Understanding Sheila’s depression

Now that Sheila has been diagnosed with depression, it is important to understand why she is feeling this way. When we are thinking about Sheila’s mood the diagram below can be a helpful way of conceptualising how she is feeling and of guiding interventions to manage her depression.

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One of the major causes of Sheila’s depression appears to be the loneliness she is feeling as her heart failure progressively affects her lifestyle. (Interestingly, research studies suggest that loneliness can be a risk factor for heart disease but it is difficult to find similarly validated research looking at heart disease as a risk factor for loneliness.)

The following articles include interesting information on loneliness:

• New Scientist: Loneliness is a modern epidemic in need of treatment
• Mental Health Foundation: The Lonely Society?
• PLOS Medicine: Social Relationships and Mortality Risk: A Meta-analytic Review

Age UK define social isolation as “separation from social or familial contact, community involvement or access to services, while loneliness can be understood as an individual’s personal, subjective sense of lacking these things.” Loneliness has become such a major factor affecting the wellbeing of so many older people that a national campaign has been started to address this.

• Campaign to End Loneliness

Sheila is feeling lonely and socially isolated because she is less able to get out of the house to socialise with people. This is partially due to her inability to mobilise as well as she previously did, due to her progressing heart failure, and partly due to her husband’s increasing dependence on her. The GP decides to ask the heart failure nurse to pay Sheila a visit, to assess whether anything can be done to combat her loneliness.

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Page last reviewed: 25 Sep 2020