| Is It the Blues or Depression?
Is It Worry or Anxiety?
Reduce Your Anger and Stress
Aging and Alcohol Abuse
--------------------------------------------------------------------------------
Is It the Blues or Depression?
Every woman gets the blues days of feeling sad or unhappy. But when these feelings darken, interfere with everyday life, and last for several weeks, they could be symptoms of a serious medical illness called clinical depression. One out of every four women will suffer one or more bouts of depression during her lifetime.
Depression is even more common among women with heart disease, especially if they have had a heart attack, invasive surgery, or a heart transplant. In fact, a recent Canadian study found that women are twice as likely as men to experience depression after a heart attack.
Some researchers also believe that depression may actually cause heart attacks because it creates biological hormonal changes that put added stress on the heart. Also, women suffering from depression may not take good care of themselves, lack the energy to exercise, and forget to keep healthcare appointments and take their prescription medications.
Symptoms
According to the American Psychiatric Association, if you have five or more of the following symptoms of clinical depression and they last for three weeks or more, then you should see a doctor or therapist for treatment:
- Persistent sadness and crying
- Low energy and tired all the time
- Feeling hopeless or helpless
- Changes in eating or sleeping patterns
- Problems with memory, concentration or decision-making
- Irritability and excessive worrying
- Loss of pleasure in usual activities, including sex
- Low self-esteem
- Thoughts of suicide.
Causes
Depression is a physical illness that affects moods, thoughts, and feelings. According to the National Mental Health Association, it often results from an imbalance in brain chemicals that happens for many reasons, such as:
- Uninterrupted stress or trauma (such as a heart attack)
- Death of a spouse or family member
- Underlying disease such as heart disease, cancer or diabetes
- Adverse reactions to some medicines
- Drug and alcohol abuse
- Unemployment or poverty
- Being involved in abusive relationships or a bitter divorce
- Use of birth control pills and changes in women's hormones, especially at puberty and following childbirth.
Depression also has an inherited, or genetic, component which means that the illness is often passed on among family members from one generation to the next. These genes can make people more susceptible to experiencing one or more episodes of depression.
Sex also plays a role in depression, as many more women than men suffer from the illness. (Some researchers think that the rates between the sexes are actually more equal but that men hide their depression with alcohol abuse or aggressive macho behavior). Depression is not normal, nor is it part of living with heart disease or the aging process. It is a medical condition that can be treated with medicines and/or psychotherapy. Remember: untreated depression can lead to additional major health problems and is the leading cause of suicide.
Many women with depression also abuse alcohol as a way of self-medicating. Or, alcohol abuse can trigger the depression. If this sounds like you, you will need to stop drinking so your doctor can diagnose and treat your underlying depression. Also, if you start taking anti-depressant medicines, you should not drink alcohol while taking them.
Older Women
According to the National Mental Health Association, women over 65 are of increased risk for depression, which may be triggered by several factors such as:
- Harmful interactions among medicines
- Another medical illness (cancer, Parkinsonâs disease, heart disease, stroke and Alzheimer's Disease)
- Loss of physical abilities (vision, hearing, and mobility)
- Moving (especially to a nursing home)
- Deaths of family and friends.
Older women with depression often think it is a normal part of growing old or donât know that anything can be done to treat it. They show some or all of the following symptoms:
- Teary and sad
- Worry excessively about money and health problems
- Pace and fidget
- Lose weight
- Neglect their personal appearance
- Withdraw from social activities.
Treatments
Unfortunately, only one-third of women who suffer from depression receives treatment. The reasons they don't get help are many, such as:
- They don't know that women with heart disease often suffer from depression.
- They don't know or recognize the symptoms of depression.
- They don't know that effective treatment exist or where to find them.
- They cannot afford healthcare insurance or pay for treatment.
- They falsely believe their sad feelings are a personal weakness or a result of sin.
- They falsely believe they can handle depression on their own or that it will pass in time with prayer.
- They feel ashamed and embarrassed, and may be abusing alcohol to cope.
- They are fatalistic about their sad feelings and resigned to feeling bad.
- They are overwhelmed with work and/or family responsibilities.
- They donât want to impose their suffering on others.
- They are involved in an abusive relationship or with a controlling partner.
- Their family or cultural traditions disapprove of anti-depressant medicines or psychotherapy.
But effective treatments do exist and are available through doctors, therapists, and community mental health centers that treat women with low incomes or without health insurance. Tell your doctor if you are having any symptoms of depression, and s/he will first examine you to rule out other possible physical causes of your symptoms.
According to the National Mental Health Association, the following treatments are available:
- Anti-depressant medicine. These prescription medicines work to restore the balance among chemicals that affect mood and appetite in your brain. However, for women with heart disease they may present a problem because they can place added stress on the heart and, in some cases, interfere with medicines you take to treat heart disease. They can also cause rapid heartbeat, dizziness, anxiety, and possibly problems with heart rhythm. Talk over these concerns with your doctor before you start taking anti-depressant medication. Also, discuss with your doctor additional side effects of each medicine and what you should do if you experience any of them. (Your doctor may refer you to a psychiatrist to supervise your medicine. If you have on-going trouble with the medicine, ask to see a psychopharmacologist who is a doctor that specializes in these medicines).
- Most anti-depressant medicines take about six weeks to take effect so be patient and don't give up hope. Also, many women find that the first medicine a doctor prescribes does not work well for them so they try others until they find one that works. Don't be shy about telling your doctor you want to try another anti-depressant medicine.
- Also, don't drink alcohol or stop taking the medicine without first discussing it with your doctor. And take the medicine as often and in the dose that the doctor prescribes.
- Therapy. Therapy, combined with anti-depressant medicine, is often the most effective method to treat depression. Licensed therapists psychologists, marriage and family therapists, pastoral counselors, clinical social workers, and psychiatrists all offer short-term psychotherapy to help you understand depression and recover from it. (Sometimes longer-term therapy is needed if the depression is rooted in trauma or childhood abuse.)
- These therapists offer different types of therapy. Be sure to ask them if they are licensed and about their training, experience treating depression in women, and what approach they plan to use with you. Shop around if you need to until you find a therapist you are comfortable with; if finances are a concern, ask they have a sliding fee scale.
To find a therapist:
- Ask your doctor or pastor for a referral.
- Call a community mental health center.
- Look in your health insurance plan's or HMO's Provider Directory.
- Look in The Yellow Pages under Counselors, Mental Health Services, Psychologists/Psychiatrists.
- Go online -- two therapy organizations list their members on their Web sites: the American Association for Marriage and Family Therapy, whose members treat individuals, couples, and families, and the American Association of Pastoral Counselors whose members are ordained clergy who use religious and spiritual resources within therapy.
- all the American Psychological Association toll free at 800-964-2000 for a referral to a clinical psychologist near you and the American Psychiatric Association at 202-682-6000 for a referral to a psychiatrist near you.
For more information:
Depression and Bipolar Support Network
730 North Franklin Street Suite 501
Chicago, IL 60610
Phone: 312-642-0049
www.dbsalliance.org
National Mental Health Association
1021 Prince Street
Alexandria, VA 22314
Toll free: 800-969-6642
http://www.nmha.org
top
--------------------------------------------------------------------------------
Is It Worry or Anxiety?
Every woman worries from time to time about her family, job, finances, and health. They often get nervous about meeting new people, traveling to a new place, or having dinner guests. And women with heart disease often worry about heart attacks and stroke, and whether they will survive a planned surgery. However, when the worry becomes excessive, constant, and interferes with daily life, these are symptoms of a medical condition called anxiety.
Anxiety is more than just "bad nerves" it can cause you to feel so uncomfortable that you completely avoid some situations or the occasional incident may be so intense that it can paralyze you with fear.
Symptoms
According to the National Mental Health Association, the following are symptoms of anxiety:
- Inability to relax
- Inability to fall asleep or stay asleep
- Trembling or irritability
- Twitching or muscle tension
- Headaches
- Sweating or hot flashes
- Feeling lightheaded or out of breath
- Feeling nauseated
- Going to the bathroom frequently
- Feeling tired or unable to concentrate
Some women who survive heart attacks show certain symptoms of a type of anxiety called post-traumatic stress disorder. These symptoms include:
- Intrusive and recurring memories of the heart attack
- Recurring nightmare about the heart attack
- Heightened vigilance, or expecting the worst with every new ache and pain
- Emotional distress when they pass by hospitals or on the anniversary of the heart attack
- Avoiding situations that remind them of the heart attack
- Becoming distant and detached.
Treatment
Both medicines and therapy can successfully treat anxiety. If you recognize yourself having some or all of the symptoms of anxiety, tell your doctor who can prescribe anti-anxiety medicines.
Licensed therapists psychologists, marriage and family therapists, pastoral counselors, clinical social workers, and, in some cases, psychiatrists all offer effective short-term psychotherapy to help you understand anxiety and recover from it. (Sometimes longer-term therapy is needed if the anxiety is rooted in trauma or childhood abuse.)
These therapists offer different types of therapy. Be sure to ask them if they are licensed and about their training, experience treating anxiety, and what approach they plan to use with you. Shop around if you need to until you find a therapist you are comfortable with; if finances are a concern, ask they have a sliding fee scale.
To find a therapist:
- Ask your doctor or pastor for a referral.
- Call a community mental health center.
- Look in your health insurance plan's or HMO's Provider Directory.
- Look in The Yellow Pages under "Counselors," Mental Health Services, "Psychologists/Psychiatrists."
- Ask your friends.
Go online -- two therapy organizations list their members on their Web sites:
the American Association for Marriage and Family Therapy (http:www.aamft.org -- whose members treat individuals, couples, and families) and the American Association of Pastoral Counselors (http://www.aapc.org -- whose members are ordained clergy who use religious and spiritual resources within therapy).
Call the American Psychological Association toll free at 800-964-2000 for a referral to a clinical psychologist near you and the American Psychiatric Association at 202-682-6000 for a referral to a psychiatrist near you.
For more information:
Anxiety Disorders Association of America
8730 Georgia Avenue, Suite 600
Silver Spring, MD 20910
Phone: 240-485-1001
http://www.adaa.org
top
--------------------------------------------------------------------------------
Reduce Your Anger and Stress
Anger:
Do you often feel angry or hostile? Researchers at Duke Medical School have found that women who are often antagonistic and angry, who lash out at others, risk raising their blood pressure and cholesterol levels by releasing stress hormones into their bloodstreams. These hormones, in turn, free fatty acids and keep more LDL (or bad) cholesterol in circulation. In fact, these angry women's cholesterol levels were 18% higher than their peers.
If you experience frequent outbursts of anger each day, tend to explode when you become angry, or are easily angered, you need to understand that you have a problem. Even if this is what you were taught and how your family always expressed anger you need to take better care of yourself, learn how to manage your anger, and control this destructive behavior. You can
- Physically remove yourself from the person or event that is making you angry go sit in another room or outside for 20 minutes.
- Learn relaxation exercises to calm yourself sit down and close you eyes for ten minutes or take a walk around the block.
- Schedule a brief time out when approaching situations or time of day when you tend to get most stressed and angry.
- Talk yourself down from the anger. Breathe deeply from your gut and repeat - I will remain calm... or Relax
- Learn new ways to express your anger assertively, not aggressively, without hurting others. If someone has offended you, say to him/her: I am angry with you because you did [] and the reason it makes me angry is [].
- You may also want to work with a therapist to learn new anger management skills, or to probe deeper for the underlying causes of your angry and hostile behavior, such as alcohol abuse, physical violence, or childhood abuse.
Stress:
A certain amount of stress is a normal and healthy part of life for most women, especially as they frequently juggle several roles at once homemaker, wife, mother, employee, and often caretaker of elderly parents. But for a woman living with heart disease, too much prolonged stress releases excessive amounts of adrenaline into her bloodstream. It can increase blood pressure and further damage her heart.
To see if you are stressed out, take the following quiz:
1. Do minor problems and disappointments upset you excessively?
2. Do the small pleasures of life fail to satisfy you?
3. Are you unable to stop thinking about your worries?
4. Do you feel inadequate or suffer from self-doubt?
5. Are you constantly tired?
6. Do you experience flashes of anger over situations that used to not bother you?
7. Have you noticed a change in your sleeping or eating patterns?
8. Do you suffer from chronic pain, headaches, or backaches?
Source: National Mental Health Association
If you answered YES to most of these questions, chances are you are stressed out. If this sounds like you, you need to learn to manage stress better by slowing down, setting clear boundaries, and taking better care of yourself. You can
- Examine your daily activities and decide which ones you can reduce, postpone, eliminate, or delegate to someone else.
- Learn how to say No to requests for extra work assignments, additional family responsibilities, boring social activities, or being around negative and critical people. Learn to be very selective about how and with whom you spend your time.
- Stop trying to be Superwoman -- perfect and pleasing everyone around you. Try to set more realistic standards for yourself. If you are a perfectionist or workaholic, you may need to see a therapist to get your life into balance or to identify deeper causes for these unhealthy behaviors.
- Walk or exercise for a minimum 20 minutes each day. It will relax your muscles, clear your mind, and increase the flow of oxygen into your bloodstream. Even better, walk with a friend or spouse you can confide in and laugh with.
- Take several five-minute relaxation breaks during the day, when you close the door, turn off the lights, sit in a comfortable chair, and shut you eyes. Breathe deeply several times and then relax think beautiful thoughts!
- Create balance and connections in your life. Women with heart disease fare better if they are active and participate in community activities, attend religious services, or perform volunteer work. Staying connected to other people soothes your heart.
- Take good care of your body. Eat healthy and nourishing foods (fresh fruits and vegetables), drink alcohol in moderation, drink lots of water, and get enough sleep. Say good-bye to fast foods, fried foods, snack foods, and - most of all - cigarettes.
- Treat yourself with tender loving care. Take a bubble bath or long shower, light some candles, listen to your favorite music, cuddle with your lover or pet, put fresh flowers in your room, get a massage, or laugh with your best friend. Give hugs and receive hugs. Do whatever it takes to help you relax and feel nourished.
top
--------------------------------------------------------------------------------
Aging and Alcohol Abuse
From the National Institute on Aging and the National Institute on Alcohol Abuse & Alcoholism
Anyone at any age can have a drinking problem. Great Uncle George may have always been a heavy drinker -- his family may find that as he gets older, the problem gets worse. Grandma Betty may have been a teetotaler all her life, just taking a drink "to help her get to sleep" after her husband died -- now she needs a couple of drinks to get through the day. These are common stories. Drinking problems in older people are often neglected by families, doctors, and the public.
Physical Effects of Alcohol
Alcohol slows down brain activity. Because alcohol affects alertness, judgment, coordination, and reaction time, drinking increases the risk of falls and accidents. Some research has shown that it takes less alcohol to affect older people than younger ones. Over time, heavy drinking permanently damages the brain and central nervous system, as well as the liver, heart, kidneys, and stomach. Alcohol's effects can make some medical problems hard to diagnose. For example, alcohol causes changes in the heart and blood vessels that can dull pain that might be a warning sign of a heart attack. It also can cause forgetfulness and confusion, which can seem like Alzheimer's disease.
Mixing Drugs
Alcohol, itself a drug, is often harmful when mixed with prescription or over-the-counter medicines. This is a special problem for people over 65, because they are often heavy users of prescription medicines and over-the-counter drugs.
Mixing alcohol with other drugs such as tranquilizers, sleeping pills, pain killers, and antihistamines can be very dangerous, even fatal. For example, aspirin can cause bleeding in the stomach and intestines; when aspirin is combined with alcohol, the risk of bleeding is much higher.
As people age, the body's ability to absorb and dispose of alcohol and other drugs changes. Anyone who drinks should check with a doctor or pharmacist about possible problems with drug and alcohol interactions.
Who Becomes a Problem Drinker?
There are two types of problem drinkers -- chronic and situational. Chronic abusers have been heavy drinkers for many years. Although many chronic abusers die by middle age, some live well into old age. Most older problem drinkers are in this group.
Other people may develop a drinking problem late in life, often because of "situational" factors such as retirement, lowered income, failing health, loneliness, or the death of friends or loved ones. At first, having a drink brings relief, but later it can turn into a problem.
How to Recognize a Drinking Problem
Not everyone who drinks regularly has a drinking problem. You might want to get help if you:
- Drink to calm your nerves, forget your worries, or reduce depression
- Lose interest in food
- Gulp your drinks down fast
- Lie or try to hide your drinking habits
- Drink alone more often
- Hurt yourself, or someone else, while drinking
- Were drunk more than three or four times last year
- Need more alcohol to get "high"
- Feel irritable, resentful, or unreasonable when you are not drinking
- Have medical, social, or financial problems caused by drinking
Getting Help
Older problem drinkers have a very good chance for recovery because once they decide to seek help, they usually stay with treatment programs. You can begin getting help by calling your family doctor or clergy member. Your local health department or social services agencies also can help.
Resources
Alcoholics Anonymous (AA) is a voluntary fellowship of alcoholics who help themselves and each other get and stay sober. Check the phone book for a local chapter or write the national office at:
475 Riverside Drive, 11th Floor
New York, NY 10115; or call
(212) 870-3400
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) provides information on alcohol abuse and alcoholism. Contact:
NIAAA
6000 Executive Boulevard
Bethesda, MD 20892-7003
(301) 443-3860
The National Council on Alcoholism and Drug Dependence, Inc., can refer you to treatment services in your area. Contact:
National Headquarters
NCADD
12 West 21st Street
8th Floor
New York, NY 10010
(800) NCA-CALL (800-622-2255)
The National Institute on Aging offers a variety of resources on health and aging. Contact:
NIA Information Center
P.O. Box 8057
Gaithersburg, MD 20898-8057
(800) 222-2225, TTY (800) 222-4225
--------------------------------------------------------------------------------
Printed by the National Institute on Aging, U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health. 1995
top
|
