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Mailbag 
Questions & Answersline 
Nutrition 
Behavioral Aspects of Nutrition in Children with Cystic Fibrosisline 
Genetics 
New Developments in Gene and Cell Therapy for CFline 
CFW Update 
CFW and the Gulf Respiratory Society host Cystic Fibrosis Conference in Omanline 
Personal Experience 
Living Abroad With Cystic Fibrosis: My Experience in Germanyline 
Medical/Scientific 
Assessment and Interpretation of Arterial Oxygen Saturation in Children with Cystic Fibrosisline 
Kidney Disease and Cystic Fibrosisline 
Transplant 
Q&A with Bi-Lateral Lung Transplant Recipientline 
Book Review 
Burke’s Tour: The Story of Burke Bearline 
Psychosocial 
Motivations in Clinical Research: Why do people participate?line 
CFW Partner News 
International Physiotherapy Group for Cystic Fibrosis Announces Scholarship Recipientline 
European Cystic Fibrosis Nutrition Groupline 
Snippets 
Child Health International: Could We Help You?line 
Hippotherapy for Cystic Fibrosisline 
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Q: I have a brother who has CF and is dealing with a lot of angry issues, depression. I need more information on what we can do to help him and dealing with him on depression. If you have anything that would be great!!

Leah, USA


A: I’m sorry to hear that your brother is struggling with depression. He is fortunate to have a sister who wants to help. The most important step you can take is to encourage him to seek treatment. Depression is a complex condition with multiple etiologies (biological, social, etc.), but the good news is that most men and women who experience depression can be helped with counseling, medication, lifestyle changes, or combinations of these.

If your brother is willing to consult a professional, his CF physician or team members should be able to refer him to a competent practitioner. If he is resistant, remain supportive. Some of the predominant symptoms of depression--hopelessness, anxiety, decreased energy, difficulty sleeping--contribute to reluctance to get help. Too, some fear seeking mental health treatment means they are "crazy."

Also, there are gender differences in how depression is experienced. Men find it hard to ask for help in a society that values strength and self-control. If CF has affected his bodily appearance (weight, clubbing of fingers, height, etc.) or his ability to work, your brother may feel he is not meeting cultural expectations.

Here are some additional ways you can help your brother:

1. Let your brother know that you are concerned about him and encourage him to get help. Offer to explore treatment options and to go with him if he wishes. If he refuses, ask him his reasons. His answers may help you better understand his world through his eyes.

2. If you are concerned he might be suicidal, ask him. There is no evidence asking a depressed man or woman about suicide promotes an attempt. If he is actively suicidal (has a plan and a means), you should take steps to get him treatment (even involuntary hospitalization) according to the laws of your area.

3. Be there for him. Let him know you love him and are willing to listen should he want to talk.

4. Learn about depression. Consult websites, books, and local resources. Understanding the condition should help you better understand your brother and may give you additional insights into how to help.

5. Do not try to diminish your brother’s feelings by denying his view of the world or reminding him that others have more serious problems. It is difficult for those of us who have never experienced clinical depression to understand its overwhelming nature.

6. Look for occasions when your brother seems less depressed. Then, build on these. For instance, if he likes sports, suggest going to a game or watching sports on TV with him.

7. Those who are depressed often feel powerless and out of control. This is also true of those with chronic, progressive diseases like CF. Helping you brother find areas where he has power and choice may help him feel less vulnerable.

8. If you have access to and/or a relationship with your brother’s doctor, you may consider calling him/her and expressing your concerns. If you do, you may want to let your brother know.

Depression affects not only the individuals who are experiencing it, but those who care for them. Recognize the stress that your brother’s condition is causing you and your family and take steps to care for yourselves as well. Your brother is fortunate to have a loving sister like you. I wish you all well and hope that my response has been helpful.

Eileen Widerman, PhD, MSW
Senior Lecturer
Temple University
Philadelphia, PA
Psychosocial Advisor, CFW

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