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Posts Tagged “Depression”

The Link Between Chronic Pain and Depression

home care Paradise Valley Chronic pain is described as any persistent or intermittent pain that lasts more than three months. Depression is described as a psychological state that causes fatigue, appetite changes, sadness, lack of motivation, slowed response times, difficulty sleeping, feelings of helplessness and thoughts of suicide. Studies have revealed that up to 50% of patients suffering from chronic pain are also affected by severe depression.

It can be difficult to assess whether depression has led to chronic pain, or vice versa. Depression can frequently cause unexplained pain, such as back pain and headaches, and people who are experiencing chronic pain can develop increased stress or feelings of guilt and helplessness, often leading to a depressive state. These effects can create a cycle that is difficult to break. Those patients that have chronic pain-induced depression have a poorer prognosis than those suffering from chronic pain without depression. It seems pain and depression create a vicious cycle in which pain worsens the symptoms of depression, and the resulting depression worsens the feelings of pain. Suffering from both conditions tends to promote their own severity.

One of the reasons depression and chronic pain are so intertwined is because of the way stress works on the body. Chronic pain turns on the “fight or flight” stress signals in the brain, preparing the body to fight off whatever is causing the pain. The nervous system is in a high state of alert, and eventually this wears the body down, leaving the person vulnerable to depression. Finding ways to deal with stress and cope with chronic pain can give you an edge in the battle against developing depression.

Chronic pain-induced depression can keep you from enjoying life, such as spending time with your children and grandchildren, engaging in hobbies, exercising and traveling. It can also lead to isolation, exacerbate other health conditions, and can be emotionally draining.  It can quickly lead you in a downward spiral, and without treatment and attention, can gravely affect your quality of life.


Those patients suffering from chronic pain-induced depression benefit most when a team of professionals is involved in their care. This team may include a:

Physician: Thorough exams and evaluations are of primary importance in the diagnosis and treatment of pain and depression. Physicians may also include psychiatrists to help manage depression, and pain specialists to help manage the pain. When necessary, both pain and psychiatric medications may be prescribed.

Therapist: Anxious and negative thinking patterns can be alleviated during regular sessions with a trained therapist. Coping skills and behavioral therapy skills can be taught to reduce the symptoms of pain and depression. A therapist can also work with the patient’s family to help them understand this complex disease process.

Physical Therapist: A physical therapist can be invaluable in their instruction on exercise and muscle relaxation techniques to help improve mobility and reduce pain. The added benefit is that regular movement can help improve mood.

Other Health Professionals: Occupational therapists, nutritionists and acupuncturists can also help alleviate the symptoms of chronic pain-induced depression.


Catching chronic pain and depression in its early stages can help you get your life back. Early treatment of chronic pain and/or depression can help fight this downward spiral.


Often, when patients present with chronic pain to their physician, they may be prescribed antidepressants, even if the patient’s mood seems fine. While this may seem odd, the use of low dose antidepressants for pain control is well-studied and has been a standard practice for many years. In low doses, antidepressants cause chemical changes in the brain that alter the way pain is perceived. Of course, another reason they are prescribed is that they can stop the cycle that leads to depression prior to it starting.

Standard analgesics are often prescribed to treat chronic pain. For severe chronic pain, opioids are the most effective medications. Several studies have found that opioids may help achieve antidepressant effects by regulating neurotransmitters; however, the use of opioids in chronic pain-induced depression has been controversial due to patients’ dependence and addiction to them. The long-term use of opioids (over 30 days) has actually been shown to increase the risk of depression. Be sure and thoroughly discuss their use and risks with your physician.

Talk Therapy

Also called psychological counseling or psychotherapy, talk therapy can be very effective in treating both depression and chronic pain by changing patterns of thinking and application of coping skills. Look for a therapist who applies Cognitive Behavioral Therapy, which can provide real-life coping skills that are greatly beneficial to patients.

Stress-Reduction Techniques

Many patients suffering from chronic pain and depression find great relief from utilizing stress-reduction techniques. Many of these techniques are taught in therapy sessions, but many more can be learned on your own. Meditation and journaling can both be extremely helpful in coping with chronic pain and depression. Gentle physical activity such as yoga and tai chi are also very healing. Sometimes, just getting out into nature can help those suffering from chronic pain and depression.

Pain Rehabilitation Centers

In these centers, a team approach is provided to treat both the medical and psychiatric aspects of chronic pain-induced depression. These centers offer outpatient or inpatient programs and can provide immediate and long-term support when chronic pain and/or depression is severe. These programs are effective because they involve a combination of treatments. The Comprehensive Pain Rehabilitation Center at the Mayo Clinic is one such program.

Peer Support

Many people suffering from chronic pain and depression find that support groups can be irreplaceable. Peer support groups offer emotional support through caring, encouragement, reassurance and avoidance of criticism. These groups can also offer information support in terms of advice, suggestions, problem-solving and dissemination of facts. The families of patients suffering from chronic pain often have a difficult time relating or understanding, and these groups provide an outlet where the patient is heard without judgment.

The PAINS Project is a great resource for finding more support.

If you are in crisis and need immediate emotional support:

  • Call your or your loved one’s health professional
  • Call 911 for emergency services
  • Go to the nearest hospital emergency room
  • 1-800-273-TALK (1-800-273-8255) National Suicide Prevention Hotline
  • 1-800-442-HOPE (1-800-442-4673) Kristin Brooks Hope Center National Hotline
  • 1-877-Vet2Vet (1-877-838-2838) Veterans peer support line or chat online
  • 1-800-SUICIDA (1-800-784-2432) Spanish-speaking suicide hotline
  • (volunteers are trained and certified in crisis intervention)

If you think you might be suffering from depression in addition to chronic pain, be honest with your health care team and seek the support that will help you regain control over your mind, body and spirit. Nightingale Homecare can serve as an invaluable resource to you as well, with a full range of customized skilled and non-medical in-home care services. Contact us for a free in-home consultation at (602) 504-1555 to discover how we can help enhance joy, comfort, and overall wellbeing and quality of life. You can also learn more about our Phoenix in home care services and the areas we serve.

The Elderly Mental Health Concern We’d Rather Not Think About: Senior Suicide

senior home care Phoenix  son with senior father looking depressed

Learn the signs of senior suicide and how to help.

Suicidal thoughts can affect anyone regardless of gender, background or age.However, while the elderly account for just 13% of the population, they account for nearly 16% of all suicides. The statistics are shocking, especially knowing the elderly are the fastest growing segment of our population, making this elderly mental health concern – senior suicide – a public health priority.

Caucasian men aged 65 to 84 are at an even higher risk, accounting for 14.9 out of every 100,000 suicide deaths – and the number rises even higher in men over aged 85. It is estimated that suicide deaths in the elderly may be under-reported by over 40%.

These figures do not include the “silent suicides” – deaths from self-starvation, dehydration, accidents and overdoses. The elderly also have a higher than average rate of completing a suicide, as they are often deaths by firearms, hanging and drowning. And, there is a higher incidence of double suicide involving a spouse among the elderly population.

Senior suicide is often the result of an untreated elderly mental health condition. Although common, suicidal thoughts should not be considered normal and often indicate more serious issues.Health care providers often report that the elderly have an exceedingly difficult time in talking with others, especially mental health professionals, about their feelings or challenges. This is largely due to the stigma surrounding mental health issues and makes missed detection the biggest contributor in the high suicide rates among the elderly.

Those at Risk

It is very difficult to identify individuals at risk for suicide, even for professionals. However, there are some risk factors to keep in mind:

  • Being a white male over the age of 65
  • Prolonged, chronic or terminal illness
  • Pain, especially if pain is severe, chronic
  • Depression
  • Alcohol abuse and/or dependence
  • Financial difficulties
  • Recent loss of a spouse, loved one, or pet
  • Feelings of hopelessness
  • Physical, social and emotional Isolation/loneliness
  • Loss of role or stature in family or community
  • Recent change in living situation or employment status or productive activities

Warning Signs

The following are common warning signs that an elderly person may be contemplating suicide:

  • Crying and sad mood; typical signs of depression
  • Weight loss and poor appetite
  • Feeling trapped in a situation and unable to see a way out
  • Statements about death and suicide
  • Statements about being a burden
  • Reading material about death and suicide
  • Statements of hopelessness, helplessness and worthlessness
  • Disruption of sleep patterns (insomnia or over-sleeping)
  • Loss of interest in hobbies or activities
  • Giving away possessions
  • Increased alcohol or prescription drug use
  • Failure to take care of self or follow medical orders
  • Stockpiling medications
  • Sudden interest in firearms
  • Withdrawal of social interactions or elaborate good-byes
  • Rush to complete or revise a will

How to Help

As many as 50% to 75% of elders considering suicide will give someone a warning sign. However, not everyone who is considering suicide will say something, and not everyone who threatens suicide will make an attempt, though every threat of suicide should be taken seriously. Remaining aware of the risk factors and warning signs and talking openly to your loved one about your concerns are critical in preventing elder suicide.

It is also important to identify the mental health professionals in the community who can provide assistance. Remember, you never have to be alone in seeking help for your loved one, and if you are unsure whether your loved one is immediately at risk for suicide, get help by taking the individual to the nearest emergency room for evaluation and treatment.

One great resource is the Institute on Aging’s 24-hour toll-free Friendship Line for elder adults in crisis: 800-971-0016. Their trained professionals are available to support seniors who are struggling with depression, loneliness and suicidal thoughts. The Veteran’s Crisis Line is also available toll-free 24 hours a day for senior veterans and their families to receive counselling and support: 800-273-8255.

At Nightingale Homecare, the top providers of senior home care Phoenix families trust, we offer a program devoted to elderly mental health and safety: Transitions. Our team of experts (nurses, social workers, and therapists) can provide an assessment to determine if depression, anxiety, coping skills and other emotional concerns are in place, and determine what resources would be most beneficial. Contact us at (602) 504-1555 any time to learn more.


When the Holidays Are Anything But Merry and Bright: Help for Senior Holiday Blues

Senior Holiday BluesWhile the holidays can be a time to reunite with friends and family, they can also be a time of stress and loneliness, especially for our elder loved ones. Keep these tips in mind, courtesy of the Arizona home health care team at Nightingale Homecare, as you plan your festivities and prepare for what may present a time of undue stress and holiday blues for your loved one.

Plan Ahead

Talk about plans and expectations with your loved one. She may have been the family member who hosted family gatherings in the past, but physical limitations may add stress in keeping that tradition. Consider hosting the event yourself and limit your loved one’s preparation for the event. You can suggest she make the traditional favorite dish with your help, or help with decorating, but keep in mind your loved one’s limitations, while keeping her involved in the fun.

Monitor Moods

Often, our elder loved ones have some sadness over the holidays, especially when they have lost someone close to them. Keep your finger on the pulse of this and keep open communication with your loved one, while recognizing what may trigger sadness, confusion and stress. Talking about losses, recognizing this may be a time of sadness, while being supportive and understanding will help your loved one cope during a difficult time.

Monitoring stress in a loved one with dementia may be a bigger challenge, so it’s best to have an alternative plan if you notice more confusion or stress in your loved one during the holidays. Often, crowds overwhelm our elders, so it’s best to discuss this prior to the event and keep your gatherings small and intimate when possible. It may be better to have several small social gatherings rather than one large event.

Consider Dietary Needs

While it may be tempting for your loved one to experience all of the flavors of the season, be mindful of dietary restrictions when you plan the meal. Many people have a tendency to over eat when they are stressed, so keep that in mind and have healthy alternatives to rich holiday dishes. Keeping fresh vegetables and fruits on hand is a good plan. Make sure your loved one has plenty of fluids available to keep hydrated as well. Avoid alcohol, which can dehydrate, cause confusion and interact adversely with many medications. Keep bottled water or festive alcohol-free beverages available as an alternative.

Provide Rest Periods

The holidays can be a whirlwind of events and activities, and your loved one may have traveled a distance to be with family. Offer ample periods of rest, especially following a long travel day. Consider postponing the visiting until your loved one puts her feet up and rests, and dedicate a quite room in the house for the senior to retreat from noise or crowds. Ample periods of rest between shopping, visiting and holiday preparations will help keep stress at bay.

Share Your Feelings

Reminding your loved one how important he or she is to you never gets old! The holidays are a wonderful time when you can recall special memories you share with your loved one. Take some time to pamper him or her with love, and focus on the real meaning of the season. It’s easy to get too wrapped up in the gifts, parties and food and ignore the value our loved ones bring to our lives. Spending this extra time to communicate your feelings can bring true joy to your loved one.

For more suggestions on helping seniors enjoy the holiday season, contact the Arizona home health care experts at Nightingale Homecare. We’re also available to brighten the lives of seniors with cheerful companionship and encouragement to participate in fun activities, assistance with meals and housework, transportation and accompaniment to outings, and so much more. Call us to learn more about our Phoenix in-home care for seniors at (602) 504-1555.

From all of us at Nightingale Homecare, we wish the happiest of holidays to you and yours!


Posted in Blog, Holidays, Phoenix on December 21st, 2017 · Comments Off on When the Holidays Are Anything But Merry and Bright: Help for Senior Holiday Blues

Nightingale’s Phoenix Caregivers Suggest These Tips for Recognizing and Overcoming Senior Depression

Phoenix CaregiversWe all go through periods of time where we just want to be alone for a little while, to think through situations in our lives without distraction, or to simply have some downtime to ourselves. For older adults, however, an extended period of isolation could indicate one of the all-too-common problems for seniors: depression.

At Nightingale Homecare, our Phoenix caregivers have walked beside many of our senior clients who struggle with depression. First and foremost, it’s important to contact the physician immediately if depression is suspected. It is a treatable condition, and help is available.

Keep an eye out for any of the following red flags of depression in your senior loved ones:

  • Loss: Loss in a variety of ways is a key indicator of depression or other medical concern: loss of weight, appetite, self-worth, interest in once enjoyed activities or hobbies, or in spending time with friends or family.
  • Slowness: Take note if the senior’s speech or movements have slowed down, if energy and motivation are decreased, or if it takes her longer than normal to recall or share memories.
  • Sleep: Depression can wreak havoc on healthy sleep patterns, causing difficulty falling or staying asleep, waking up, or staying awake and alert during the day.
  • Neglect: Pay close attention to changes in how the senior takes care of herself; for example, if she has always been attentive to her personal appearance and hygiene, and suddenly begins to neglect personal care, including eating healthy, taking medications, etc.

There are a number of conditions that can either mask as depression or make existing depression worse. Be especially mindful if your senior loved one has or has experienced:

  • Stroke
  • Heart disease
  • Cancer
  • Parkinson’s disease
  • Diabetes
  • Multiple sclerosis
  • Alzheimer’s disease or dementia
  • Thyroid conditions

Suspected depression in seniors should never be taken lightly, or shrugged off as, “She’s just feeling sad; she’ll get over it!” It is a chronic medical condition and requires help and treatment.

And, you don’t have to go it alone! The Phoenix caregivers of Nightingale Homecare are here to help seniors struggling through depression or any other condition. We’re experienced in providing compassionate, understanding care for seniors, serving as a friendly companion to help gently encourage healthy eating, participation in social activities, and exercise programs, provide transportation to doctors’ appointments and to pick up prescriptions, and more.

Contact us at 602-504-1555 any time for more tips on helping seniors with depression, or to begin a dialogue about how in-home care from our Phoenix caregivers can help your senior loved one experience a renewed interest in life.

Posted in Aging Issues, Blog, Caregiving on September 7th, 2016 · Comments Off on Nightingale’s Phoenix Caregivers Suggest These Tips for Recognizing and Overcoming Senior Depression

Persistent Depression and Your Loved One: Help from Nightingale Homecare in Phoenix

Nightingale Homecare in PhoenixFor those who’ve never experienced depression, it’s easy to have the misconception that it’s a short-term condition, related to a traumatic life event. However, the senior care experts at Nightingale Homecare in Phoenix are striving to help families understand that there’s a more long-term depressive condition, known as persistent depressive disorder, which can be very challenging to grasp, especially when it appears the person suffering has nothing to be sad about.

As with all mental illness, there’s a certain stigma that can surround a depression diagnosis. Many people believe that by middle age, depression shouldn’t be an issue. We are supposed to have dealt with our own failings, and those of the world by that time. Then there’s another common perception that depression is a normal part of aging or that depression sufferers somehow choose to stay depressed. As a result, those who suffer with depression often do so in silence, nodding at comments by others who tell them, “Pull yourself together,” or, “Snap out of it!”

Because persistent depression is such a prevalent chronic disease, it is important to understand it and recognize it, not only in ourselves, but in our loved ones.

Episodic depression usually last anywhere from 2 weeks to 20 weeks. For those suffering from a major depressive disorder (MDD) or persistent depressive disorder, symptoms can last for years. And the differences between episodes and persistent depression are more than just duration. Persistent depression causes more functional impairment, suicidal risk and mood disorders, and an increase in relapse when treatment is discontinued. Treatment must be more intensive for those with persistent depression and involve a combination of psychotherapy (to include cognitive behavioral therapy) and medications.

Regardless of the type of depression you or your loved one suffers from, it is important to be aware of the symptoms and what to do if you recognize symptoms in a loved one.

Symptoms of Depression that Require Physician or Psychiatrist Involvement:

  • Sad or empty mood most of the time
  • Decreased interest in food
  • Ignoring personal care and poor hygiene – staying in pajamas all day, or wearing clothes to bed
  • Difficulty getting out of bed, loss of motivation
  • Isolating from family and friends
  • Sleep disturbance and insomnia
  • Decreased ability to have fun or experience pleasure
  • Increased feelings of irritability and anger
  • Decreased interest in performing daily activities and chores
  • Not taking medications regularly or keeping physician appointments
  • Increased anxiety
  • Decreased ability to concentrate or remember – making poor decisions
  • Excessive crying
  • Excessive worry

Dangerous Symptoms of Depression that Require Immediate Medical Attention:

  • Overwhelmed by feelings of sadness or despair
  • Complete isolation – unwilling to answer the phone or door for anyone
  • Feeling hopeless, helpless, worthless and a burden to others
  • Unable to get out of bed
  • Suicidal thoughts or behaviors
  • Excessive use of alcohol or drugs to self-medicate or “numb” the pain
  • No longer eating
  • Cannot sleep
  • Unwilling to take medications or keep physician appointments

If you or a loved one is living with persistent depressive disorder, reach out to Nightingale Homecare in Phoenix to discuss your specific needs for home care and monitoring of the disease. Our team of caring professionals has developed a unique program called Pathlink, designed to empower our patients to control and manage their chronic disease. Working with physicians to closely manage depression, while helping patients understand that treatment works best when patients participate in their own treatment goals, is the primary focus of the Pathlink Depression Management program. The result is improved treatment outcomes!

Nightingale Homecare is tailored to the needs of each individual situation. Contact us any time at 602-504-1555, or complete our simple online contact form to let us know how we can help. If getting trusted senior care at home and maintaining independence is critical to your long-term care plan, Nightingale Homecare in Phoenix can help.

Posted in Aging Issues, Blog, Senior Health on July 27th, 2016 · Comments Off on Persistent Depression and Your Loved One: Help from Nightingale Homecare in Phoenix