When a Loved One has Thoracic Outlet Syndrome (TOS)
From the moment your loved one was diagnosed with TOS,
you’ve probably gone through an entire range of
emotions. Family members and friends of women with TOS
have said that they feel angry, sad, anxious, scared,
and lonely. One or more of these feelings may come and
go, or you may have all of them at once, and they may
continue as your loved one goes through treatment and
even after treatment has ended. Family members have also
said that they want and need to do something to help,
but that they don’t always know what to do or how to do
"But you don't look sick..."
Helping Your Loved One
Often family members and friends don’t know where to
begin to help their loved one. There are some tips that
others in your situation have found helpful:
• Spend time and talk with them. Let them take the lead.
If they want to talk, be a good listener.
• All it takes sometimes is a touch or a hug to let
someone know you care. It doesn’t have to be a long
conversation. Just being there is important.
• Try to feel comfortable when there is a lull in the
conversation. Silence can often be comforting.
• Remember that they may not always want to talk or
think about TOS.
• Help put TOS in perspective by obtaining accurate,
factual, and honest information.
• Be an educated family member or friend. Know what
resources are available. Seek out new, reliable
information from your healthcare provider, from the TOS
web sites, your local library, and local support groups.
• Help them find a healthcare provider who understands
them and meets their needs.
• Try to involve them in as many shared activities as
they would like. Play cards, watch movies, go out to
dinner, or go shopping.
• If you don’t live with them, continue to visit, call,
e-mail, or write.
• Keep your promises. If you say you are going to stop
by, follow through. Understand if they tire quickly and
you can’t stay as long as you expected. Learn to read
signs that they need rest or time alone.
• Encourage them to do things with others.
• Run simple errands. Often these small tasks seem
insignificant but can provide great relief to them and
• Write a little note letting them know you are thinking
about them or make a quick phone call.
• Allow them privacy.
• Discuss needed changes in family roles and activities.
Decide what is important, what needs to be done, what
can be delegated, and what can wait.
• Don’t minimize the effect of TOS but don’t be
• Most importantly, be yourself!
Communicating with Your Loved One about TOS
Why is it hard to talk about TOS?
Many people feel that it’s very hard to talk honestly
with their loved ones about TOS. You may feel like you
have to protect them. Or you may feel like they have
enough to worry about without worrying about your
stress, or your problems, or your emotions. You may
worry that if you talk about your fear or anxiety, you
may make them scared, or anxious, or you may make them
Communicating more effectively with your
These are some tips others have found helpful when
trying to communicate with their loved ones with TOS:
• Express your feelings and try to communicate openly.
This is crucial to creating a healing environment and
for helping one another gain the strength necessary to
deal with TOS.
• Give your loved ones permission to openly express
their feelings. Some patients may keep feelings bottled
up for fear of worrying or scaring their family and
• Let your loved one know that it is OK to cry in front
of you and that it is not a sign of weakness to express
• Try to set aside time every day to talk to each other
without interruptions. Turn off the ringer on your
phone, turn off the television, don’t answer your
• Use "I" statements, such as "I feel angry when . . ."
or "I feel frustrated because . . ." or "I feel sad
because . . ."
• Clarify statements with each other: "I heard you say .
. . is that right?" If you think your loved one
misunderstood something you said, try saying it a
• Try to avoid serious discussions when you are tired or
angry. Messages are more likely to be poorly
• Don’t stop making plans for the future. Discuss life
goals and plans for when recovery goes well but also if
the condition exists as a chronic condition. Talking
about this can help both of you be ready for what the
Communicating with Others about Your
Why is it important to communicate with
others about what you’re going through?
The experience of TOS affects the entire family, as well
as friends and co-workers. As a family member or friend
of a person with TOS, you are not alone. Just as you are
working to cope with the TOS of your loved one, friends,
co-workers, and other family members are affected too.
Children and parents face uncertainty and
misunderstanding. Co-workers worry and may also have to
deal with crises and interrupted schedules. Everyone
needs support—learn to ask for help and encourage others
to do the same.
With permission from your loved one, explain to
friends and co-workers what is going on, so they can
understand if you have to change your plans.
There are no disadvantages to having support in
place, in case you need it. Keep in touch with your
friends, family, and anyone else who supports you.
Most importantly, in your role as a support person
for loved ones who have TOS, you may find that you need
help in helping them. Asking for help is a sign of
strength and taking control.
Knowing how and when you should ask for help
It’s never too early to ask for help from a variety of
sources. Ask in advance of needing the help, if you can.
This gives them time to plan too. Have friends and
family assist you with . . .
• Accompanying your loved one to doctor and treatment
• Babysitting, or taking kids to activities.
• Creating a list of "how family and friends can help"
and see if they can come up with their own ideas.
• Spiritual help—prayers, meditation, rituals, scripture
reading, getting to church or communion, etc.
• Emotional help—sharing, crying, laughing, etc.
• Practical help—chores, housework, laundry,
transportation, getting information, etc..
• Appoint one of your friends or family to organize
everyone else. You may not have to identify needs—they
may do it for you.
• Have one friend or family member be the contact person
for information and news. Then he/she can pass on
information to the rest of your support network.
• If communication is difficult, seek the assistance of
a licensed counselor, therapist, or clergy member.
Here are some suggestions on what you could
• "Please help us with our shopping."
• "We need a hug."
• "I would like you to help by inviting my loved one out
and taking her places."
• "We would love it if you’d water our flowers!"
• "Please pray for us and share your faith with us."
• "Talk to us about the future; hope is important to
• "I/she would love a call when you have a minute to
• "We enjoy getting mail or e-mail.
• "Could you help me (or my loved one) with chores? We
still have dirty dishes, clothes, and a house that need
• "Bring a positive attitude; it’s catching."
• "Please help me/her feel good about myself/herself."
• "Can you take our children or us somewhere?" Be
• "We might need transportation to her treatment, to her
doctor’s office, or the store."
• "Could you walk or feed our pet?"
• "I’d like you to just listen to me/her."
• "Make us laugh, tell us jokes and funny stories. TOS
has not taken away our sense of humor."
• "Talk to me about my concerns about them having TOS
and how that has changed me, without thinking I have a
Lotsa Helping Hands is an organization that provides
an on-line tool to assist in organizing support. This
free web-based service helps manage and simplify
everyday tasks of family, friends, colleagues, and
neighbors wishing to help loved ones in need. For more
information go to:www.helpinghands.org
Communicating with Children about TOS:
Why is it important to tell children about a loved one’s
TOS is a difficult secret to keep from children. Often
children will know something is wrong. They may sense
your worry, or overhear your conversations, or
unknowingly, friends may talk to them about it before
you do. Without appropriate, accurate information,
children may imagine the worst. In addition, if you keep
information from them at first, they may not trust that
you are telling them the truth later on.
What should children be told about TOS?
What and how you tell children about TOS depends on
their age. The goal should be to talk to them at a level
they can understand and in a way that they can be
prepared for the ways they may be affected. According to
the American Cancer Society (ACS), all children need to
know . . .
• The name TOS including the part of the body that is
• How it will be treated.
• How their own lives will be affected.
It is also important to talk with them and
reassure them about other worries they might have.
Some common concerns that children have voiced
• Concern that something they did or said may have
caused their loved one’s illness. Most children blame
themselves at some point in their loved one’s illness.
Unfortunately, most children will not bring this up on
their own, so it’s important to reassure kids about this
rather than waiting for them to share their worry.
Communicating with Healthcare Providers
Note: In order to maintain your loved one’s privacy,
healthcare providers are required to ask permission from
your loved one before sharing any of them healthcare
information with you.
Why is it important to communicate with
Almost everyone feels better and more in control when
they understand an illness, how and why it is being
treated, and what kinds of side effects may occur.
However, many people have a difficult time talking with
doctors or nurses. Some feel uncomfortable asking
questions or talking about their loved one’s cancer and
treatment because they’re afraid they might look foolish
or ask a silly question. Some are afraid if they report
too many things, their loved one’s treatment will be
stopped. You will need a great deal of information to be
informed and make decisions. Some of this information is
complicated, and often it must come from a wide variety
of healthcare providers caring for your loved one.
Talking with doctors and nurses to get the
information you need:
Sometimes, it can be difficult to get the information
Here are some tips that others have found to
• Approach medical staff with the assumption that they
want to help you and would like to give you the
information you need.
• Buy a notebook and write down all the questions you
and your loved one want to ask at the next doctor visit.
Writing down your questions beforehand is one of the
best ways to be sure you are being clear. If you get
flustered, which happens to many people, you can read
• Help your loved one speak frankly with their
healthcare providers. Help them to express them feelings
and to let their know them concerns.
• Ask your healthcare provider to repeat anything you
and your loved one don’t understand. Repeat it back to
make sure you’ve got it right.
• Take notes during the appointment and ask permission
to tape record the visit so you can use it as a reminder
• Let the healthcare providers know when your loved
one’s needs are not being met.
• Appreciate what the healthcare providers are doing to
help your loved one and tell them from time to time.
Important information to tell the doctors and
Tell them about any problems your loved one is having.
• Symptoms: Tell them about the symptoms your loved one
is having and be specific. How severe is the pain? (Use
a 0-10 scale where 0 = don’t have any and 10 = it’s bad
as it could be.) How often throughout the day/week do
they occur? What makes them worse or better? What are
you and they doing for symptom relief? How well do those
• Any problems she has in performing their usual daily
• Financial problems because of your loved one’s
• Be sure that them healthcare team knows about all the
medications, vitamins, supplements, herbal medications,
or alternative therapies that your loved one is taking.
What you should know about your loved one’s
People should have all the information they need to
provide the best possible care at home. There are many
kinds of information that you need:
• An understanding of TOS diagnosis and stage of
• What medicines are involved in your loved one’s
• Side effects to expect from treatment.
• How to best keep track of treatment and side effects.
• Other treatment that might be available.
• When you should call your doctor or nurse.
• Where you can go to get more information.
• Where you can get support.
Calling the doctor
If you feel the situation is an emergency or urgent and
you cannot get the information you need, then call the
doctor or an emergency room. To do this, use the word
"emergency" in your question, and then be persistent
until you have the information you need.
Here are some examples of phrasing you might
• "I have an emergency (or urgent need) and need to talk
to a doctor."
• "I have a question about ________ and I’m not sure if
this is really an emergency. Who can help me?"
• "I’m very concerned about _________. It is urgent."
There are many things you can do to improve your ability
to get information you need:
• Be sure you know who you need to reach and how to
reach them. If your loved one sees many different
doctors, know who you should call for which problems.
• Learn who can answer your questions. Learn which staff
members give different kinds of information to people.
Example: "Who can tell me when my partner will be
• Ask the questions yourself.
• Be sure your statements or questions are phrased
• Know exactly what information you need. Example:
• "My partner’s pain medication is not effective."
• "My partner’s pain is at level ____." (0 = none to 10
= as bad as it could be)
• Focus your attention on what is most important.
• Say the reason you are concerned.
• Get to your question immediately.
• If you and your loved one have a long list of things
to talk about, make a consultation appointment, so the
doctor can allow enough time.
• Educate yourself about your loved one’s TOS.
• Learn the routine at their doctor’s office or clinic
so you can make the system work for you.
• Accept that all questions do not have answers.
• Try to separate your anger and sense of helplessness
about not being able to help your loved one as much as
you would like from your feelings about the healthcare
Things that can prevent you from getting the
information you need
Some people are afraid to ask "stupid questions." This
is TOS—there is no such thing as a stupid question. Some
people feel that healthcare providers are so important
or so busy that they should not take up their valuable
time with questions. This is not so! Healthcare
providers are there to help people by sharing
information and answering questions. If your loved one’s
healthcare provider appears very busy, ask: "If this is
not a good time, when would be?" Do not feel
intimidated. Their role includes answering questions and
educating patients and family members. Your loved one
has a right to the information.
Think of other obstacles that could interfere with
you getting the information you need and make a plan of
how you will handle them. Don’t be afraid to encourage
your loved one to seek a second opinion, especially
during times when she is being asked to share in
important treatment decisions. Occasionally, there is a
bad match between patients and doctors. If you and your
loved one find that communication with the healthcare
team is so difficult or unsatisfactory that it is
interfering with your loved one’s treatment or
well-being, consider switching doctors.
Providing Direct Care to Your Loved One
Providing direct care to a loved one can be difficult
and stressful at first. Learning new skills takes time
and practice. Taking on tasks that you have not done
before such as cooking, lawn maintenance, laundry, or
managing the finances can be overwhelming. Most family
members agree that the most difficult thing is being
able to fit these tasks into their already busy lives.
These are some tips that may help you provide
direct care for your loved one at home:
• Make a list of all the healthcare tasks that you need
to perform for your loved one.
• Identify tasks that you are willing to perform.
• Circle the tasks that you don’t know how to perform.
Ask the doctor or nurse for information and/or training.
Have them watch you do the task.
• Talk with your loved one’s doctor or nurse about other
providers who may be able to help by performing tasks of
care that you are unable or unwilling to perform
(visiting nurses, home health aides, Meals On Wheels,
chore/housekeeping service, transportation service).
• If you have other people providing care to your loved
one, monitor what they are doing so that you know that
your loved one’s needs are being met.
• Prioritize the tasks of care that need to be
• Schedule care tasks as much as possible to help you
establish a daily routine. Make a list of activities and
• Encourage your loved one to do as much for
herself/himself as possible.
• Keep a list of signs and symptoms that need to be
reported to the doctor or nurse.
• Keep a list of emergency telephone numbers near the
telephone (ambulance, hospital, doctor’s office,
doctor’s answering service).
• Find a support group for caregivers. Other caregivers
will share their experiences with you and can provide
tips for providing care.
• Be sure to take care of YOU. This means getting enough
rest and exercise, and eating a balanced diet.
• Take time out for yourself each week to go have lunch
or dinner with a friend, go to a movie or sporting
event, take a walk, or read for pleasure.
If you need more information, the following
two books provide very helpful information:
"American Medical Association Guide to Home Caregiving."
American Medical Association. New York: Wiley, John &
Sons, Inc., 2001.
"Coping: A Practical Guide for People with
Life-Challenging Diseases and Their Caregivers." Rubin
Battino. Bancyfelin, Carmarthen, UK: Crown House
Taking Care of Yourself When Your Loved One
Do you look like you feel? Are tears just under the
surface? Are you turning down opportunities to go out
for fear of being away from your loved one?
Many friends and family members spend so much time
worrying about and caring for their loved one that they
forget to take care of themselves. It is critical for
you to maintain your own health and well being, because
it makes you better equipped to take care of your loved
one. Proper diet, adequate sleep, and regular exercise
is important for all of us and more so when someone you
love has cancer.
The following are suggested strategies for
taking care of yourself:
• Participate in physical activity at least three times
a week for at least 30 minutes. Exercise promotes better
sleep, reduces tension and depression, and increases
energy and alertness. If finding time to exercise is a
problem, try to incorporate it into your usual day (take
the stairs, walk, play with your kids, etc.).
• Get enough sleep so that you feel rested in the
morning—try for at least 7 hours every night.
• Eat balanced, nutritious meals (5 servings of fruits
and vegetables). Take time to sit down and eat your
meals. Do not skip meals.
• Take care of your own physical health (get regular
medical check-ups: blood pressure, cholesterol, cancer
• Participate regularly in recreational/leisure
• Drink at least eight glasses of water daily.
• Limit alcoholic beverages. Avoid using alcohol,
medications/drugs, or cigarettes to calm your nerves.
• Maintain a healthy weight.
• Set limits to your life. Learn to say NO! Make
• Find a hobby that takes your mind off your worries for
a while: fishing, boating, painting, woodworking,
knitting, reading, etc.
• Take long, warm baths.
• Look for things to laugh about.
• Get a massage.
• Wear colorful clothes; seize every opportunity to
dress more "up" than "down."
• Give yourself permission to take a break from worrying
• Go out for lunch or dinner with a friend or relative.
• Go to the movies, a play, or a concert.
• Find a place to cry and let out the grief and worry.
• Read non-stressful books and magazines.
• Do crosswords, puzzles, jigsaws, garden—anything that
diverts your mind.
• Telephone friends; go visit someone you like.
• If possible, stay at work as long as you normally
would. Try not to start leaving work or interrupting
• Take long walks and enjoy the sounds, smells, and
beauty of nature.
Part of the success of taking a break is ensuring
that your loved one is content and cared for in your
absence. If you can relax during your time away, then
the break will work wonders for you.
Identify Areas Where You Need to Take Better Care of
Be sure to get enough rest. Your body needs rest to face
everyday challenges. As you adjust to life after your
loved one’s diagnosis of TOS, your sleep patterns may be
disrupted. If you find that you can’t get to sleep or
can’t stay asleep, seek out advice from your doctor
about what to do.
If you have trouble sleeping try:
• Reading a book before bed may relax you and help you
to fall asleep faster.
• Avoid loud noises and turn on slow, relaxing music.
• Avoid alcohol. A few glasses of wine may make you
drowsy at first, but it will cause you to be wakeful
during the night.
• Avoid caffeine and sugar before bed.
• Try to maintain a regular sleeping schedule.
• Don’t take frequent naps during the day.
• Use your bed only for sleeping (don’t work, watch TV,
eat in bed).
• Exercise during the day, but avoid exercising two
hours before bed.
• Some prescription drugs can cause sleep problems.
Consult your doctor if you think a medication is causing
your sleep problem.
• Make your room a good place to sleep: use
room-darkening shades and keep it at a steady
Regular check-ups by your doctor, dentist, and
optometrist are essential parts of maintaining your
health. Visits with such doctors also help in
identifying health problems in their early and most
treatable stages. Going to the doctor also helps to
verify that the positive things that you are doing to
help your health are working.
Call your doctor and schedule an appointment. Find
out how often you should be going to the doctor, as this
changes with age. Write reminders to yourself on your
calendar to schedule appointments.
Think of some of the ways that you have taken care of
yourself in the past (before your loved one was
diagnosed with TOS) and try to start doing them again.
Balancing multiple demands
Many family members need to continue working when their
loved one is diagnosed with TOS. This may cause you to
experience competing demands and distress. Work is a
financial necessity and/or a source of satisfaction for
many, yet the responsibilities of caring for and
supporting a loved one often conflict with
responsibilities at work. People who strive to do both
well can feel caught in the middle.
How can I cope with competing demands?
The following tips offer ideas and resources that can
help you manage your responsibilities efficiently and
balance both work and the caring roles more effectively:
• Look in the personnel manual or other human resources
publication to find out your company’s policy on
caregivers. Does it offer benefits or services that
could help with your situation?
• Talk with your work supervisor about your issues. It
is better he/she knows the reasons for your late
arrivals or seeming preoccupation rather than draw his
or her own conclusions. Before having the conversation,
come up with some strategies about how you will cope
with absences and time away from work.
• Ask your employer if there is an employee assistance
• Ask your Human Resources or Personnel Department to
give you information on the Family and Medical Leave
Act. (This law entitles eligible workers a maximum of 12
weeks a year of unpaid leave for family caregiving
without loss of job security or health benefits.) There
are a variety of restrictions, however, such as company
size and the amount of time the worker has been
• Take advantage of flex-time policies if that would
help your situation.
• Offer to work a less desirable shift or be willing to
make up time taken for caregiving by working days or
shifts when most people want to be off.
• Check for information and referral resources in your
• Consider job sharing or working part time if possible.
• Avoid mixing work with time with your loved one. Do
your best to avoid interruptions and distractions at
work from your loved one’s health issues. If you need to
make phone calls or search the internet for information
related to your loved one’s needs, do it on a lunch
• Manage your time. When you must take time off for
caregiving, set priorities and accomplish the most
important things first.
• Delegate responsibilities when you can. Pace yourself,
as these demands may extend over a prolonged period of
• Accept help when you need it. Consider community
resources for yourself and your loved one.
• Get all the support you can from family members,
friends and community resources.
• Take care of your own needs. Take a break when the
pressure gets too great.
• Be sure to thank those at work for the consideration
and assistance you receive.
Contact the following organizations for more
The Family Caregiver Alliance has information helpful to
caregivers. Their website has a resource center that
offers practical information: www.caregiver.org
The AARP website – Caregiving Section: www.aarp.org
Why time management?
TOS and treatment related activities are often
overwhelming and require much time of family members and
friends who are juggling multiple roles. It is important
that you manage your time wisely, so you can carry out
these multiple roles and maintain your own health.
Managing time effectively puts you in control of your
life. If you get a handle on how you spend your time,
you’ll work smarter, have more time to get things done
in your multiple roles, and enjoy life more with less
How do I cope with all the different demands
on my time?
These are some tips on how to save time and reduce
• Know how long it takes to complete tasks. Take
advantage of small bits of time. Set priorities,
delegate, or ask others for help.
• Focus on one task at a time.
• Create a manageable list of things to do each day.
Check off tasks as you complete them, so you can see
• Make a weekly schedule of tasks that need to be done.
• Set realistic goals. Break large tasks into small
• Set and follow priorities. What are your real
priorities each day? Make your lists in order of
priority and start with the high priority tasks. Often
things can be delayed or put off.
• Set aside an hour a day to make phone calls and check
• Set aside time each week to do errands.
• Say "no" to things you do not want to do or that are
not really necessary.
• Use your high-energy time of day to work on important
tasks so that you are in charge of your day.
• Establish routines and stick to them.
• Some time will be spent on things beyond your control.
This is just a necessity.
• Delegate what you can to others; you do not need to do
• Ask for help when you need it; accept help when others
• Set time limits for tasks.
• Don’t waste waiting time. Use that time.
• Some time each day must be spent for you.
Access the following sites for more
• Family Caregiving 101: Time Management
Recognizing When You’re Stressed Out
Too much stress can lead to more serious health
problems. Learn to recognize signs of stress in
yourself, and contact your healthcare provider if you
experience the following on a regular basis:
• Denial about the disease and its effect on your family
• Anger at your loved one.
• Social withdrawal from friends and activities that
once brought you pleasure.
• Anxiety about facing each day and the future
• Depression and feeling unable to cope.
• Exhaustion making it impossible to complete necessary
tasks of the day.
• Sleeplessness caused by constant concern and worry.
• Irritability that triggers negative responses and
reactions in others.
• Lack of concentration making it difficult to perform
usual daily tasks.
• Health problems which take their toll, both mentally
and physically—worsening chronic disease, colds.
• Managing Anxiety
What is anxiety?
Anxiety is a vague feeling of uneasiness, unpleasant
feelings, or fear resulting from expecting some bad news
or harm. Anxiety can happen to anyone, but family
members and friends facing the serious illness of a
loved one may get anxious more easily than others.
Anxiety and fear are common and normal feelings when
coping with a diagnosis of TOS.
People who have anxiety say they feel uneasy, tense,
apprehensive, wary, or agitated. They have a feeling of
restlessness and uncertainty, and they are fearful or
have a sense of dread or impending doom. People tremble,
sweat, have rapid breathing, have a rapid heart rate, or
can feel their hearts pounding in their chests. In
addition, some people experience shakiness or difficulty
falling asleep. Sometimes people may become overly
fearful and may no longer cope well with their
Coping with anxiety
No two people experience anxiety in the same way. These
are tips other people have found helpful:
• Try to identify what "triggers" your anxiety.
• List coping strategies that have helped you in the
• Talk with others, such as in a support group, about
• Increase pleasurable, distracting activities such as
listening to your favorite music.
• Use relaxation techniques such as controlled breathing
or guided imagery (picture a pleasant scene in your
• Be around others as much as possible, if this is
• Use prayer or other types of spiritual support, such
• Talk with your doctor or nurse about prescribing
medicine to help reduce your anxiety.
• Use relaxation tapes.
• Express feelings and concerns to others.
• Limit your caffeine intake by decreasing your intake
of coffee, caffeinated colas, tea, and chocolate.
• Ask your doctor for a counseling referral if these
tips are not helpful.
Family members and friends can help you with
• Have family members and friends help you with
relaxation exercises such as deep breathing or
visualizing pleasant scenery.
• Ask family members and friends to help you with
situations or chores that you’ve identified as
• Ask family members and friends to bring home books
from the library or bookstore about teaching relaxation
exercises or imagery.
Talking with others about your anxiety
• Be open and honest about your feelings and concerns
with your family members.
• Try to describe your feelings when you’re experiencing
them (racing thoughts, lump in your throat, nausea,
shortness of breath, dizzy or scared, etc.).
• Ask your family members and friends how your anxiety
is affecting them.
Call your doctor or nurse if you experience
any of the following problems:
• Panic attacks.
• Problems with anxiety that last beyond 2 weeks.
• Persistent fearfulness.
• Shortness of breath that lasts beyond 2 weeks.
• Shakiness, agitation or restlessness that lasts beyond
• Heart racing and beating hard.
• Excessive sweating.
• Persistent problems sleeping or getting to sleep.
• No relief after trying suggestions.
Managing Depression and Sadness
What is depression and sadness?
Depression is sadness that happens in response to an
event or due to changes in your body chemistry.
Depression is sadness that is greater than normal, lasts
two weeks or more, and greatly impacts your daily life.
Recognizing depression and sadness
People describe depression as the darkest times in their
lives. Many people report crying spells, or problems
with sleep (either sleeping all day or not sleeping
enough). Others describe problems with eating (too much
or not enough), feeling hopeless, helpless, worthless,
or even feeling like they want to hurt themselves.
People may have trouble experiencing any pleasure or
interest in daily life, and they may not want to talk to
family or friends.
Depression is not the same as an occasional, short-lived
period of sadness. In depression, these low feelings are
severe and stay for two or more weeks.
The causes of depression and sadness
Depression can occur as a result of specific events,
such as a loved one being diagnosed with TOS. It can
also be caused by medications or fatigue or from
chemical changes in the brain. Generally, most people
can cope with short-term feelings of depression.
Persistent depression (greater than two weeks) should be
evaluated by a healthcare provider for possible
counseling and/or medication.
Coping with depression and sadness
Every person uses different approaches when they are
depressed and sad. These are some tips other people have
• Try controlled breathing and relaxation exercises;
these help release mood-enhancing substances from the
• Express your feelings through journal writing or
creative expression (dance, cooking, exercise, painting
• Avoid alcohol consumption; it can make you feel more
• Try to get enough sleep at night; avoid napping during
• Try to identify something that brings you pleasure
• Be with other people as much as possible, if this
helps you relax.
• Participate in regular, routine exercise. Exercise has
been shown to improve mood and well-being.
• Make an appointment with your doctor and tell him/them
exactly how you feel and that you need help.
• Make a list of all the medications you take; show this
to your doctor or nurse. Some medicines may have to be
stopped or changed.
• Join a support group. This can help relieve the
isolation that is often felt by those who are depressed.