, reflux or any other medical illness. I say this because many people, including some physicians, do not view psychiatric (mental) illnesses in the same realm as physical illnesses. Well, it is and needs professional attention as well. Sometimes all one may need are lifestyle adjustments, others may need medication only, while still others may need lifestyle changes, medications and counseling.

Well, what can you do to get energy, patience, creativity, joy, love, sexuality and good relationships back in your life and how do you keep those that you still have? Simple. Call a therapist, counselor and/or a psychiatrist.

Don’t be shy. Go see someone if you’re not sure or if you are having difficulty coping in your life. Depression that comes from constant stress deserves attention just as much as depression that comes on for no apparent reason. Even if the situation isn’t going to change soon, you can still change the depression. Many therapists, counselors and social workers specialize in helping people who are living with medical situations that would try the patience of a saint. Psychiatrists are medical doctors who specialize in the medical treatment of mental issues. Many also do counseling with their patients. You can often get a good recommendation from a doctor or nurse who deals with a lot of caregivers or from any local support group of caregivers - regardless of what disease the groups focus on, the members experience the same kinds of stress.

Now what can we do preventively to try to keep ourselves from getting depressed when life gets tough? If you are a caregiver, you must understand one simple fact: you must take care of you. If you’re not caring for yourself, you will run out of ‘you’ to give to others. You must take care of you; it is a requirement for anyone who wants to remain whole, productive and remotely sane. Even soldiers in war are given rest and relaxation time or they will not be able to function in a productive manner. Yes, I know this can be a difficult task to do especially if you are the primary or sole caregiver to someone, but you are not a machine you need down time or you will break down.

Now how do you get downtime? I don’t have enough space to cover the infinite ways to rest and rejuvenate oneself. Think back and remember what your likes, loves and passions are and get a little dose of that on a very regular basis. And don’t forget to interact with the outside world – isolating yourself only makes things worse. If you have a family or a partner you may have an unending source of emotional and spiritual renewal not to mention helping hands, but don’t forget your other loved ones.

I know this may not answer all your questions or concerns, but it is a place to begin if you are feeling any of the above mentioned feelings. Do not be afraid to reach out, you are not alone and there are people available to help. Support groups are fabulous ways to connect with others and learn about this horrible disease, but you may need more help if you are getting depressed. It is hard to find a way to call for help when you feel like you are drowning, but you have to be strong for your child and get the help you need. Modern counseling is often short term and focuses on getting you through a crisis. Months of lying on a couch and free associating about your potty training aren’t required. You might be amazed at what a few short hours invested in helping yourself can do for you and your whole family.

Ed Freeman, MD is a psychiatrist in private practice. He is moving his practice to Killeen, Texas.

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