Shades of BlueShades of Blue

Grief and Depression in Grief and Depression in Chronic IllnessChronic IllnessRamita Bonadonna, PhD, RNRamita Bonadonna, PhD, RN

GriefGrief

Is a normal emotional response to a Is a normal emotional response to a loss of someone/something valuedloss of someone/something valued

A person living with IPF has A person living with IPF has experienced many lossesexperienced many losses– ““Healthy” self-image: medical care Healthy” self-image: medical care

becomes centralbecomes central– Decreased ability to engage in physical, Decreased ability to engage in physical,

social activitiessocial activities– Altered social, economic statusAltered social, economic status

Grief can look likeGrief can look like

Anger, irritability, impatienceAnger, irritability, impatience Sadness, tearfulnessSadness, tearfulness Exhaustion, fatigue, heavinessExhaustion, fatigue, heaviness Poor concentration/memoryPoor concentration/memory Yearning for what has been lost, Yearning for what has been lost,

preoccupation with pastpreoccupation with past

Grief can become Grief can become complicatedcomplicated

Absence of Absence of anyany emotion may emotion may indicate delayed grief responseindicate delayed grief response

Depression is one type of Depression is one type of “distorted” grief reaction“distorted” grief reaction

““Of course I’m Of course I’m depressed...”depressed...” Depression affects 1 in 10 people Depression affects 1 in 10 people

with chronic medical illnesswith chronic medical illness Depression is one of the most Depression is one of the most

“treat-able” of mental disorders“treat-able” of mental disorders Untreated depression impacts the Untreated depression impacts the

immune system and can immune system and can complicate recovery from acute complicate recovery from acute episodes of illnessepisodes of illness

Criteria for Major Criteria for Major Depressive DisorderDepressive Disorder Either depressed mood or loss of Either depressed mood or loss of

interest/pleasure for 2 wks, plus 4 of interest/pleasure for 2 wks, plus 4 of the followingthe following– Weight loss/gainWeight loss/gain– Insomnia/hypersomniaInsomnia/hypersomnia– Restlessness/lethargyRestlessness/lethargy– FatigueFatigue– WorthlessnessWorthlessness– Diminished ability to thinkDiminished ability to think– Recurrent thoughts of death/suicideRecurrent thoughts of death/suicide

Factors that increase Factors that increase risk of Depressive risk of Depressive DisorderDisorder Prior episodes, family hx of Prior episodes, family hx of

depressiondepression Female genderFemale gender Lack of social supportLack of social support Stressful life eventsStressful life events Personal hx of abusePersonal hx of abuse Current substance abuseCurrent substance abuse

If you suspect you If you suspect you might be depressed…might be depressed…

Seek help! Discuss your concerns Seek help! Discuss your concerns with your primary care provider with your primary care provider or a mental health professional.or a mental health professional.

The The combinationcombination of of psychotherapy and medication is psychotherapy and medication is the most effective treatment for the most effective treatment for depression.depression.

If someone you care If someone you care about seems about seems depressed…depressed… Let them know you are concerned Let them know you are concerned

about their mood.about their mood. Ask about suicidal thoughts.Ask about suicidal thoughts. Listen.Listen. Use the Use the 211 Hotline211 Hotline in crisis in crisis

situations and to identify mental situations and to identify mental health resources in your health resources in your community.community.

And in the end, it's not And in the end, it's not the years in your life that the years in your life that count. It's the life in your count. It's the life in your years.years.

Abraham LincolnAbraham Lincoln