Tag Archives: mental health

Bit Post: Dementia

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Posted on Facebook, in rapid response to my friend’s share of an Alzheimer’s Awareness Week message:

More and more of my patients seem to live in fear of dementia, and rightly so. I see it as my job to hold that fear, validate it, and also monitor for its immediate effects. Constant fear that looms over us like a black cloud is threat stress, and that has significant negative health consequences in itself, both immediate and long term.

How can we get to peace with our inevitable end, however it may occur? I was just thinking about it this morning, as I have written about it often the past 8+ years on the blog. Today I believe that if I were to die tomorrow, and I had five minutes at the end to relfect, I could be at peace. But who TF knows? I could be a thrashing rage case at the end of my life, depending on the circumstances. But I realized this morning that this may be an excellent example of a Useful Delusion. Because I feel, however irrationally, at peace with my own death today, I can live more peacefully now, freed from that particular fear. Maybe. That’s the story I tell.

Of note: None of us can actually control our future health and death. But we have so much agency to influence risk and likelihood. Thankfully, all of the behaviors that help prevent heart disease also lower the risk of everything else: cancer, diabetes, obesity, and dementia. None of us can be perfect in all of our health habits; some are easier than others for each of us. But if we focus more on goals and trade offs, acting intentionally and mindfully as much as possible, assessing and adjusting often, I think we will have less to regret at the the end, no matter what happens.

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Someone once said when you love someone with Dementia you lose them more and more everyday. When they are diagnosed, when they go through different stages, when they need treatment and when they die. This is called “Ambigua Loss.”

I wouldn’t wish Dementia on anyone. As the brain slowly dies, it changes physically and eventually forgets who their loved ones are. They can end up lying in bed not moving and not eating or drinking.

There will be people who will scroll by this post because Dementia has not touched them. They may not know what it’s like to have a loved one who battled or is fighting Dementia.

To Raise Awareness of this Cruel Disease, I’d like my Friends to Put this on their Page Today.

Hold Finger on Post to Copy and Paste to Your Timeline.

A Special Thank You to All Willing to Post This On their Timeline for Alzheimer’s Awareness Week 💜💜

Witnessing

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So much suffering, friends—everywhere, all the time, every day.  It’s overwhelming. 

Our current circumstances feel like the most distressing case of sensory overload I have ever experienced:  intense, prolonged, and complicated.  Paradoxically, I also often feel like my head and heart could explode from sheer hopefulness—at no other time in my life have I felt so much potential for meaningful, positive collective change.  We stand on the knife edge of a continental divide of sorts, simultaneously overlooking the worst and best extremes of humanity.

People. Are. Losing it. 

Patients with underlying anxiety and depression are increasingly agitated and even combative, at home and in the clinic.  They threaten themselves and/or office staff, sometimes with mortal results.  Lifelong friendships are ending from irreconcilable differences over politics, ideology, and disagreements over social distancing and masking, among other things.  People lash out in rage at the slightest, often innocent provocations.  We doom scroll on social media, amplifying and reverberating (mis)information in our echo chambers, driving ourselves to the cliff’s edge of sanity with fear, fury, and hatred.

I watch it unfold before my eyes, escalating in the past few weeks.  I have joked for a while that the world may end in my lifetime; now it feels less and less like a joke. 

How we do process it all?  How do we get through?

Physicians, therapists, nurses, and many other professionals make a living watching and listening to people through their suffering.  Often we cannot cure people’s problems; sometimes it feels like we can’t even help.  But the truth is we can always help—all of us.

By simply being present to someone in pain, we help.   By not looking or running away, by sitting and facing them full on, we help.  By allowing, even embracing our own discomfort, and holding safe, quiet space for another’s suffering, we help.  We know this because when we suffer, the loving presence of others is what heals us first.

I cannot take away your depression or anxiety.  I cannot create a stronger social support network for you.  I cannot get you a job, bring back your deceased loved one, make the pandemic go away, or stop the next police officer from profiling your son by his skin color.  But I can sit with you in your grief.  I can stand in solidarity with you and advocate for our common cause.  Most importantly, I can take good care of myself so I can keep showing up for you and all those who may need to lean on me from time to time.  I have those who let me lean on them sometimes, too, and I make sure to thank them often.

To witness means to see.  The best witnesses make us feel seen, heard, understood, accepted, and loved, no matter what.  This is what we can do for one another right now.  It is the highest calling of humanity, to take care of each and every other as ourselves.  It is an infinite rather than a finite calculation.  Love shared is multiplied, not divided.  Caring for you feeds me too, whereas disconnecting from you costs me more than I know, and diminishes us all.

“Although the tale of human experience is certainly universal, it contains unique elements for each us and we continue the art of storytelling, both verbally and nonverbally, each and every day. While some stories are sweeter than others, all long for the benefit and necessity of a witness, for a witness assures us that our stories are heard, contained, and transcend time; for it can be said that one is never truly forgotten when one is shared and carried in the hearts of others.” –Kristi Pikiewicz, PhD

The only way out is through. The best way through is together.