
On Fridays I will address a question related to depression and find the answer from an expert. If you have a question you want answered, please ask it on the combox of this post, and I'll try my best to do some research and feature it in an upcoming Friday post.
Today I have the pleasure of interviewing one of my favorite therapists, Elvira Aletta, Ph.D., on a very important topic: chronic illness. I say important, because it now pertains to me (and thus is important), and I need to learn some coping techniques ASAP before I fall over, into the Big Black Hole of depression.
Dr. Aletta is a clinical psychologist, wife, mom to two teenagers and blogger, seeking the balance in upstate New York. She is working on a book "How to Have A Chronic Illness So It Doesn't Have You," and would love to hear your story about how you or someone you love thrives with chronic illness. Write to her at draletta@explorewhatsnext.com. To learn more about Dr. Aletta, check out explorewhatsnext.com.
Question: I know that you have dealt with chronic illness personally and professionally, and this is an area of specialty for you. Do you have five good rules for living with both chronic illness and depression?
Dr. Aletta: Yes, I've had my share of chronic illness. In my early twenties I was diagnosed with nephrotic syndrome, a rare kidney disease that usually affects young boys. Weird. Then in my thirties I came down with scleroderma. Never heard of that either. When we are young it is our God given right to take our health for granted. Chronic illness means getting sick and being told it's not going away, and that stinks. Our bodies have suddenly freaked out on us and we've lost control of the one thing we thought we could count on.
It's not depression if you are adjusting to a major loss. That's grief, which needs time to process. Allow yourself that time to mourn, to be angry and sad about what you've lost. You need time to accept the new reality.
Then at some point, we need to take action. If we don't, grief morphs into depression and that can make your physical illness worse.
Be aware that one or a combination of factors can cause lowered mood when you have a chronic illness:
➢ The situation. Loss. Grief.
➢ Changes in appearance, mobility, independence.
➢ The illness itself may have depression as a symptom.
➢ Pain and fatigue.
➢ Side effects of medication and other treatments.
➢ Social pressure to appear OK, especially hard if there's no diagnosis.
My five good rules to deal with it all? OK, here we go...
1. Be confident you have the right doctor.
When you have CI your relationship with your doctor is second only to your spouse or your parents. Being honest (and you must be honest!) with that person means you need to be able to trust them to hear you. If you don't have that kind of relationship get a second opinion. Shop around. In my CI career I fired three highly recommended specialists because they were jerks. Thankfully I've also had wonderful physicians who literally saved my life and my mind.
2. Define your circle of support carefully.
Isolation leads to depression and it is so easy to isolate when you feel lower then dirt. People may surprise you. Peripheral friends may step up and be terrific support while others you thought you could count on cave. If someone inside the circle asks, "How are you?" Tell them the truth. When someone outside the circle asks, lie, say, "I'm fine" and change the subject. Too often they can't handle the truth and they suck any energy you have taking care of them. A patient of mine found her mother would get hysterical at any medical news so it was better to keep her at arms length.
If someone asks if they can help say yes. Accepting help is a gift to them. Trust that someday you will be on the giving end. My patient's mother could do laundry for her and that made both of them happy. One big way someone can help is to go to doctor's visits with you. The extra eyes and ears take the pressure off you when the news is emotionally laden and important, even if the news is good.

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