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A Coping Plan Can Help Fend Off Depression From Vision Loss
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A Coping Plan Can Help Fend Off Depression From Vision Loss

Treatments

DAVID GREENE, HOST:

This is MORNING EDITION from NPR News. Good morning. I'm David Greene.

STEVE INSKEEP, HOST:

And I'm Steve Inskeep. Today in Your Health, two tales of eyes - the first story is about a condition called age-related macular degeneration. It afflicts approximately 2 million Americans over the age of 50. Many patients get so depressed and so scared they don't leave their homes. NPR's Patti Neighmond has more on a type of therapy that might help.

PATTI NEIGHMOND, BYLINE: When people lose their vision, they lose a lot of other things, too.

BARRY ROVNER: You can't read; you can't cook; you can't socialize.

NEIGHMOND: Dr. Barry Rovner is geriatric psychiatrist at Thomas Jefferson University in Philadelphia. Macular degeneration causes a tiny part of the retina to deteriorate. And it's a crucial part that enables the eye to make out fine details. When patients lose vision like this, Rovner says, they often can't recognize faces.

ROVNER: And if you can't see somebody's face, you feel, well, disengaged and frightened because you don't know how other people are perceiving you. And you can't perceive other people, and so the consequence is that you withdraw - many people withdraw.

NEIGHMOND: In fact, 1 in 4 people with macular degeneration in both eyes develop clinical depression. A few years ago, 84-year-old Marilyn Friedman was at risk.

MARILYN FRIEDMAN: My world was stopping. It was like, I can't do anything anymore, and just reading books was a big part of my life. I couldn't do that anymore.

NEIGHMOND: And she couldn't do something she really loved -baking.

FRIEDMAN: If I can't read a recipe, I can't bake. That stopped me right there. I didn't do any more baking.

NEIGHMOND: But Friedman got lucky; she was recruited for a study with psychiatrist Rovner who was testing a strategy to prevent depression and help patients get back on track - 188 people took part. A therapist to came to their home for one hour, six times over two months. Half the patients talked with therapists about their disability. The other half planned a sort of work around. For Friedman, that meant writing recipes in two inch letters with a single ingredient on each page.

FRIEDMAN: On each page, I'll put down a cup of sugar; the next page could be - it's a teaspoon full of salt. The next page will be eggs - I have three eggs.

NEIGHMOND: Pages were collated in a binder, one recipe per binder. Friedman also got different colored measuring cups and spoons with Braille-like dots - small changes that made a big difference.

FRIEDMAN: I had a very big dinner not too long ago with the whole family, everything from the soup to nuts. I did it all.

NEIGHMOND: Others in the study improved lighting in their homes or bought magnifiers, some that fit around necks. Those who'd become isolated made specific dates and times with friends to get out of the house - crucial to the new plan, says Rovner, something of a just do it philosophy.

ROVNER: When they're thinking over and over about how life is not right for them, how they can't do this, I can't do that, to catch themselves, to be aware of that mental state and to say to stop it, get up now, do something - don't follow the feeling, follow the plan.

NEIGHMOND: It turned out patients who followed the plan reduced their risk of depression by up to 60 percent compared to those who received talk therapy alone. That not only benefits quality of life, says Rovner, it dramatically reduces the high price of treating depression. Patti Neighmond, NPR News.

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