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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.

Anxiety or Excitement: You Decide

Interesting article in the New York Times today about the whether you perceive an elevated heart rate as anxiety or excitement; and how this perception can affect your ability to successfully negotiate:

anxiety or excitement, you decided

photo courtesy of the New York Times

A study from MIT recently showed that when confident people enter a negotiation, they perform better if they have an elevated heart rate.  So if you are looking forward to asking for that raise from your boss, get on a treadmill, get her on the phone, and ask.  You are more likely to achieve success than if you talked with her while seated at your desk.

What about people who are not confident about their ability to negotiate?  If you are nervous and doubt your abilities, you may label that elevated heart rate while on the treadmill as anxiety.  If you label physical response from exercising (pounding heart, shortness of breath, & sweating) as anxiety, you will perform worse than if you negotiated while resting.  If, however, you can say to yourself, “I always feel this way when I exercise”, “this is a natural, expected response”, and “I am excited to be asking for a raise”, you will improve your ability to engage in negotiations. 


Alison Wood Brooks, Assistant Professor of Business Administration and a scholar at the Harvard Business School, recommends:

“Get on the treadmill, get your heart racing and once it’s racing, 
appraise the feeling as excitement — tell yourself ‘I am excited, not anxious,’ ” 
she said. “And then go forth and prosper.”


Source:New York Times Article

Happiness at 103 years old

Really fun article in the New York Times describing the nightly dining habits of 103-year-old Harry Rosen.  He believes his nightly meal out is his therapy that has contributed to his long, productive life.Sounds good to me!

happiness

Photo: Dave Sanders New York Times
Harry Rosen with a photo of himself in his 20’s.

http://www.nytimes.com/2013/09/29/nyregion/a-nightly-dinner-out-thats-like-therapy.html?src=me

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. 

Decisions and Emotions

decisions and emotionsChipotle’s Scarecrow video and game app is an effort to influence your decisions and emotions.  If you haven’t seen the video, you can view it here:

The video went viral with almost 6 million views on youtube and received wide critical acclaim for the video production quality.

The Week’s Peter Weber calls it “the most beautiful, haunting infomercial you’ll ever see.”  Read Peter Weber’s Review to see the rest of his opinions on the advertisement.
On the other hand, Funny or Die has produced a scathing video parody of  Scarecrow.  You can watch that video along with commentary by Scott Meslow here:

Critics of the Scarecrow campaign believe Chipotle is misleading consumers by displaying an inaccurate view of current factory farming practices.  Others believe Chipotle is attempting to make changes to current practices by increasing awareness.  Chipotle chief marketing officer Mark Crumpacker states in a USA Today article, “We’re trying to educate people about where their food comes from.”

Human beings make decisions based on emotions.  Chipotle’s Scarecrow is a classic attempt at generating an emotional response in individuals that will lead to buying decisions that are favorable to Chipotle.  The rebuttal videos and commentaries are attempting to generate emotional responses that will lead to buying decision that are unfavorable to Chipotle.

Where do you stand?  Is Scarecrow unethical, or is it exactly the same as any other type of marketing we are exposed to everyday?

How an Addict make Choices

addicts

John Tienery reports today in the New York Times on the research of a professor of psychology at Columbia University.  Dr. Carl Hart’s experiments demonstrate an addict is able to make rational choices when given the opportunity to choose between a dose of the drug or cash rewards.  As the amount of the cash reward increases, and the amount of the drug offered decreases, the addict chooses the cash reward.

His findings represent a significant shift from the thinking that addicts will continue to choose more and more of their drug of choice no matter the consequences or other opportunities.  Dr. Hart suggests addicts can stop using drugs when offered more appealing alternatives.  He writes about the effect of drug addiction on his life and his scientific research findings in his book, High Price.

Mr. Tienery’s full article is Here

 

Happiness and Belonging

happiness

How Do We Find Happiness?


Dallas author and psychotherapist, Pamela Milam, writes about finding happiness on the website www.RewireMe.com.  In her article, I love the way Pamela describes her thinking as a young adult in the line:

“I just went with the societal flow without examining how I really felt or what I really wanted.”

As a psychotherapist, I regularly treat clients who are struggling with life choices and decisions of all kinds (financial, career, family) that were made based on societal flow. They describe themselves as very successful and “having it all”, and state they cannot understand their overwhelming feelings of emptiness or sadness. During the therapy process, they often find relief by allowing themselves to explore what they really want and separating individual wants from societal influences. They are able to find joy by making changes in their lives to honor their true feelings.

Can you find a way to allow yourself to explore what you really want, change your thinking, and create happiness?

CASAColumbia.org: News Room: 2012 Family Dinners Report

grandmother, father, daughter, son, motherHere’s a summary of the relationship between family dinners and teen drug abuse from CASAColumbia.  Some pretty powerful findings.

TEENS WHO HAVE EXCELLENT RELATIONSHIPS WITH THEIR PARENTS LESS LIKELY TO HAVE — USED MARIJUANA, ALCOHOL OR TOBACCO

NEW YORK, N.Y., SEPTEMBER 24, 2012

Teens who have frequent family dinners (5 to 7 per week) are more likely to report having excellent relationships with their parents, according to The Importance of Family Dinners VIII, a new white paper released today by The National Center on Addiction and Substance Abuse at Columbia University (CASAColumbia™).

The CASAColumbia white paper revealed that compared to teens who have infrequent family dinners (fewer than 3 per week), teens who have frequent family dinners are almost 1 ½ times likelier to say they have an excellent relationship with their mother and 1 ½ times likelier to say they have an excellent relationship with their father.

Relationships Between Parents and Teens are Important
Teens who have excellent relationships with their Mom and Dad are less likely to use drugs, drink or smoke. Compared to teens who say they have an excellent relationship with Dad, teens who have a less than very good relationship with their father are almost 4 times likelier to have used marijuana; twice as likely to have used alcohol; and 2½ times as likely to have used tobacco. And compared to teens who say they have an excellent relationship with Mom, teens who have a less than very good relationship with their mother are almost 3 times likelier to have used marijuana; 2 ½ times as likely to have used alcohol; and 2 ½ times likelier to have used tobacco.

“If I could wave a magic wand, I would make sure that every child in America had dinner with his or her parents at least five times a week. Dinner serves as an ideal time to strengthen the quality of family relationships and helps kids grow up healthy and drug free,” said Joseph A. Califano, Jr., Founder and Chairman Emeritus of CASAColumbia and former U.S. Secretary of Health, Education, and Welfare.

Family Dinners and Teen Substance Use
The CASAColumbia white paper found that compared to teens who have frequent family dinners, those who have infrequent family dinners are:

  • Almost 3 times likelier to say, “it’s okay for teens my age to use marijuana”
  • 3 ½ times likelier to say, “it’s okay for teens my age to get drunk”
  • Twice as likely to say that they expect to try drugs (including marijuana and prescription drugs without a prescription to get high) in the future

Family Dinners and Teen Stress Levels
Nearly half of teens surveyed report high levels of stress in their lives (6 or higher on a scale of 1 to 10). The white paper finds that compared to teens who have infrequent family dinners, teens who have dinner with their parents at least 5 times per week are less likely to report high levels of stress in their lives. Compared to teens who report low stress in their lives, those who report high stress are:

  • Nearly 3 times likelier to have used marijuana
  • Twice as likely to have used alcohol
  • Almost twice as likely to have used tobacco

“Family dinners are an excellent forum for parents to share their beliefs on substance use with their children, but dinner certainly isn’t the only time parents can engage with their children,” said Kathleen Manning, who manages the CASAColumbia Family Day initiative and is theCASAColumbia Director of Marketing. “Whenever the conversations occur, it is important for parents to talk to their teens about what is going on in their teen’s life and what is expected of them with respect to alcohol and drugs.”

Frequency of the Family Dinner
57% of teens surveyed report having family dinners with their families at least 5 times a week. The proportion of teens that have frequent dinner with their families has remained constant over the past decade.

“Teens who have frequent family dinners are more likely to say that their parents know a lot about what’s really going on in their lives, and such parental knowledge is associated with decreased incidence of teen substance use,” said Emily Feinstein, Senior Policy Analyst atCASAColumbia. “Family dinners are the perfect opportunity when kids can talk to their parents and their parents can listen and learn.”

Family Day — A Day to Eat Dinner with Your Children™
Family Day is a national movement launched by CASAColumbia in 2001 to remind parents that frequent family dinners make a difference. Celebrated on the fourth Monday in September—the 24th in 2012—promotes parental engagement as a simple and effective way to reduce children’s risk of smoking, drinking and using illegal drugs. What began as a small grassroots initiative has grown to become a nationwide celebration, which is expected to once again be proclaimed and supported by the president, all 50 U.S. governors and the mayors and executives of more than 1,000 cities and counties. This year the first spouses in 33 states are serving as Honorary Chairs of Family Day. The Coca-Cola Company is once again serving as Family Day’s Presenting Sponsor. Fourteen Major League Baseball teams are celebrating and promoting Family Day as well as The World Famous Harlem Globetrotters. The Empire State Building, Niagara Falls, the Wrigley Building in Chicago, the Cira Centre and One Liberty Place in Philadelphia, the Terminal Tower in Cleveland, and the governor’s residences in Nevada and New Jersey are lighting up in red and blue in support of Family Day. For more information about Family Day visitCASAFamilyDay.org or find Family Day on Facebook or Twitter.

The findings in this report come from The National Survey of American Attitudes on Substance Abuse XVII: Teens, released on August 22, 2012. QEV Analytics conducted the survey from April 18 to May 17, 2012. The firm interviewed at home by telephone a national random sample of 1,003 12- to 17-year olds (493 boys, 510 girls). Sampling error is +/- 3.1%.

CASAColumbia is a science-based, multidisciplinary organization focused on transforming society’s understanding of and response to the disease of addiction. Founded in 1992 by Former U.S. Secretary of Health, Education, and Welfare Joseph A. Califano, Jr., CASAColumbiaassembles the professional skills needed to research, prevent, treat and eliminate this disease.CASAColumbia conducts its own research and also utilizes the scientific findings of others to inform Americans of the economic and social costs of substance use and addiction in all sectors of society and its impact on their lives. CASAColumbia aims to reduce the stigma attached to this disease and replace shame with hope. For more information visit www.CASAColumbia.org.

Abstainer or Moderator? Gretchen Rubin explains why it matters to your Happiness

Couples-2During therapy, people often identify behavior changes (stop smoking, be more social, rekindle friendships) as one of their primary goals.  Changing behaviors comes more easily to some than others.  Gretchen Rubin writes in The Happiness Project about how to apply the studies and theories on happiness to your life.  The quiz below provides information on how to make changing behaviors easier for you.

Identifying yourself as a moderator or an abstainer is important for you to make better choices about the easiest way to make positive behavior changes.

 
You’re a moderator if you…
– find that occasional indulgence heightens your pleasure–and strengthens your resolve
– get panicky at the thought of “never” getting or doing something
 
You’re an abstainer if you…
– have trouble stopping something once you’ve started
– aren’t tempted by things that you’ve decided are off-limits
Knowing which strategy works best for you can be a great tool to help you change. There is no right way or wrong way.
Let’s say you want to start walking every morning before work.
If you are a moderator, you may want to use the 80/20 rule.  Ask yourself to adhere to the behavior change 80 percent of the time, but do not try to go “cold turkey”.  Plan to walk 5 or 6 days, but plan to allow yourself 1 or 2 days off each week.
An abstainer would want to plan to walk everyday.
If you are struggling with trying and failing to make a change in your life, try the above quiz, apply the results, and see if you are more successful!

Your Happiness

408px-Happy_man_in_a_rainy_dayI have become a big fan of Gretchen Rubin’s book The Happiness Project, and her website. According to Ms Rubin, we become unhappy “when we feel depleted and drained, and when we have no time or energy devoted to the things that give us pleasure.”  Treating ourselves throughout the day with small pleasures is an important way to avoid those feeling of depletion and to prevent becoming unhappy.  

Ms Rubin suggests creating a list of treats and pleasures that have a very low cost in time, energy, or money. Ms Rubin’s readers have shared a fun and varied list of their treats and pleasures.  Some of my favorites are listed here:

Small Treats and Pleasures

taking the pup to the park
dance party in my office
getting a hot chocolate
reading a chapter of my book in bed
Photo courtesy of squacco

Photo courtesy of squacco

looking at a family photo album
taking an extra long shower
stretching or yoga
Belting along to the Dixie Chicks, Patty Loveless or Lyle Lovett while driving
My Nana’s coffee cake
Iced Dunkin’ Donuts coffee with skim milk and sugar
Really good cheese
Doing the NYT Sunday acrostic
Re-reading my favorite children’s books (esp. the “Shoes” and Betsy-Tacy books)
Calling my mom
Walking a different way to work or coming home, especially through a park
Getting into bed when it’s just been made up with crisp fresh sheets
Monkey Bay Sauvignon Blanc
Fresh strawberries, raspberries or peaches when they’re in season.  And tomatoes!
Having breakfast from a wooden tray with a linen napkin on it
A gardenia beside the bed.
Mrs. Meyers’ Honeysuckle hand soap.
washing my hands with Molton Brown hand soap
Make home made soup
Lubricating eye drops – make my eyes feel great!
Planting ferns
Give myself a foot massage
Read a travel guide
Petting a dog I meet in the street
Incense
Lighting a candle
A face mask, especially a minty one
A hot shower
Writing lists
Crafting
Making my own bread, kneading is soothin
Watching foreign movies
Stare at trees stretching to reach the sky
Buy a new color of lipstick
 
I encourage you to make your own list.  Try to work one or two of these into your day.  Enjoy.