More than Sadness: the Physical and Mental Effects of Depression

"I'm so depressed."

People are quick to throw this phrase around when their favorite show gets cancelled or after a bad day. But people who suffer from clinical depression, also known as major depression, are dealing with much more than sadness. They may experience a deep feeling of hopelessness that persists for weeks. It is all-consuming and often starts to have a negative effect on their normal activities and relationships. Other symptoms can include fatigue, feelings of worthlessness, impaired concentration, insomnia, and recurring thoughts of death or suicide.

Depression can also manifest itself in physical ways: significant weight loss or gain, headaches, digestive disorders, and chronic pain. There is even mounting evidence that depression can take a more serious toll on physical health, in the form of stroke or coronary artery disease.

People who are suffering from untreated clinical depression may feel unmotivated to take care of their health, follow doctors' orders, or attend healthcare appointments. If you know someone who is struggling with depression and may not be caring for themselves mentally or physically, it's important to choose your words wisely.

Don't Say:
"Pull yourself together."
"Snap out of it."
"You should be grateful for what you have."

This type of advice is not beneficial and could possibly cause harm, leaving your friend to feel even more misunderstood or stigmatized. What may seem irrational to you is reality to someone who is depressed. They do not have a choice to "just feel better" because they may have a chemical imbalance in their brain which they cannot control.

Do Say:
"I'm here for you."
"What can I do for you?"
"Would you like me to go with you to an appointment?"

Depression is so disorienting that it can make even the most commonplace daily tasks seem insurmountable. Just letting someone know that you're there to listen (without prying) or take a chore off their hands (without judgement) might mean the world to them. Encouraging a friend or family member to seek treatment can be awkward, but offering to accompany them to an appointment, whether a therapist, primary care physician, or even just the pharmacy, shows that you care about their wellbeing. It illustrates that you're being supportive and acknowledges that they're suffering from a medical condition, which isn't something one can easily shake off.

Most primary care physicians can assess the physical symptoms of depression and make referrals for mental health care. In the Baltimore County area, there are several resources available to help residents treat depression. Call the Baltimore County Department of Health at 410-887-3828 or email behavioralhealth@baltimorecountymd.gov. The National Hopeline Network (www.hopeline.com) is a 24/7 national phone hotline specifically for people suffering from depression.

Did You Miss the Art of Nursing TV Special?

In case you missed it, WMAR-ABC2 aired a 30-minute TV special on December 7 that featured GBMC HealthCare nurses! It took viewers behind the scenes to show powerful, real stories of patients and the nursing teams who care for them.

Baby Josiah and the Neonatal Intensive Care Unit
Baby Josiah was born at 25 weeks’ gestation, weighing in at only 1.7 pounds. Follow him, his family and their care team on his journey.

A Visit with a Home Hospice Patient
Join Delores Williams, RN, as she takes her usual trip to visit a patient suffering from stage 4 prostate cancer. Gain insight into the emotional work she does every day and the unique connection she holds with her patients and their families.

A Day in the Medical Intensive Care Unit (MICU)
The environment within the MICU is hectic and intense. Watch as Amanda Henderson, RN, cares for patients and shares her touching story about why she became a MICU nurse.

If you weren’t able to watch the special on its TV air date, it is now available for you to watch here. Although it focuses on intensive care and hospice nurses, the special is reflective of GBMC’s organizational family as a whole and illustrates our vision of providing every patient, every time with the care that we would want for our own loved ones.

Handwashing: Powerful Illness Prevention

Handwashing: it's something you do multiple times a day, every day. It's probably so ingrained into your daily routine that you rarely give it much thought. However, when done properly, it's the single most effective way to prevent the spread of germs. December 4-10 was National Handwashing Awareness Week, and also the time of year when influenza (flu) viruses in the United States start to peak. If you follow the 4 Principles of Hand Awareness, as advised by the Centers for Disease Control and Prevention, you can virtually isolate yourself from the germs people around you may be spreading:

1. Wash your hands when they are dirty, before eating, and after using the toilet.
2. Do not cough into your hands.
3. Do not sneeze into your hands.
4. Above all, do not put your fingers into your eyes, nose, or mouth.

The mucous membranes of your eyes, nose, and mouth are referred to as the T-Zone, and this zone is where the majority of diseases enter the body. In fact, for respiratory and gastrointestinal diseases, it is the only portal of entry, which is why not touching this area is crucial to avoiding getting sick. If you never touched your T-Zone with a contaminated finger again, you could avoid flu, conjunctivitis, strep throat, bronchitis, pneumonia, and many more! Handwashing is very much like a "do-it-yourself" vaccine (though you should never forego your flu shot!), when these five simple and effective steps are followed:

1. Wet your hands with clean, running water
2. Lather by applying soap and rubbing hands together. Remember to get the backs of your hands, between your fingers, and under your nails.
3. Scrub your hands for at least 20 seconds.
4. Rinse your hands well under clean, running water.
5. Dry your hands using a clean towel.

There are some situations where you may find yourself without soap and water, but still need to wash your hands: food trucks, outdoor events like concerts, festivals, and fairs, or in emergencies such as water outages. Then what? Will hand sanitizer get the job done? The answer is yes if you use the SaniTwice method, developed by infection prevention specialists to help the military safely feed recruits in the desert when there is no running water.

SaniTwice:

1. Apply hand sanitizer (two pumps!)
2. Rub all over hands for 15-20 seconds (including backs and between fingers)
3. Towel wipe while hands are still wet.
4. Apply sanitizer again.
5. Air dry.

By following these simple steps for hand hygiene and sanitizing etiquette, not only are you preventing yourself from getting sick, but you're assisting in preventing epidemics and pandemics everywhere.

Crunchy Pumpkin Pie

Ingredients

For the pie crust:

1 cup quick cooking oats
¼ cup whole wheat flour
¼ cup ground almonds
2 tablespoons brown sugar
¼ teaspoon salt
3 tablespoons vegetable oil
1 tablespoon water

For the pie filling:

¼ cup packed brown sugar
½ teaspoon ground cinnamon
¼ teaspoon ground nutmeg
¼ teaspoon salt
1 egg, beaten
4 teaspoons vanilla
1 cup canned pumpkin
2/3 cup evaporated skim milk

Directions

Preheat oven to 425F

Mix oats, flour, almonds, sugar and salt together in a small mixing bowl

Blend oil and water together in measuring cup until emulsified

Add oil mixture to dry ingredients and mix well. If needed, add small amount of water to hold mixture together.

Press into a 9-inch pie pan and bake for 8-10 minutes, or until light brown

Turn the oven down to 350F

Mix sugar, cinnamon, nutmeg, and salt together in a bowl.

Add eggs and vanilla and mix to blend ingredients

Add pumpkin and milk and stir to combine

Pour into prepared pie shells

Bake for 45 minutes at 350ºF or until an inserted knife near the center of the pie comes out clean.

Nutrition Information

Serving Size: 9 servings – 1/9 of a 9-inch pie
Calories: 177
Total Fat: 8 g
Saturated Fat: 1 g
Cholesterol: 24 mg
Sodium: 153 mg

Recipe retrieved from Stay Young at Heart provided by the National Heart, Lung and Blood Institute.