Depression is a very common symptom of Cushing’s Syndrome. Depression is a response to chemical changes in our brain that occur when we are overwhelmed by stressors. There are many factors that can contribute to feelings of depression, however, a few of the following items may assist you in coping.

• Recognize that with Cushing’s, your body chemistry is extremely out of balance. The normal checks and balances that allow your body to deal with stress are no longer functioning. Under normal conditions, cortisol provides the important function of helping your body respond to stress. Since your body can no longer deal with stress in the normal ways, you can help yourself by reducing the stress in your life as much as possible. Make an inventory of the stressors and decide over which ones you have no control, some control and total control. Then set your priorities and plan how to lighten your stress load.
• Part of depression is feeling helpless and hopeless. The above exercise will help empower you to have some control over part of your life. Now you can make a list of the areas of your life in which you do have control to assure yourself that you are in the driver’s seat. Explore ways in which you can become more proactive in steering your way through this experience. Some ways include;

• • gaining as much knowledge about your condition as you can. Knowledge is power.
  • Get into contact with others who have Cushing’s or other rare diseases. Many of your problems overlap and you can support each other with information and affirmation.
  • It helps to have someone who is willing to hear your complaints without turning off, such as a therapist, clergy person or support group. Be cautious using family and friends for this purpose as they may not be equipped to deal with your anguish.

• Part of your depression is probably due to grief about the losses you are experiencing. The loss of energy, being able to do all you used to do, changes in your body, changes in relationships due to your condition, are only a few of the losses. The list can go on and on. Recognizing your losses and honoring them as valid can assist you in moving toward the acceptance that is necessary before you can move on.
• Another way to take care of yourself is to seek out those things that give you pleasure. Even the simplest object of beauty or time with a special person can give you a boost. Surround yourself with sights, sounds and fragrances that please you. Remember that your whole person needs nurturing even when you feel the need to focus on your condition.
• Above all, be kind and gentle to yourself!

Example of Step 2

Stressor                                  Ways to empower

Physical Symptoms               Don’t dwell on it, One day at a time,
Learn more about Cushing’s

Housework                              Have the family help, make lists, hire help?

Can’t do fun things                Think of things I can do that are fun. Cut roses, take a bath.

Feel alone                               Contact others with Cushing’s, find a support group

Dealing with my doctor         Take someone with me

Author: Margaret McClelland, OTR, MA, MFCC (Fall, 1995)

Editor’s Note: Margaret is an Occupational Therapist and Marriage, Family, and Child Counsellor in Livermore, CA. Margaret is a cancer survivor and has run numerous support groups for those dealing with illness and disabilities.