Thursday, December 22, 2011

Depression Revisited

Depression in the extreme can lead to suicide. As the young woman in this video demonstrates, suicide cuts a wide swath of destruction through the lives of those left behind.

While depression is common in RA and other autoimmune diseases, my battle with severe depression came long before my diagnosis.

This post is probably the hardest one I've ever written. While I love to write, my writing usually revolves around facts or fiction. Rarely do I write anything as deeply personal as this but I felt compelled to share my story.

My battle with depression began when I was in junior high. It had nothing to do with life circumstances or having had a bad childhood. Just the opposite. I had loving parents who were always there for me. My family was a good, decent family.

So often, when someone is depressed and commits suicide, we hear people wondering if they have been abused or unloved. In my situation, that was not the case. I was not abused and I was very loved.

People also say, "If only the kids could see this problem is temporary." For me, there were no problems that caused me to be depressed. It had nothing to do with a boy or with other kids picking on me.

I just felt inconsequential. No purpose. Useless. I felt that every breath I took was a waste of oxygen. While I had friends I ran around with and I enjoyed life in many ways, in the back of my mind there was always that thought that my life held no meaning.

In high school, the depression continued and I became suicidal. I thought about ways to kill myself but I didn't want to hurt my parents so I never followed through on any of those thoughts.

After high school, I got married. Marriage is difficult under the best circumstances but when two immature kids get married, it's impossible. As my marriage fell apart, my feelings of uselessness increased. 

I was in nursing school and working full-time trying to make a life for myself but I still felt that I was a waste of breath. During this time is when I really began to think about suicide. In my mind, I thought if I could make my death look like an accident, my parents wouldn't be as hurt. 

Late one night I drove down the interstate and decided I couldn't take my life anymore. I was going to drive straight into the pylons holding up the overpass. My parents knew I drove too fast and they would think it was just an accident. Right? They would be okay.

As I drove towards the overpass, gaining speed, A voice spoke to my heart. I knew the voice was God's. The voice told me that I wouldn't die but I would be a vegetable that my parents had to care for. For the rest of my life.

I pulled over on the shoulder and sat and cried. After all, if I was a waste of breath and a burden when I could take care of myself, how much more of a waste would I be with my parents having to tend to my every need?

During this time, I began to see that suicide would hurt those I loved the most and I began to understand that if God made me, formed me in the womb with His own hands, I could not be a waste of breath.

I recovered from my depression with God's help and the help of a wonderful, Christian counselor. He helped me see that my life did have meaning and purpose. 

If you are struggling with depression, please seek help. Reach out. There are people who care about you and would be devastated if you disappeared from their lives.

Monday, December 19, 2011

Joint Protection in RA

Joint protection in Rheumatoid Arthritis is very important to help prevent damage, preserve joint function and to manage day to day pain. RA can cause permanent damage and the affected joints cannot tolerate the pushing, pulling and stress that a healthy joint can.

It's important to move your joints through full range of motion exercises each day but use caution and do not move past the point of a tolerable stretch. Move slowly and methodically as you go through the range of motion exercises. Listen to your body. Some days you will have a greater range of motion in your joints than other days.

When using your hands, don't use movements that push your fingers toward the pinkie finger. Instead, push your hands in the other direction. When wiping a counter, for example, make a point of wiping in the direction with the little finger leading, this will push your fingers toward the thumb instead of toward the pinkie finger. Also, grip the sponge or rag losely and not with a tight grip.

Writing with a small pen or pencil for prolonged periods places stress on the finger joints. Use a fat pen or build up your pen with foam. Also, look for gel ink or other pens that have easy ink flow and require less pressure.

If you are opening a package, don't try to pull it open with your fingers, use scissors, a knife or other utensil to prevent undue stress on your joints.

Something as simple as turning a key can add to joint damage. Use a built up key or a key turner when opening locks, starting your car or locking doors.

Also avoid making tight fists. Use ergonomic handled tools and kitchen tools. Good Grips makes a line of ergonomic grips to help prevent damage to the hands. You can also use foam to build up handles on kitchen tools, yard tools, or home tools.

It's also important to use fat handled mugs or cups instead of the dainty cups with a small handle.

It's also important to carry things like laundry baskets with open hands. Hold books, plates, bowls, etc with a flat palm. When reading, if you are going to read for a prolonged period, use a book holder or rest your book on a pillow as you read.

You can also download a PDF file Here from Kleinert Institute that includes many ideas for joint protection.

Wednesday, December 7, 2011

Depression and Rheumatoid Arthritis

Depression and Rheumatoid Arthritis seem to go hand in hand. In fact, according to a research study funded by the Arthritis Foundation, a recent diagnosis of RA and the associated disability put the patient at a greater risk for developing depression. In addition, outcomes are generally worse for RA patients who suffer from depression as compared to those who do not.

Another study from 2008 showed that RA patients are twice as likely to experience depression but most do not discuss this with their physicians. The study showed that almost eleven percent of RA patients suffered from moderate to severe symptoms of depression but only one in five would discuss these symptoms with their physician.

While we all feel blue or sad at times. If these feelings become overwhelming or last for long periods of time then they interfere with the patent's ability to enjoy life and live a normal, active life. At this point, the patient should seek medical help for clinical depression.

Failure to seek help for depression can result in worsening of the symptoms and suicidal thoughts or attempts.

They symptoms of Depression include:
  • difficulty concentrating, remembering details, and making decisions
  • fatigue and decreased energy
  • feelings of guilt, worthlessness, and/or helplessness
  • feelings of hopelessness and/or pessimism
  • insomnia, early-morning wakefulness, or excessive sleeping
  • irritability, restlessness
  • loss of interest in activities or hobbies once pleasurable, including sex
  • overeating or appetite loss
  • persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
  • persistent sad, anxious, or "empty" feelings
  • thoughts of suicide, suicide attempts
Because depression can result in death, anyone who expresses suicidal thoughts or intentions must be taken seriously. If you or someone you care about is having these feelings, seek medical attention immediately or call the suicide hotlines:
  • 1-800-SUICIDE (1-800-784-2433)
  • 1-800-273 TALK (1-800-273-8255)
  • 1-800-799-4TTY (1-800-799-4889) Deaf hotline
Warning signs of suicide may include:
  • a sudden switch from being very sad to being very calm or appearing to be happy
  • always talking or thinking about death
  • clinical depression (deep sadness, loss of interest, trouble sleeping and eating) that gets worse
  • having a "death wish," tempting fate by taking risks that could lead to death, like driving through red lights
  • losing interest in things one used to care about
  • making comments about being hopeless, helpless, or worthless
  • putting affairs in order, tying up loose ends, changing a will
  • saying things like "It would be better if I wasn't here" or "I want out"
  • talking about suicide (killing one's self)
  • visiting or calling people one cares about
Depression is not something to be embarrassed about. It is a medical problem that will not improve without help. If you are having symptoms of feeling down or blue that don't go away, talk to your physician before the depression becomes worse.

Remember, you do not have to face this alone.

Friday, December 2, 2011

Facing the Holidays with Fatigue

Rheumatoid Arthritis and the accompanying autoimmune diseases cause severe fatigue. This lack of energy is more than just feeling tired. It causes a debilitating fatigue that is often worse upon waking up from a full-night's sleep.

RA can also cause anemia, adding to the fatigue that makes daily life difficult and when when the holidays roll around, trying to complete the cooking, decorating and Christmas shopping may be overwhelming.

Some ways to cope around the holidays and everyday:

  1. Prioritize - think about which things are the most important to you and do those first.
  2. Ask for help -It's difficult for those without RA to understand the fatigue but once you explain it to them, many will be more than willing to help. Ask them to assist with specific things. If your friend is going to the store, ask her to pick up something for you while she's there. Ask family members, to help with the housework, laundry, etc.
  3. Eat a well-balanced diet - Divide your plate in half and then divide one of the sides into fourths. Half of the plate should be vegetables, one-fourth meat and one-fourth carbohydrate. For snacks, try to stick to fruits and vegetables.
  4. Exercise - It's difficult to exercise when you feel exhausted but lack of exercise creates a vicious cycle. After checking with your physician to ensure you are healthy enough to exercise, begin small, walk in place during commercials while watching TV and slowly build until you can walk around the block.
  5. Rest - Get plenty of sleep. People with RA need at least ten hours of sleep per night. An afternoon nap of thirty-minutes to one hour will help re-energize you also.
  6. Take medication - Take your medications to keep the inflammation in check. When you have increased inflammation, your fatigue will be worse.
  7. Decorating - When decorating for Christmas, don't go all out. Put out a few of your favorite things, buy a small tree and just enjoy the season without pushing yourself to the point that exhaustion overwhelms you.
  8. Meals - Allow others to cook Thanksgiving and Christmas dinners. If you choose to prepare part of the meal, have other family members bring side dishes. Or for a totally different twist, have sandwiches or finger foods. Purchasing a pre-cooked meal is another option. Many restaurants will prepare the entire dinner for you and all you must do is pick it up. Or ask a family member pick up it up.
  9. Shopping - Try cyber shopping. There are some great sites out there and many of them will even send your gifts directly to the recipient - Amazon will even gift-wrap for you.
  10. Wrapping  - instead of going all out making the packages look just perfect, opt for gift bags or have the store do the gift wrapping.
  11. Christmas Cards - If you feel the need to send Christmas cards, order pre-printed ones so you don't have to write out each one. If you order photo cards from Snapfish, you can upload your mailing list, and they will address them and send them out for you.
The main thing to remember during the holiday season, is not to over extend yourself. It's very easy to want to do all of the special things this time of year and attend all of the Christmas parties and fun functions but balancing these desires with your energy level is imperative in order to enjoy the Christmas season.