Mind Matters
Written by Ron Sterling, M.D. and Published in Northwest Prime Time Magazine

        The Mind Matters Column.

      This page contains the most recent Mind Matters column and links to archived columns. As noted, this page was last updated to reflect its new status as part of the DearShrink.com archives. No significant changes to content have occurred since late 2007.

      Links to archived columns are below the current column.

      The first Mind Matters column was published in the October 2002 edition of the Seattle monthly magazine, Northwest Prime Time. Northwest Prime Time is a available without charge at selected book stores, such as the downtown University Bookstore, or you can e-mail them and get information on how to subscribe. In 2003, Dr. Sterling received a Second Place Award for a Senior Issues column from the North American Mature Publishers Association.

      All Mind Matters columns are Copyright 2002-2007 Ron Sterling, All Rights Reserved. Please do not utilize in publications or Web sites without purchasing single-use publication rights.

        The November 2007 Mind Matters Column.

Kudos to Caregivers!
by Ron Sterling, M.D. -- November 2007

    It's been over two years since I last wrote about caregivers and the challenges that caregivers face. Several things have changed since 2005. For instance, three very recent articles reported the continuing and growing awareness of the plight of caregivers. A Seattle Times article of October 14, 2007 was entitled "Caregivers: Color them bluest." A CNN.com article of August 14, 2007, was entitled "Exhaustion, anger of caregiving get a name." An American Journal of Geriatric Psychiatry (Journal) report dated September 2007 is entitled "Preserving Health of Alzheimer Caregivers: Impact of Spouse Caregiver Intervention."

    The Times article reported a government study where depression was tracked within 21 major occupational categories for two years (2004-2006). Although the data relied on self-reporting of depression and the categories were somewhat broad, those involved in giving personal care and service had the highest rates of depression lasting two weeks or longer -- 10.8 percent.

    The CNN article reported that the term "caregiver syndrome" is gaining more acceptance and validity in the medical community. The American Academy of Family Physicians, the National Center on Caregiving, and the American Association for Geriatric Psychiatry have called for every caregiver to be screened for stress and depression. Unfortunately, a survey done by the American Academy of Family Physicians found that fewer than half of caregivers were asked by doctors about how they were doing with stress and depression.

    The September 2007 Journal reported the results of a 20-year study that showed that counseling and support for people caring for a spouse with Alzheimer's disease helps to preserve the caregiver's health. You might think that this would be common sense, but, in fact, as a nation, we have been very slow to understand the difficulties that caregivers face and to provide the acceptance and support that allows caregivers to seek and ask for help. For too long, it was only the caregivers who knew how tough their job was, and for too long, they tried to cope as best as possible without our support. Hopefully, those times are very close to gone.

    Although you could appropriately be concerned about whether we should come up with the name and criteria for another "disorder" (caregiver syndrome), it is my opinion that if we give it an official name, people who are slowly deteriorating from the stresses of caregiving might seek help earlier. In other words, they might realize that it isn't just them, it is happening to many other people and they have "permission" to seek assistance.

    When an employee is already moderately depressed, it is very difficult for them to take on the stressful task of talking to a supervisor about their problems. Sometimes, it really helps to have a co-worker, family member or friend sit in when the caregiving employee talks with the employer about their caregiving situation. This is one important role non-caregivers can play in supporting caregivers.

    Caregiving, in and of itself, does not cause depression. However, depending upon an individual's vulnerability to depression, the chronic stress of caregiving, especially for a loved one who may be suffering, can be more than enough to "burn" brain cells. I have written about the link between stress and clinical depression before. Please visit our All About Depression page for more information. Once there are significant signs of a biological basis for depression, appropriate antidepressant medication is often required. We generally cannot think ourselves out of a clinical depression. However, caregivers can help prevent clinical depression by utilizing support services, respite care relief, positive self-talk, and exercise.

    My heart goes out to caregivers, and they have my utmost respect. For more information about caring for caregivers, please visit All About Caregiving. -- Best wishes, Dr. Ron.

      The content offered through Mind Matters is for information only and is not intended for medical, psychiatric, or psychological diagnosis or treatment. Never disregard professional advice or delay seeking it because of something you have read in this column. Read our Disclaimer. If you wish to understand more about Dr. Sterling's potential biases in health care advocacy, please check his Conflicts of Interest Disclosure Statement. Dr. Sterling has no financial interest in any pharmaceutical company, whatsoever, and does not accept nor utilize sample medications.

        Links to Archived Mind Matters Columns.
    The most recent columns are listed first.

      • October 2007 - Off-Label Drug Use -- Dr. Sterling answers a question from a reader who wants to know more about the "cocktail" of medications a family member is using.

      • August 2007 - Caring for Medicare -- Dr. Sterling encourages his readers to advocate for changes in Medicare that would allow better mental health care.

      • July 2007 - The Power of "Yes" -- Dr. Sterling answers a question from a reader who wants us to know that "old dogs" can learn new tricks.

      • June 2007 - Yellow, Pink and Blue People -- Dr. Sterling answers a question from a reader who wonders why some people handle stress better than others.

      • May 2007 - How Does Depression Kill? -- Dr. Sterling discusses several of the ways that depression shortens lives and contributes to increased illness.

      • April 2007 - Depression Kills -- Dr. Sterling discusses a recent research study about depression among older adults in the United Kingdom.

      • February 2007 - The Work of Forgiveness -- Dr. Sterling answers a question from a reader who has encountered obstacles and is frustrated with the process of forgiveness.

      • January 2007 - Profiling Procrastinators -- Dr. Sterling answers a question about procrastination and offers some thoughts about what may be root causes for breaking resolutions.

      • December 2006 - Skeletons and Obesity -- Dr. Sterling answers a question from a reader who is concerned about her son's weight gain.

      • November 2006 - Partner Conflict, Part 2 -- Dr. Sterling continues his discussion about marital conflicts and the latest research about what makes marriages work.

      • October 2006 - Partner Conflict -- Dr. Sterling answers a reader question about marital conflicts and divorce.

      • September 2006 - Retired Partner Syndrome -- Dr. Sterling answers a reader question from a wife who is hoping for some "breathing space" from her recently-retired husband.

      • August 2006 - Personality Disorders 101 -- Dr. Sterling answers a reader question about personality disorders.

      • July 2006 - Set in Our Ways? -- Dr. Sterling answers a reader question -- "As we get older, do we really get more set in our ways?"

      • June 2006 - Psychotherapy vs. Medication -- Dr. Sterling answers the question "what is better for mild depression, psychotherapy or medication?"

      • May 2006 - The Problem with "Disorder" -- Dr. Sterling answers a question about the diagnosis of adjustment disorder and discusses the words "disorder" and "normal."

      • April 2006 - Spread the NPH Word -- Dr. Sterling answers a question about normal pressure hydrocephalus in older adults and how it is often a reversible dementia.

      • March 2006 - Older and Ruder? -- Dr. Sterling answers a question about whether the aging process makes older adults more prone to rude behavior.

      • February 2006 - This Full House -- Dr. Sterling answers a question about the disorder of "hoarding."

      • January 2006 - The Mind and the Immune System -- Dr. Sterling answers a question from a reader who wants to know if emotions and attitudes affect our immune system.

      • December 2005 - Self-Esteem Reevaluated -- Dr. Sterling proposes that we use the term "self-appreciation" rather than "self-esteem."

      • November 2005 - Healthy Humor -- Dr. Sterling answers a question from a reader who wants to know how humor is beneficial to the brain.

      • September 2005 - Older Adult Gambling -- Dr. Sterling writes about what has been called a new epidemic of older adult gambling and what can be done about it.

      • August 2005 - Depression and Your Heart -- Dr. Sterling writes about how depression affects our heart.

      • July 2005 - New Help for Sleep Disorders -- Dr. Sterling writes about Lunesta┬«, a new medication to assist with sleep difficulties.

      • June 2005 - Caring for Caregivers -- Dr. Sterling answers a question from a reader who is concerned about a workmate who seems overwhelmed.

      • May 2005 - May is Mental Health Month! -- Dr. Sterling writes about mental illness treatment advocacy and encourages his readers to support legislation that would make mental health care more accessible for older adults.

      • April 2005 - Our Mindset Matters -- Dr. Sterling answers a question about what comes first, good health or happiness?

      • March 2005 - Born to be Rude -- Dr. Sterling answers a reader's question about a very irritable and impatient mother.

      • February 2005 - Retirement Repercussions -- Dr. Sterling answers a question from a reader who wants to know more about the psychological aspects of retirement.

      • January 2005 - Anti-Anxiety Medications -- This is the second half of Dr. Sterling's answers to a reader's question about anxiety disorders and medication. This article discusses medication solutions to the anxiety response.

      • December 2004 - The Relaxation Response -- This is the first part of Dr. Sterling's answer to a reader's question about anxiety and medication. This article talks about the fight-or-flight response and non-medication solutions to the anxiety response.

      • November 2004 - Complicated Grief -- Dr. Sterling answers a reader's question about a father's very difficult recovery from his son's death and whether an antidepressant medication is appropriate for him.

      • October 2004 - Reversible Dementias -- Dr. Sterling answers a reader's question about her mother's recent problems with memory and thinking.

      • September 2004 - The Power of Programming -- Dr. Sterling answers a reader's question about happiness and depression and discusses some of the psychological issues related to depression.

      • August 2004 - Melatonin on My Mind -- Dr. Sterling answers a reader's question about the use of melatonin, a dietary supplement often used for assisting sleep.

      • July 2004 - Life After Loss -- Dr. Sterling answers a reader's question about grief, mourning, and life after experiencing a significant loss.

      • June 2004 - Psychotherapy 101 -- Dr. Sterling answers a reader's question about the definition and process of psychotherapy.

      • May 2004 - May is Mental Health Month! -- Dr. Sterling writes about what you can do to advocate for better mental health care for older adults.

      • April 2004 - Alcohol and Aging -- Dr. Sterling answers a question about alcohol and its use and abuse by older adults.

      • March 2004 - Older Adult Attention Deficit Disorder -- Dr. Sterling answers a question from a reader who wonders if Attention Deficit Disorder can affect older adults.

      • February 2004 - The "S" Word -- Dr. Sterling answers a question from a reader asking about depression and suicide in older people.

      • January 2004 - A New Drug on the Block -- Dr. Sterling answers a question from a reader who wants to know more about Alzheimer's and notifies readers about a new medication.

      • December 2003 - Holiday Perspectives -- A reader asks Dr. Sterling for some thoughts on how to deal with some of the major stresses of the holiday season.

      • November 2003 - Depression and Antidepressants -- Dr. Sterling answers questions about clinical depression and antidepressants.

      • October 2003 - Brain Fitness -- Dr. Sterling sums up most of the current knowledge about how to keep your brain as fit as possible.

      • September 2003 - Defining Dementia -- Dr. Sterling answers a question about how to decide when "normal" forgetfulness crosses the line to something that needs more serious attention.

      • August 2003 - Pumping Up Mental Wellness -- Dr. Sterling replies to a reader who wants to know more about mental wellness.

      • July 2003 - Finding Forgiveness -- Dr. Sterling answers a reader question concerning what to do about difficult parents who want to make things right, all of a sudden.

      • June 2003 - Following Your Heart -- Dr. Sterling answers a reader question about an estranged family member and a very ill parent.

      • May 2003 - Analyzing Anger -- Dr. Sterling answers a reader's questions about irritability and anger.

      • April 2003 - Stress Reduction of Different Kind -- Dr. Sterling talks about what he feels are one of the key factors in our reactions to stress.

      • March 2003 - Resolving Regrets -- Dr. Sterling answers a reader question about how to deal with unresolved emotional issues after the death of a close family member.

      • February 2003 - The Spirituality Factor -- Dr. Sterling writes about the challenges of getting older, falling apart, and getting closer to dying.

      • December 2002 - Seriously Sleepless in Seattle -- Dr. Sterling offers an answer and an exercise to a reader who is experiencing sleep difficulties.

      • November 2002 - It's All About the Hippocampus! -- Dr. Sterling answers a reader question about the relationship between physical exercise and depression. Does exercise help?

      • October 2002 - The "D" Word -- In this first edition of Mind Matters, Dr. Sterling responds to a reader question about her mother's depression and talks about the difficulties us senior folks often have with speaking about or seeking help for depression.

        Thank You for Stopping By!

      Have a great day!

            -- Best wishes, Dr. Sterling

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