Depression and Transplant
Possible Signs of Depression
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You feel sad or empty for weeks or months at a time.
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You are not interested in things you usually like to do.
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You can't keep your mind on anything for long. You have trouble making decisions.
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You feel more nervous, jumpy, or short- tempered than usual.
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Your eating habits change. You gain or lose weight without meaning to.
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You have trouble sleeping or you sleep too much. You wake up early and can't get back to sleep.
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You don't seem to have any energy. You feel sluggish or tired most of the time.
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You feel hopeless or guilty.
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You have thoughts of killing yourself or you try to kill yourself.
Recent Articles
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Brain Images Reveal Effects of Antidepressants - The experience of millions of people have proved that antidepressants work, but only with the advent of sophisticated imaging technology have scientists begun to learn exactly how the medications affect brain structures and circuits to bring relief from depression. For the first time functional mangnetic resonance imaging ( fMRI) -technology that provides a view of the brain as it is working - to see what changes occur over time during antidepressant treatment while patients experience negative and positive emotions. The researchers found that when they gave the antidepressant venlafaxine (Effexor) to a small group of clinically depressed patients the drug produced robust alterations in the anterior cingulate. Unexpectedly, the changes were observed in just two weeks. It was noted that the findings were surprising becaue patients don't usually begin noticing mood improvements until after they have been taking antidepressants for three to five weeks. The researchers also found that while the depressed patients displayed lower overall activity in the anterior cingulate than non- depressed controls, those depressed patients who showed relatively more activity before treatment responded better to the medication than those with lower pre-treatment acitivity. It is expected that physicians in the future will be able to predict which patients will be the best candidates for antidepressants simply by looking at brain scans. ( Source - University of Wisconsin - Madison - Feb. 6, 2003,)
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Methylphenidate Aids Weaning of Depressed Patients from Mechanical Ventilation - Physicians in Germany have demonstrated that methylphenidate is a rapidly effective and safe treatment for patients who are difficult to wean from mechanical ventilation because of depression. The researchers initiated methylphenidate at 2.5mg per day, increasing the dose by 2.5 mg per day with two doses given by noon, up to 15mg a day. Mood, activity and respiratory efforts improved within 3 to 4 days in five patients without side effects and subsequent weaning was successfully completed within 8 to 14 days. (Source: Journal of Clinical Psychiatry November 2000)
Depression: Could it Happen to You?
If you have a chronic illness or a transplant depression could happen to you. Although you are grateful for receiving your transplant, you are now more at risk for depression than people without a chronic medical illness. The daily stress of following strict medical routines, adjusting to physical changes, explaining to others about your illness and fighting to fit into a world where you are not quite sick and not quite well can take its toll on your mood. Combined with stress, the inability to solve life's everyday problems can lead to depression. Your risk of depression can increase if you are socailly isolated and have lost contact with loved ones, or your health care providers. When people are forced to live with a chronic illness, it can lead to changes in self-esteem that can be another factor contributing to depression. The way you view yourself, and how much you perceive your illness to limit you can contribute to depression. This is called self-illness schema and has been shown to be a key contributor to depression in patients with a chronic illness. Metabolic changes and medication side effects are two ways your illness can contribute to depression. Additionally, depression is more likely if one or both of your parents suffered from depression. There are many ways to manage depression these days. For some, emotional and social rehabilitation alone can help. Increasing your contact with others and planning enjoyable activities on a regular basis can help improve your mood. Returning to an active life can be an important step to help relieve your depression. Physical activity has been shown to help alleviate depression in some people. For many patients suffering from depression especially if that depression is greatly interfering with their day to day functioning, anti- depressant medication is recommended. Because depression is often affected by the neurotransmmission of certain brain chemicals, medication that helps our brain chemicals, medication that helps our own brain chemistry work better, can often lift depression. Just because you have recieved a long awaited transplant doesn't mean that your adjustment to living with chronic illness is over. Feelings of fear and inadequacey are common, especially during the first few years following transplant.
(Source: Transplant Chronicles)
Where to find Help
The first place to get help is from your transplant team. They deal with transplant and depression on a daily basis and know best how it should be approached and treated.
Organizations
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National Depressive and Manic-Depressive Association - 730 N. Franklin St., Suite 501, Chicago, IL 60610, 800-826-3632 or 312-642-0049,
http://www.dbsalliance.org/ -
National Mental Health Association, 1021 Prince St., Alexandria, VA 22314, 800-969-NMHA,
http://www.nmha.org -
National Alliance for the Mentally Ill, Colonial Place Three, 2107 Wilson Blvd., Suite 300, Arlington, VA 22201, 800-950-NAMI,
http://www.nami.org -
Psychological Readiness for Transplant
Assessing psychological readiness for transplant : Extensive evaluations are supposed to screen out people who are unlikely to follow treatment regimens or who are emotionally unstable. What they've learned is that even the most cooperative patients struggle to adhere to complex regimens. Maintaining a transplant is a lifelong commitment that requires incredible effort and motivation. Requirements for psychosocial screening for transplant patients vary depending on the medical center and the organ. "You need to make sure this is someone who can understand the risks of long term immunosuppression and that they can psychologically deal with having another person's body part attached to their own," said Dr. Granger. Compliance can become a problem as people feel better. Patients think they no longer need their medication or simply forget to take it.
(Source: American Medical News)
Depression Following Transplantation During the pre-transplant period, anxiety and depression are considered to be reasonable responses to the difficult circumstances of life at that time. So why is it that recipients and their families experience periods of depression and anxiety in the months and sometimes years following transplantation? It's easy to see that there are a number of challenges to face that might result in anxious or depressed feelings. Some recipients report feeling alone and somewhat ashamed when these feelings arise.
Transplantation is a complicated, time consuming, and physically and emotionally draining proces for recipients and their families. Big lifestyle adjustments must be made even after returning home with a successful transplant. Recipients are continually coping with significant immune system suppression, infections, changes in appearance and other health concerns. In addition, we are busy trying to reclaim or reinvent our lives; we are forced to confront the difference between our wishes and the reality of our physical condition. For some, continued involvement in support group activities may help, while for others, individual or family counseling may be a better match. Medication can also be an essential part of a plan to address depression and anxiety. We must be our own advocates in these matters if we are interested in quality, not just length , of life. It is important to understand that depression and anxiety are common feelings for recipients and spouses, and are not a sign of weakness or inadequacy.
Remember, you have worked hard to acquire the opportunity to enjoy living, so take care of yourself during this part of the transplant experience, too.
(Source: Transplant Chronicles)
