For a long time it had seemed to me that life was about to begin - real life. But there was always some obstacle in the way, something to be got through first, some unfinished business, time still to be served, a debt to be paid. Then life would begin. At last it dawned on me that these obstacles were my life. -- Father Alfred D'Souza

Meetings in 2002 - Cleveland, Padua
Travel Assistance from Mercy Airlift
Defeating Depression, adapted from Milestones
Audio and Computer text
VHL in Germany, by Gerhard Alsmeier, Germany
Sigma Phi Gamma Supports VHLFA
New Alabama Chapter, by Linda D.
Triathlon -- Alice completes the Danskin Triathlon

Adapted from Milestones

Feeling happy one day and gloomy or frustrated the next happens to many patients following surgery. Such mood swings are often a normal and temporary part of the post-operative recovery process, but depression is a different condition — and much more serious.

Depression is an Illness

Depression is a specific illness that can be caused by a combination of genetic (inherited), mental and medical influences. There are different kinds of depression, but they have certain symptoms in common:

- Uncontrollable feelings of sadness and grief, and the inability to cheer up even for a brief time

- Feeling hopeless, worthless or guilty for no particular reason

- Loss of pleasure and interest in activities you formerly enjoyed

- Sleep problems — trouble falling asleep, and either waking up too early or constantly oversleeping

- Less energy than usual, always feeling tired and sluggish

- Difficulty concentrating, thinking or making simple decisions

- Either a loss of appetite and weight loss, or urges to overeat

- Frequent thoughts of death or suicide

You may not have all of the symptoms at once but, depending on how serious the depression is, those that are present can last for days, weeks or even months at a time.

An Ignored Problem

Depression can be a complication of long-lasting diseases and the suffering they cause, so it may start even before surgery. After any surgery there are many new stresses and certain medications that can contribute to depression, especially steroid drugs.

Sometimes patients and their loved ones try to dismiss symptoms of depression as just a natural reaction to dealing with recovery or a temporary setback. Some people still view depression as a sign of mental weakness, rather than a specific medical problem.

Caring for the Caregivers

It is not just the patient who is at risk for depression. The rest of the family may also be at risk. Caregivers and other members of the family may feel their own needs have to be put on hold in order to serve the patient. The unaffected siblings may feel they are ignored, or may even feel left out, or guilty that they have been spared.

Help is Available

The good news is that, once it is recognized, depression is treatable.

Emotional support is a first step, so professional counseling is usually recommended. There are also a number of medications — called antidepressants — that may be helpful for relieving symptoms. It usually takes over a month for these antidepressants to work effectively, and, meanwhile, it may be necessary to closely monitor levels of other post-surgical medications to make certain they are not affected.

Your medical team should be told about any symptoms of depression so that they can recommend the best treatment.

Milestones: Post-Transplant Issues and Information is a publication of the Transplant Patient Partnering Program, an educational service of Roche Laboratories. Patient Partnering Program, 1-800-893-1995, P.O. Box 1464, Bluebell, PA 19422. http://www.tppp.net

As printed in the VHL Family Forum 9:3, September 2001. For permission to reprint, please contact VHL Family Alliance, editor@vhl.org. Further information is available from the VHL Family Alliance, info@vhl.org.