Posts

Depression in Seniors is Often Unnoticed

depression uptown dallas counseling

Family members and even primary healthcare providers often mistake an older adult’s symptoms of depression as just a natural reaction to illness or an unavoidable part of the aging process. Older adults themselves often share this belief and suffer unnecessarily because they don’t understand that they could feel better with appropriate treatment.

Statistics on Mental Health and Seniors

Recent data indicate that an estimated 20.4 percent of adults aged 65 and older met criteria for a mental disorder. (Karel, Gatz & Smyer, 2012). The CDC’s 2013 report on The State of Aging and Health in America identified “addressing mental distress among older adults” as one of its primary Calls To Action needed to improve the health and well-being of older adults.  The CDC estimates:  About 25% of adults aged 65 years or older have some type of mental health problem, such as a mood disorder not associated with normal aging. Mental distress is a problem by itself, and it has been associated with unhealthy behaviors than can interfere with self-management and inhibit recovery from an illness.  

How Can we Help Change these Statistics?

Talking to seniors about their mental health can be challenging. Family members, caregivers, and even many medical professionals are not trained to assess mental disorders.  Conversations can be awkward.  Seniors are often reluctant to talk about their symptoms.  

The most common mental disorder among older adults is depression.  Depression, once diagnosed, often responds quickly to treatment.  Most older adults with depression improve when they receive treatment with an antidepressant, psychotherapy, or a combination of both. If left untreated, however, depression may result in the onset of physical, cognitive, functional, and social impairment, as well as decreased quality of life. 

If you suspect an older adult has depression, there is an easy, direct way to talk with them about their symptoms.  The Geriatric Depression Scale (GDS) is a reliable 15-question assessment that anyone can use.  Ask the senior to answer the following questions:

Geriatric Depression Scale: Short Form
Choose the best answer for how you have felt over the past week:
1. Are you basically satisfied with your life? YES / NO
2. Have you dropped many of your activities and interests? YES / NO
3. Do you feel that your life is empty? YES / NO
4. Do you often get bored? YES / NO
5. Are you in good spirits most of the time? YES / NO
6. Are you afraid that something bad is going to happen to you? YES / NO
7. Do you feel happy most of the time? YES / NO
8. Do you often feel helpless? YES / NO
9. Do you prefer to stay at home, rather than going out and doing new things? YES / NO
10. Do you feel you have more problems with memory than most? YES / NO
11. Do you think it is wonderful to be alive now? YES / NO
12. Do you feel pretty worthless the way you are now? YES / NO
13. Do you feel full of energy? YES / NO
14. Do you feel that your situation is hopeless? YES / NO
15. Do you think that most people are better off than you are? YES / NO

Answers in bold indicate depression. Score 1 point for each bolded answer.
A score > 5 points is suggestive of depression.
A score ≥ 10 points is almost always indicative of depression.

Source: http://www.stanford.edu/~yesavage/GDS.html
This scale is in the public domain.

Any score greater than 5  warrants a follow-up assessment by a medical professional. If your senior scores higher than 5, help them schedule an appointment to discuss the results and form a treatment plan with a healthcare provider.

If you or someone you care about is in crisis, please seek help immediately using one of the following methods:

  • Call 911
  • Visit a nearby emergency department or your health care provider’s office
  • Call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (4889) to talk to a trained counselor

Sources: 

Centers for Disease Control and Prevention. The State of Aging and Health in America 2013. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2013.

Karel, M. J., Gatz, M. & Smyer, M. A. (2012). Aging and mental health in the decade ahead: What psychologists need to know. American Psychologist, 67, 184-198.

Lyness JM, Noel T, Cox C, King DA, Conwell Y, Caine ED. Screening for Depression in Elderly Primary Care Patients: A Comparison of the Center for Epidemiologic Studies—Depression Scale and the Geriatric Depression Scale. Arch Intern Med. 1997;157(4):449-454. doi:10.1001/archinte.1997.00440250107012.

U.S. Department of Health and Human Services, National
Institutes of Health, National Institute of Mental Health. (2015).
Depression (NIH Publication No. 15-3561). Bethesda, MD: U.S.
Government Printing Office.

 

 

Depression: Waiting 10 Years for Help

depression uptown dallas
One in 10 Americans are suffering from Depression at any given time. Are you worried someone you know may be more than just sad? It is often hard to know the difference between Clinical Depression and sadness. In this 4-minute Ted-Ed video, Helen M. Farrell examines the symptoms and treatments of depression, and gives some tips for how you might help a friend who is suffering.

A surprising statistic from the video:
An individual waits and average of 10 years to seek help for depression.

CBT For Weight Loss

quote

The concepts from Cognitive Behavioral Therapy (CBT)  can be especially helpful when trying to lose weight.  In this week’s ReadersINC blog post, Anthony Healy, a personal trainer at Vivacia, outlines ideas on motivation for weight loss.  Each of these ideas is an example of techniques learned during Cognitive Behavioral Therapy.

Here are Anthony’s top tips on how to motivate yourself to lose weight:

1. Decide why you want to lose weight

Is it to look good in a bikini, to feel better about yourself or another reason?

2. Set goals

‘Lose weight’ is too vague. You need a clear and achievable goal, such as ‘lose 10lb in 10 weeks’. Write down how you’re going to achieve this, such as ‘run three times a week’ or ‘go to the gym every Monday, Wednesday and Friday’ and STICK TO IT.

2. Create visual goals

Visual cues are a great motivator. If you want to look good on the beach in a size 10 bikini then buy that bikini (or dress for special occasion/favorite pair of jeans) and hang it outside your wardrobe.

3. Write a morning mantra

Write and then read a motivational mantra every day. Make the goal seem like something that has already having been achieved,

E.g. “I have successfully lost 10lbs, and I am about to board the plane for Spain at Heathrow airport. I can’t wait to get to the beach in my yellow bikini….”

By doing so you get the good feelings associated with the goal ahead of time.

4. Kick the bad habits

Long-term transformations take time.

To get quick results and keep the weight off you need to kick bad habits.

In the beginning you need to go cold turkey. For many people the enemy is booze, processed food and/or sugar in all its forms – most obviously, chocolate and sweets.

Giving these up for at least 6-12 weeks “breaks the back” of the usual suspects, forms some good eating habits, and brings about those quick results – which will keep you motivated and “hungry” for more success.

5. Think positive

With sufficient motivation anything is achievable, and those obstacles can now be overcome.

CBT for Anger Management

Image courtesy of artur84 at FreeDigitalPhotos.net

Image courtesy of artur84 at FreeDigitalPhotos.net

CBT for Anger is one of the most effective ways to treat uncontrolled anger problems.  Anger can be managed using a method from Cognitive Behavioral Therapy (CBT) called Cognitive Reframing.

 

 

In the following article published on PsychCentral.com, Dr. Hartwell-Walker outlines 7 common assumptions that can be reframed to reduce anger.

7 Mistaken Assumptions Angry People Make By Marie Hartwell-Walker, Ed.D.

I guess I have an anger problem. I lose my temper pretty quick. But it’s not like my wife doesn’t do things to make me mad.”

Richard has reluctantly come to treatment because his wife took out a restraining order after their last fight. He admits he lost control. He acknowledges that maybe he said things he shouldn’t have. But he also thinks she shouldn’t have done or said what she did. “I can’t help getting mad when she jerks my chain. I can’t let her get away with that!” he says.

What Richard doesn’t yet understand is this: Temper isn’t something you lose. It’s something you decide to throw away.

Raging, shouting, name-calling, throwing things and threatening harm is all a big bluff. It’s the human equivalent of animal behavior. From the puffer fish that puffs itself up to twice its size to look more intimidating to the lion on the veldt who shakes his mane and roars, creatures who feel threatened posture and threaten in order to protect themselves and their turf. The display often is enough to get the predator or interloper to back off. If not, the fight — or flight — is on.

People who rage are the same. Feeling a threat, they posture. They throw away all mature controls and rant and rage like an out-of-control 2-year-old. It’s impressive. It’s scary. It gets folks around them to walk around on eggshells. Others often let them “win” just to get away.

But are they happy? Usually not. When I talk to the Richards of the world, they usually just want things to go right. They want respect. They want their kids and their partners to give them the authority they think they deserve. Sadly, their tactics backfire. Not knowing what might set him off, kids, partners, coworkers and friends distance and leave him more and more alone.

Helping someone like Richard with “anger management” requires more than helping him learn how to express his angry feelings appropriately. Giving him practical skills alone assumes more control than he can probably hold on to. To be able to integrate those skills into his self-image, he needs to reconsider some of his basic assumptions about life and his place in it.

 

7 Mistaken Assumptions Angry People Often Make

They can’t help it. Angry people have lots of excuses. Women will blame their PMS. Both sexes will blame their stress, their exhaustion, or their worries. Never mind that other people who have PMS or who are stressed, tired, or worried don’t pop off at the world. Angry people don’t yet understand that they are actually giving themselves permission to rant. In that sense, they are very much in control.
The only way to express anger is to explode. People who rage believe that anger is like the buildup of steam in an overheated steam engine. They think they need to blow off the steam in order to be OK. In fact, raging tends only to produce more of the same.
Frustration is intolerable. Angry people can’t sit with frustration, anxiety or fear. To them, such feelings are a signal that they are being challenged. When life doesn’t go their way, when someone doesn’t see things as they do, when their best-laid plans get interrupted or they make a mistake, they simply can’t tolerate it. To them, it’s better to blow than to be left with those feelings. They don’t get it that frustration is a normal part of everyone’s life and that it is often the source of creativity and inspiration.
It’s more important to win than to be right. Chronically angry people often have the idea that their status is at stake when there is conflict. When questioned, they take it overly personally. If they are losing an argument, they experience a loss of self-esteem. At that moment, they need to assert their authority, even if they are wrong. When it is certain that they are wrong, they will find a way to prove that the other person is more wrong. For mature people, self-esteem is grounded in being able to put ego aside in order to find the best solution.
“Respect” means that people do things their way. When another driver tailgates, when a partner refuses to go along with a plan, when a kid doesn’t jump when told to do something, they feel disrespected. To them, disrespect is intolerable. Making a lot of noise and threatening is their way of reasserting their right to “respect” by others. Sadly, when the basis of “respect” is fear, it takes a toll on love and caring.
The way to make things right is to fight. Some angry people have learned at the feet of a master. Having grown up with parents who fight, it is their “normal.” They haven’t a clue how to negotiate differences or manage conflict except by escalating. Then they become very much like the parent they loathed and feared when they were kids.
Other people should understand that they didn’t mean what they did or said when they were angry. Angry people feel that anger entitles them to let loose. It’s up to other people not to take seriously hurtful things they say or do. After all, they say, they were just angry. They don’t get it that other people are legitimately hurt, embarrassed, humiliated, or afraid.
Helping my patient Richard means helping him identify which of these assumptions are driving his temper tantrums. Some or all may apply. He may even have a few that are more uniquely his own. Teaching him rules for anger management, although important, isn’t enough to have long-term impact. Changing his assumptions will enable him to use such skills with conviction and confidence.

Source:

7 Mistaken Assumptions Angry People Make By Marie Hartwell-Walker, Ed.D.

Bravo, Kate Middleton!

HRH Duchess of Cambridge

Kate Middleton

In this video, HRH The Duchess of Cambridge pledges her support for children’s mental health by endorsing The Place to Be, a charitable organization for children in the UK.  The Pace to Be is “the leading UK provider of school-based mental health support, unlocking children’s potential in the classroom – and beyond.”

The Place to be has declared February 16-22 the first Children’s Mental Health Week in the UK.  Thanks to all who are bringing this important message to the public.

#ChildrensMHW

FRIDAY FUN POST: Weekend Reading Plans

For this week’s Friday Fun Post, I hope to start (and complete!) this book over the weekend:
friday fun post Proof of Heaven
PROOF OF HEAVEN, by Eben Alexander. (Simon & Schuster.) A neurosurgeon recounts his near death experience during a coma from bacterial meningitis.
 
Curling up with a good book and cup to tea is one of my favorite ways to relax and recharge.
Do you read or listen?  Paperback or Ebook? Fiction or non-fiction?

Holly Scott, MBA, MS, LPC sees clients at Uptown Dallas Counseling. Holly is trained in the specialty of Cognitive Behavioral Therapy, and holds the position of Diplomate in the Academy of Cognitive Therapy. Holly works with clients to help them overcome challenges in their daily lives that may be preventing them from achieving happiness. She helps clients with stress management, depression, parenting, marriage counseling, and other mental health concerns. If you are looking for a counselor or therapist, explore this website to see if Holly may be able to help you. 

To make an appointment for therapy or counseling with Holly at her Uptown Dallas Counseling, you have the option of using the Online Patient Portal to register and schedule. 

Building Self-Esteem

One way to measure your self-esteem.  A fun, easy exercise.

“Where do you want to go to lunch today?”  Do you often answer this question with, “I don’t care” or “I don’t know”?  Do you ever spend time thinking about what you want?  Tina Gilbertson, MA describes an easy “I like, I don’t like” exercise that can actually help you build self esteem.  Try it out, and see what you think.

self-esteem happiness
From the Good Therapy Blog by Tina Gilbertson, MA:

Holly Scott, MBA, MS, LPC sees clients at Uptown Dallas Counseling. Holly is trained in the specialty of Cognitive Behavioral Therapy, and holds the position of Diplomate in the Academy of Cognitive Therapy. Holly works with clients to help them overcome challenges in their daily lives that may be preventing them from achieving happiness. She helps clients with stress management, depression, parenting, marriage counseling, and other mental health concerns. If you are looking for a counselor or therapist, explore this website to see if Holly may be able to help you. 

To make an appointment for therapy or counseling with Holly at her Uptown Dallas Counseling, you have the option of using the Online Patient Portal to register and schedule. 

Life Goals: Are They Actually Distractions?

Your audacious life goals are fabulous. We’re proud of you for having
them. But it’s possible that those goals are designed to distract you
from the thing that’s really frightening you—the shift in daily habits
that would mean a re–invention of how you see yourself.
—Seth Godin
life goals and distraction
One of my favorite writers is Seth Godin, and I particularly this idea.  Do you think your goals are actually distractions?

Holly Scott, MBA, MS, LPC sees clients at Uptown Dallas Counseling. Holly is trained in the specialty of Cognitive Behavioral Therapy, and holds the position of Diplomate in the Academy of Cognitive Therapy. Holly works with clients to help them overcome challenges in their daily lives that may be preventing them from achieving happiness. She helps clients with stress management, depression, parenting, marriage counseling, and other mental health concerns. If you are looking for a counselor or therapist, explore this website to see if Holly may be able to help you. 

To make an appointment for therapy or counseling with Holly at her Uptown Dallas Counseling, you have the option of using the Online Patient Portal to register and schedule. 

Friday Fun Post: Happiness

Thinking about happiness:  Because I live through the long, hot summers in Texas, I am a HUGE fan of Autumn.  The cooler temperatures, rainy days, “sweater weather”, and especially the changes in the leaves.  Just discovered via www.Mashable.com that I can track the progress of changing colors across the country using a U.S Forest Service website.

Happiness

Fall Colors 2013 provides a color-coded map of the US indicating where the leaves have begun to change, where colors are at their peak, and where the leaves have fallen.  The site also provides a toll-free number where you can get updates on specific areas.  It is a great resource of you are planning a trip to see fall foliage.

Happy Fall and Happy Friday!

Holly Scott, MBA, MS, LPC sees clients at Uptown Dallas Counseling. Holly is trained in the specialty of Cognitive Behavioral Therapy, and holds the position of Diplomate in the Academy of Cognitive Therapy. Holly works with clients to help them overcome challenges in their daily lives that may be preventing them from achieving happiness. She helps clients with stress management, depression, parenting, marriage counseling, and other mental health concerns. If you are looking for a counselor or therapist, explore this website to see if Holly may be able to help you. 

To make an appointment for therapy or counseling with Holly at her Uptown Dallas Counseling, you have the option of using the Online Patient Portal to register and schedule. 

Just Discovered Alana Karsch on Upworthy.com

As I was doing my evening internet browsing, I read some posts on Upworthy.com and tweets by Alana Karsch.  Liked them so much, I wanted to share her information here:

Google+
Facebook

upworthy.com

Alana Karsch

 By day I’m a transformative photographer and art therapist. At night, I sleuth the web for outrageously important stuff. I want you to be happier, smarter, healthier, and more generous. Also, I want to paint the world with watercolors and glitter. Share all this important goodness with me on Facebook and Twitter.- Alana Karsch

I love her goals and the approach she uses to try to achieve them.  Take a look.  You may also like them.