When Chronic Illness Feels Like Depression

Am I depressed or just sick? Am I depressed because I am ill? Am I ill because I am depressed?

The National Institute of Mental Health provides the following list as signs of depression:

  • Feeling sad, irritable, or anxious;
  • Feeling empty, hopeless, guilty, or worthless;
  • Loss of pleasure in usually-enjoyed hobbies or activities, including sex;
  • Fatigue and decreased energy, feeling listless;
  • Trouble concentrating, remembering details, and making decisions;
  • Not being able to sleep, or sleeping too much. Waking too early;
  • Eating too much or not wanting to eat at all, possibly with unplanned weight gain or loss;
  • Thoughts of death, suicide or suicide attempts; and/or,
  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment.

Think about that list. Most of the items, with possible exceptions of the final two, are fairly common in cases of chronic disease or illness. For the individual, this can create uncertainty regarding mental, or even physical, health. If the root cause is unclear, so too is the treatment plan.

What does this mean for the individual? I think it means that those of us dealing with chronic illness need to take it easy on ourselves when we can’t maintain a positive mental state. It doesn’t mean we should give up, but we shouldn’t feel so guilty.

What does this mean for caregivers? Patients with chronic conditions may need treatment for depression or they may need to be reassured that these feelings don’t necessarily mean clinical depression. Caregivers may need to spend more time talking to patients to get at the psychological and emotional issues, and maybe be prepared for some tears, or guilt, or anger.

What does this mean for family and friends? The person you care for may not be able to be as fun as you want, even during times when the illness seems to be under relative control. Your loved one may need you more mentally or emotionally than physically, but simultaneously may feel an abundance of shame about that. And you may, in turn, be angry or frustrated and need to find someone else to talk to about it.

The interaction between chronic illness/disease and mental wellbeing is complicated, like people are. We can’t expect it to be simple or easy, whether we are the patient or those offering support.

Helping Your Friends and Family – The “Right” Way

I’m going a little off-brand today, though what I am about to discuss relates quite well to the concept of karma yoga. So, here we go.

This has been a weird few months in my life, starting with an unexpected but serious health event at the end of June, which coincided with a setback in the treatment of a long-term health issue, and then was followed by a broken foot (I’m now at week 6 of crutches), and a nice immune-system malfunction requiring antibiotics that make me sick. Getting old is a festival, but it sure beats the alternative. I know many others in my friend and colleague groups that have also been going through the hard stuff.

This has also been a pretty horrifying year on the world stage, and the U.S. has been a roiling mass of rage, entitlement, anger, and violence. That has produced a massive amount of sorrow and confusion for U.S. residents of all ages, as well as those watching from around the world.

So, I’m not alone in needing some extra help recently. But, asking for help is, for most of us, really hard. The individualism and belief in self-determination that characterizes the national culture has rendered many people almost incapable of asking for help. I see this in students who won’t go to counseling or tutoring (though I think more of the college generation are comfortable admitting they need emotional assistance than my generation is/was). I see this in friends who are in the sandwich generation managing the dual roles of parenting children and caring for parents, but not asking for support. I see this in colleagues going through serious health issues and trying not to do any less at work. And I see this in myself.

I’ve struggled mightily asking for help this summer. At home, I’ve been better with it. But, even there I tend to wait for my incredibly supportive spouse to come and say “do you need anything?” before I will ask (he understands because he is very unlikely to ever ask for help!). With friends and colleagues, it’s even worse. I’ve tried to miss as little work as possible, no matter how I feel. I’ve hauled myself up and down stairs lugging as much as I can on crutches because I don’t want to ask for assistance, and so on. All of this has made me think about how we offer and give help.

I think most of us have, at times, had a friend go through something – whether it is a surgery or a family crisis or an illness – and said “let me know if you need help.” We are sincere when we say it, but it puts all of the burden on the individual who is already dealing with something serious. It requires that the person suffering reach out to us and ask for the specific help needed, and that is not easy. And when there are others involved – if the person has a family or spouse somewhere in the vicinity – it may be even harder to ask for help from others without making the family members feel like they aren’t doing enough.

So, what is better? While I’m no expert – hence the “Right” in the title of this post – I think it’s better to offer specific help in ways that are more of an offer and less of a question. It’s better to offer help in a way that makes other people not feel that they are asking too much. It’s better to offer a level of help we can legitimately follow through on, because it’s really hard to get up your nerve to ask for help and get a no.

Instead of “Let me know if I can help,” maybe try:

  • I take my trash out to the curb/dumpster on Sundays. I’ll stop by and get yours around noon.
  • I go to the grocery store every Tuesday and drive by your place on my way back. I’ll text you on Monday to see what you need.
  • I’m making extras of casseroles for the freezer this month so I can use them over the holidays. I’m going to drop a few off.
  • I am headed to the laundry tomorrow after work. I’ll drop by and grab your stuff and bring it back ready for folding.
  • My teens could really use some experience with cleaning/yard work/pet care. Let me bring them over for an hour on Saturday afternoon. We’ll have coffee and they can get some stuff done.
  • I’ve been wanting to give that report/task a try. Let me do this one.
  • I know your spouse is making sure you get fed well, but I’m going to drop of dinner on Saturday so you can both take a break.
  • I’m going to get reiki on Saturday. I would love to go together, my treat!
  • I know you have to go to the X doctor on Wednesday and you should not have to do that alone. I’ll pick you up and we’ll go to lunch afterwards.

This kind of offering takes more work on the part of the giver. We have to think more about what the other might need. It requires us to be more authentic to ourselves and the other regarding what we are really willing/able to do. But, it takes the weight off of a friend, family member, or colleague who is already feeling burdenend, and that’s what we want to do in the first place.

Do you find asking for help a challenge? How about offering? What are your strategies for either one?



Splendid Spoon – The Trial

A few weeks ago, I decided to give Splendid Spoon (http://splendidspoon.com – not an affiliate link). a try. I signed up at the standard cost and plunked down my money for a week’s subscription to show up at my door.

And then I waited for my selected delivery day – Wednesday. The order arrived. Theoretically, it was food for 5 breakfasts/snacks, 5 lunches, and a day of soup fasting. They anticipate you will make something else for your dinner.

Eating 3 meals just doesn’t happen in my life, so for me, this was going to be 5 brunches and 5 dinners, and then the extras spread out into the next week since I’m typically not at this location on the weekends.

I timed it pretty well, because shortly after I got the order, I broke my foot.
Oops. That was unexpected. So, it was good to have food around that I didn’t have to really think about to get a meal in. And, living on my own Monday to Friday, it wasn’t like someone was going to make dinner for me.

The food arrives frozen and WAY packed in ice. It could sit out for quite a while and would not thaw enough to be a problem. After you receive it, you can let it thaw in the fridge and use within a week, or keep in your freezer. The soups mostly come in bowls (with a few exceptions) and the smoothies in bottles.

I’m now finishing up my second delivery from Splendid Spoon and here are my general thoughts. The soups are good. I like to add some salt or salt substitute, nutritional yeast, or hot sauce to them. They tend to be a little bit bland, but are quite filling and the ingredients don’t taste over-cooked. The broccoli still has a bit of crunch, which is nice. I haven’t run into a soup that I really didn’t like, though the beet bowl was not my favorite. While they say that you can eat them at any temperature, I find that I prefer them hot.

The smoothies are ok. I prefer my smoothies to be pretty smooth and most of these have some sort of texture that requires chewing, whether that is coconut, nuts, or seeds. Because I don’t do the soup fast, and some of those come in the smoothie containers, I’ve been a little fooled a couple of times. I tried to drink a bottle of apple and parsnip straight up and cold and then gagged on the onion flavor.

Would I recommend Splendid Spoon? Yes, with reservations. It’s not inexpensive if you are using it for 2 meals a day and then adding a third meal, plus having 1 day a week that you have to have other food for. Since I’m supplementing only with a little probiotic stuff (yogurt and sauerkraut), some apples, coffee, and other drinks, and then some food on Saturdays and Sunday mornings, it’s not so bad. I’m also only getting a shipment every 2nd or 3rd week.

But, if cooking anything interesting for yourself is a struggle, this might be a good idea. And, there is no commitment, so it’s worth it to get a week and try. You can order once and stop, or keep going but skip any weeks you are not interested in.

Have you tried a food delivery service with vegan items? What did you think?